In a Fungal Funk? Here are The Fungal Acne Treatments

Fungal acne is a sneaky little infection that sprouts up in your skin’s hair follicles.

Its biggest offense? It masquerades as regular-ass acne but refuses to be treated like it.

Throwing traditional acne treatments at fungal acne means not only flushing cash down the drain, but also further pissing off your skin — causing more irritation. *Screams in the name of skin care.*

We chatted with some derms and rounded up the best treatments for fungal acne. Keep reading for the scoop and shop some options for sweet relief.

What is fungal acne?

To get real science-y for a second, fungal acne is also known as Malassezia folliculitis or Pityrosporum folliculitis (fancy, right?).

Folliculitis happens when your hair follicles become inflamed. And Dr. Daniel Glass, a dermatologist in London, says that this specific type of folliculitis is caused by Malassezia yeasts.

Before you panic about WTF this yeast is up to, Dr. Yoram Harth, a board certified dermatologist in the San Francisco, California, explains that this stuff is actually a normal resident on our skin. Most peeps have no issues keeping it in check.

But for some, it truly thrives and overproduces, causing inflammation around the hair follicles. Harth says this inflammation causes the typical tiny, red or discolored, itchy presentation of fungal acne.

What causes fungal acne?

Dr. Emily Wood, a board certified dermatologist in Austin, Texas, says fungal acne typically happens in moist areas. “It is more common in people who are active or engage in sweaty activities.”

Glass adds that fungal acne is seen more often in young adult males.

He also points out some other risk factors like:

• oily skin with higher-than-average sebum levels (which is also seen in acne and excessive sweating)
• blockage of the hair follicles with greasy moisturizers and sunscreens
• use of antibiotics and steroids
• living in a hot, humid environment

Fungal acne symptoms

Wood tells us that fungal acne usually shows up as itchy red or discolored bumps on the chest, back, and upper arms, but can show up on your face (like your forehead, hair line, chin, and neck) too.

Like other types of acne, Harth explains that fungal acne often makes an appearance on oily areas of the skin — but there is a key difference between fungal and regular acne: “Compared to regular acne, where different acne lesions come together (some blackheads, some papules, some cysts) — all the pimples look the same in fungal acne.”

Glass adds that, unlike regular acne, blackheads are not seen in fungal acne.

But to make things even more confusing, it’s possible to have fungal acne *and* regular acne at the same time, Glass says. In fact, a large study involving people with acne showed that 25.3 percent of the participants had Malassezia folliculitis as well.

Obvi this means only your dermatologist can give you an actual diagnosis, and the derms we talked with suggest contacting one if you can.

What is the best treatment for fungal acne?

Like most things in life, there is rarely a one-size-fits-all option for treating fungal acne. But you’ve got options.

Glass recommends topical treatments as the first line of defense, since they have fewer side effects. “Then move on to oral treatments if required. Oral and topical antifungals can be combined, but this is not always necessary,” he says.

If over-the-counter (OTC) stuff doesn’t seem to be helping, Wood suggests making an appointment with your board certified dermatologist to get a prescription for stronger topical or oral medications.

Topical treatments

Wood and Glass tell us that topical treatments with ketoconazole can be effective at treating most mild cases of fungal acne. Glass adds that selenium sulfide can do the trick too.

These ingredients can be found in shampoos, body washes, and creams. Lower strength formulations are available OTC, but you’ll need a prescription to get anything stronger than 1 percent.

Oral medications

If you’ve got a more stubborn case of fungal acne, your dermatologist might recommend taking oral medication instead of (or in addition to) topical treatments.

“Oral medication with antifungals such as fluconazole and itraconazole have been successful in treating fungal acne as well,” Glass adds.

You’ll need a prescription to get fluconazole and the pill version of itraconazole, though.

How we chose the best fungal acne treatments

Here’s how we curated this list of the very best products:

• Ingredients. We listened carefully to the derms we consulted with, giving priority to their No. 1 draft picks for zapping fungal acne.
• Skin and zit type. If your acne is definitely fungal (and only your derm can confirm), odds are, your pimples all look the same and your skin is likely to be the oily type. But we considered sensitive skin types, too.
• Reviews. We can handle the truth, so we look closely at what reviewers are saying. We like to make sure they are the real deal, too (no paid reviews, pls!).
• Cost. We keep different price points in mind, but obviously if you want to test out one of the prescription options we mention, you’ll need a doc and some insurance, so that will vary.
• Vetted products only. We only included brands known for creating top-notch products with quality ingredients. We put every product through a thorough vetting process to make sure brands aren’t making any unsupported health claims or engaging in shady business practices. Only brands that passed made our list.

