Think It’s Acne? It Might Be Fungal Folliculitis

If you’ve been battling stubborn breakouts that don’t respond to traditional acne treatments, you might not be dealing with acne at all—at least not the kind you think. “Fungal acne,” more accurately known as Malassezia folliculitis or Pityrosporum folliculitis, is a skin condition that’s often mistaken for regular acne. But the cause is entirely different—and that means the treatment needs to be different, too.

At CLEAR Acne Treatment Centers, we specialize in helping clients find real solutions to chronic breakouts. If your skin hasn’t improved with the usual creams, prescriptions, or even diet changes, this guide will help you understand whether fungal acne might be to blame—and what you can do about it.

WHAT IS FUNGAL ACNE?

Despite the name, fungal acne isn’t truly “acne.” Instead of being caused by bacteria or clogged pores like traditional acne, it’s caused by an overgrowth of yeast (specifically Malassezia, a type of fungus) in your hair follicles.

Malassezia naturally lives on your skin. In small amounts, it’s harmless. But under certain conditions—like heat, sweat, or a disrupted skin barrier—this yeast can overgrow and lead to inflammation, resulting in itchy, acne-like bumps.

FUNGAL ACNE VS. BACTERIAL ACNE: WHAT’S THE DIFFERENCE?

Although fungal acne can look similar to regular acne, there are some key differences:

1. ITCHINESS

Fungal acne is often itchy, while traditional acne usually is not.

2. UNIFORM APPEARANCE

Fungal breakouts usually consist of small, uniform bumps (often on the forehead, chest, back, or upper arms). Regular acne tends to be more varied, with blackheads, whiteheads, cysts, or pustules.

3. SUDDEN ONSET

Fungal acne can flare up quickly, especially in hot, humid weather or after sweating a lot (think: after workouts or travel to a tropical climate).

4. LACK OF RESPONSE TO ACNE TREATMENTS

If you’ve been using benzoyl peroxide, salicylic acid, or antibiotics without improvement, that’s a red flag. In fact, some acne treatments—especially antibiotics—can worsen fungal acne by killing off the bacteria that help keep yeast in check.

WHAT CAUSES FUNGAL ACNE?

Several factors can throw off your skin’s microbiome and trigger an overgrowth of Malassezia:

• Hot, humid weather

• Frequent sweating (especially without rinsing or showering after)

• Occlusive skincare or haircare products

• Tight, non-breathable clothing

• Antibiotic use (topical or oral)

• Immunosuppression or medical conditions that affect the immune system

Even skincare habits intended to help acne—like over-exfoliating or stripping the skin’s barrier—can inadvertently worsen fungal breakouts.

DIAGNOSING FUNGAL ACNE

Fungal acne is often misdiagnosed, even by professionals. If you’ve tried multiple acne treatments without success, it may be worth exploring this possibility.

At CLEAR, we take a close look at your breakout history, product use, and symptoms. In some cases, we may refer clients to a dermatologist for a proper diagnosis using a fungal culture or skin scraping under a microscope—but in many cases, the presentation and history are enough to identify the likely cause.

HOW TO TREAT FUNGAL ACNE

Treating fungal acne means addressing the yeast overgrowth directly—not just treating inflammation or clogged pores.

1. USE ANTIFUNGAL INGREDIENTS

Look for products with ingredients like:

• Ketoconazole (often found in dandruff shampoos like Nizoral)

• Selenium sulfide (found in Selsun Blue)

• Zinc pyrithione (found in bar cleansers like Vanicream Z-Bar)

• Sulfur (found in certain acne masks or spot treatments)

These ingredients reduce yeast on the skin and help restore balance. Some people apply these as masks or body washes, letting them sit for several minutes before rinsing.

2. SIMPLIFY YOUR SKINCARE ROUTINE

Skip heavy moisturizers, oils, and occlusive ingredients—especially esters and polysorbates, which can feed Malassezia. Look for lightweight, non-comedogenic products labeled as “fungal acne safe.”

3. SHOWER AFTER SWEATING

Sweat, oil, and heat create the perfect environment for yeast to thrive. Showering right after workouts (and using antifungal washes a few times per week) can help keep the balance in check.

4. AVOID ANTIBIOTICS (UNLESS NEEDED)

Antibiotics can wipe out bacteria that help control fungal levels, so if your acne hasn’t responded to them—or got worse—it’s a clue fungal acne may be involved.

CAN AVICLEAR® TREAT FUNGAL ACNE?

This is a question we get a lot, and it’s important to be clear: AviClear® is designed to treat traditional, bacterial acne—the kind triggered by oil overproduction and clogged pores—not fungal acne.

That said, many clients come to us believing they have traditional acne when the real issue is fungal, or vice versa. That’s where an expert consultation comes in. If your breakouts are truly fungal in nature, we’ll help guide you toward treatments that make sense for your skin. If you’re dealing with classic acne (with blackheads, whiteheads, cysts, and oily skin), AviClear® could be an excellent long-term solution.

WHAT ABOUT PURGING OR MIXED ACNE?

Some clients experience both fungal and bacterial acne at the same time, which can become more noticeable when starting a new skincare routine or treatment. That’s why our team at CLEAR always helps you sort through your skincare routine, make targeted changes, and support your skin barrier. We’ll flag any ingredients that might be making fungal acne worse, while also supporting you through any purging or flare-ups with prescription or OTC solutions.

WHEN TO SEE A PROFESSIONAL

If you’re not sure what kind of acne you have—or you’ve tried every product at the drugstore and still aren’t seeing results—it’s time for a professional consultation. At CLEAR, we help clients every day who’ve spent months (or years) treating the wrong type of acne. And when you finally get the right diagnosis? That’s when real progress starts.

FINAL THOUGHTS: CLEAR SKIN STARTS WITH THE RIGHT DIAGNOSIS

Fungal acne can be frustrating, especially when it masquerades as regular acne and doesn’t respond to traditional treatments. But with the right approach, it’s manageable—and often clears up quickly with the right antifungal products and skincare changes.

If you’ve been spinning your wheels trying to treat your breakouts, we’re here to help. Whether you’re dealing with fungal acne, bacterial acne, or a combination of both, our team at CLEAR Acne Treatment Centers can guide you to a personalized plan that actually works.

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