GTFO, fungus: The best fungal acne treatment products

Best OTC treatments for fungal acne

Nizoral Anti-Dandruff Shampoo

• Price: $
• Key ingredients: ketoconazole
• Size: 7-ounce (oz) bottle
• Pros: go-to OTC option, budget-friendly, easy to use
• Cons: not best for severe cases, contains fragrance

You may be wondering how an anti-dandruff shampoo has anything to do with fungal acne. Like we mentioned, OTC options like this are the first line of defense suggested by the derms we chatted with (at least for mild cases of fungal acne).

They mention this shampoo by name and that’s thanks to its all-star ingredient: 1 percent ketoconazole, a serious fungus fighter.

You just use this like you would a face wash or body wash. Just ignore the word “shampoo.”

Wood says to lather it on the affected area for 5 minutes before rinsing it off (it needs some time to do its magic). She also suggests using it daily for 2 to 3 weeks to see improvement.

This is a good place to start. It’s easy to use, pretty easy to find, and it’s nice and easy on the wallet.

Head and Shoulders Clinical Strength Dandruff and Seborrheic Dermatitis Shampoo

This is yet another OTC option for fighting fungus, and one that’s available in a big ol’ bottle at a nice price.

Selenium sulfide is an ingredient for dandruff, yes, but also fungal acne. Honestly, this is basically a good runner-up shampoo choice if you can’t get your hands on Nizoral or simply want more product for your buck (this double pack here is a good value, BTW).

Again, you’d use it like you would a body wash or face wash, letting it stay on a bit before washing off.

Best prescription pill for fungal acne

Fluconazole (Diflucan)

• Price: $$$, but varies with insurance
• Key ingredients: fluconazole
• Pros: may work well for severe cases
• Cons: need a prescription, possible side effects

The derms we spoke with tell us that oral pills are an option for severe cases of fungal acne, aka ones that don’t seem to be responding to OTC or prescription topical options.

Glass says that sometimes both topical and oral antifungals are combined, but this is unusual.

Diflucan is the name brand of fluconazole, an oral antifungal tablet available only by prescription.

It slows down fungal growth, and it’s also used for treating things like vaginal yeast infections and fungal UTIs.

A drawback to an oral pill like this is the chance of side effects (common ones for this one are headaches, stomach pain, and nausea). So, this is something to chat with your derm about, since they are the only ones who can open this gate for you!

Best prescription topical for fungal acne

Ketoconazole Topical Cream

• Price: $$, but varies with insurance
• Key ingredients: ketoconazole
• Size: 15-gram (gm) tube
• Pros: may work well for severe cases, few side effects
• Cons: need a prescription

Remember how we said ketoconazole is available as a topical shampoo, which you can use as a face or body wash? Well, if you want a higher concentration of the stuff, there is a prescription cream available.

This one usually falls around 2 percent ketoconazole compared to the 1 percent shampoo.

Of course, your derm will have to deem it necessary for your case of fungal acne, but there are few side effects to this antifungal cream, which also works (like the shampoo) to slow the growth of fungus behind the infection of the hair follicles.

Best moisturizers for fungal acne

TULA Skincare Breakout Star Oil-Free Acne Moisturizer

• Price: $$$
• Key ingredients: salicylic acid, niacinamide
• Size: 1.7-oz bottle
• Pros: oil-free, lightweight
• Cons: pricey

Although it can feel scary to moisturize an oily, acne-prone zone, you still gotta do it (we know, we know). Something like TULA’S oil-free, noncomedogenic moisturizer is a good bet for addressing this area of your skin.

It has 2 percent salicylic acid — a lovely beta hydroxy acid (BHA) that helps clear acne, keep your pores from getting clogged, and also helps reduce post- acne hyperpigmentation.

This formula is also free from alcohol, which we appreciate.

Bonus: It also has niacinamide — aka vitamin B3. Among many amazing benefits, this ingredient helps with acne and hyperpigmentation.

MELÉ Plump It Up Nourishing Cream

We love this oil-free moisturizer made with People of Color in mind.

This cream is formulated for melanin-rich skin and it includes crowd favorite niacinamide (helps curb oil production, reduce acne and hyperpigmentation, and more).

Like we said, it’s all about keeping things oil-free and this option has that going for it, plus it’s free of parabens, alcohol, and phthalates.

Best wipes for helping prevent fungal acne

Cetaphil Face and Body Wipes

• Price: $
• Key ingredients: zinc gluconate
• Size: 50 wipes, double pack
• Pros: on-the- go, hypoallergenic, fragrance-free
• Cons: not super earth-friendly

Prevention is a big key player in managing fungal acne. Slipping out of sweaty clothes and showering ASAP is preferred, but we know that’s not always possible.

Cleansing wipes are basically angels, helping you quickly remove sweat that can lead to fungal acne breakouts.

This option is a popular choice and the one Wood suggests. These are a breeze to travel with, plus they’re hypoallergenic and fragrance-free. Keep a pack in your gym bag, one in the car — wherever you’ve got room to stash ’em.

We love that these are gentle and kind to sensitive skin peeps: nonstripping, nonirritating and noncomedogenic! Plus, one of their main ingredients is zinc gluconate, which is another ingredient that’s well known for zapping zits in general.

Clearasil Rapid Rescue Deep Treatment Pads

If you want wipes with a little extra oomph, these pads have salicylic acid, so you can get a confident exfoliation going on.

These wipes are made with sensitive and acne-prone types in mind and can help you with keeping your pores as oil-free as possible.

Google reviewers are big fans, loving how well they work to wipe away grime.

Best natural treatment for fungal acne

Maple Holistics Tea Tree Essential Oil

• Price: $
• Key ingredients: tea tree oil
• Size: 1-oz bottle
• Pros: natural approach, budget-friendly
• Cons: not suggested by the derms we talked with

For people who love to try a natural approach for everything, this tea tree essential oil might be a winner (although the derms we spoke with did not suggest this, FYI).

Here’s the scoop: Tea tree oil is a known antimicrobial, anti-inflammatory, and antifungal that has been used to address acne and other fungal infections.

But this is not something you buy and squirt right onto your skin.

You must dilute it with a carrier oil (like coconut oil or olive oil) before applying it topically, and never ever take it by mouth.

Plus, a patch test is key to avoiding a serious allergic reaction! We cover that more below.

How to choose

You may be wondering how to pick the winning treatment for your skin type. Here’s what you need to consider:

Skin type

The derms we chatted with tell us that fungal acne is more common in people with oily skin, which may benefit from many of the above treatments.

But if you happen to live with sensitive skin, Wood says ketoconazole shampoo may be irritating for you. If this is the case, she suggests testing a small area before using it on your entire face.

(BTW, we recommend that in general before testing any new-to-you products — this is called a patch test and it helps you avoid allergic reactions like a big ol’ rash!).

If you react, it might make sense to start with selenium sulfide (like our Head and Shoulders pick).

Acne severity

Only a derm can help you determine your acne severity. And once they do, they can use that info to determine whether you should go the topical, oral, or topical + oral route.

How to use fungal acne treatments

If you’re ready to test out a topical, here’s what Wood suggests for application. (It’s easy breezy, but remember to read directions carefully.)

“Fungal acne treatments can be used either morning or night once daily. I recommend using it first (before moisturizing) to maximize efficacy.”

1. Wash your face (toner optional).
2. Apply your topical treatment of choice (read directions for specifics).
3. Apply a gentle, oil-free moisturizer.

If you’re going the oral medication route, ask your derm for specifics on when to take it, for how long, and whether to take it with a meal.

Preventing fungal acne

Like we mentioned, Wood says showering immediately after working out can be helpful for preventing fungal acne. When that is not an option, she recommends carrying a pack of wipes in your gym bag to quickly wipe away the sweat.

What you wear when getting your sweat on matters too. Wood suggests wearing sweat-wicking fabrics when working out (and loose ones if you can!).

Harth mentions sweaty clothes too, saying that staying in them for too long can lead to fungal acne.But he also points out how yeast feeds on oil. “Always avoid skin care or makeup products that contain oil (even small amounts). It could be a trigger to fungal acne.”

When to contact a dermatologist

It’s best to contact your derm to get a legit diagnosis before you do anything — especially if things aren’t looking up with OTC options or are worsening.

Your derm will be able to confirm you have fungal acne, determine the severity, and give you prescription treatment options if they decide you may benefit from them.

Frequently asked questions

What is the best ingredient for fungal acne?

Ketoconazole is the first move to make — it’s available in a shampoo that you use as a face or body wash. Prescription-strength is available too.

If that doesn’t clear things up, a dermatologist can prescribe oral fluconazole.

Can fungal acne be cured naturally?

This depends. If by “naturally” you mean with a strong switch up in hygiene practices, then maybe. This is a big key in prevention.

“Fungal acne requires medications with specific antifungal properties,” Wood says. These can be prescription or OTC.

If you realllly want to go au naturel and try using tea tree oil diluted with a carrier oil, have at it — just remember that this isn’t recommended by our derms.

Does fungal acne go away on its own?

Usually not. Wood tells us that (occasionally) mild cases will resolve on their own thanks to those changes in hygiene routines we mentioned earlier.

The bottom line

Fungal acne is an infection that shows up in your skin’s hair follicles. This may be thanks to some factors like oily skin, greasy products, sitting around in sweaty gym gear too long, and more.

Fungal acne typically looks red or discolored, feels itchy, and usually pops up on your chest, back, and face.

Most of the time, fungal acne doesn’t look like blackheads and the pimples tend to all look alike. But it’s important for your derm to decide if you have regular acne, fungal acne, or even both at once.

There are plenty of OTC and prescription options like the ones we rounded up (creams, other topicals, pills, shampoos, etc.) that may help you kick the funky fungal to the curb.

Remember to patch test first so you don’t end up with an allergic reaction (!!!).

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