Fungal acne is common during the warmer, wetter months, making it now the best time to develop these small bumps on the hairline, jaw, buttocks, chest, and back just about anywhere on your body. “I’ve seen him a lot in the office lately,” says Doris Day, M.D., a certified dermatologist at Advanced Dermatology and Aesthetics in New York.
Here’s exactly how to differentiate fungal acne from your traditional escape – and what you can do to get rid of it as soon as possible.
What is fungal acne, exactly?
First, a little acne: your skin has tiny pores and, under normal circumstances, dead skin cells rise to the surface of the pore, where your body throws them, according to the American Academy of Dermatology (AAD). But when your body starts to produce a lot of sebum (aka oil), these dead skin cells can stick together inside your pore and clog. Good morning, bud.
Most often, the bacteria that live on your skin, called P. acnes, are trapped inside clogged pores and cause inflammation in what is called bacterial acne, says AAD. But sometimes the yeast that lives naturally on your skin is the problem and that causes fungal acne, says Dr. Day.
This is known as folliculitis, a common skin infection that develops in hair follicles, by AAD. It is often called folliculitis Pityrosporum or folliculitis Malassezia, and “it is an inflammation of the hair follicle caused by a proliferation of yeast on the skin,” explains Joshua Zeichner, MD, director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York.
What does fungal acne look like?
folliculitis on female skin
Fungal acne usually causes red bumps that are a little smaller than your standard acne bumps. “These are papules and pustules more inflammatory than blackheads and whiteheads,” explains Dr. Day.
Each dot may also have a small red ring around it (a sign of infection). “They’re generally uniform and don’t come to a head like a regular pimple,” adds Gary Goldenberg, MD, assistant clinical professor of dermatology at Icahn School of Medicine in Mount Sinai, New York. Symptoms vary widely, so the spots may be sensitive to the touch or not painful at all, slightly swollen or even itchy.
What causes fungal acne?
There are a few different things that might be behind your fungal acne. One is the type of medication you have been taking, especially if you have been on a lot of antibiotics lately. “Antibiotics decrease the amount of normal bacterial flora, allowing yeast to proliferate and cause acne,” explains Dr. Goldenberg.
But it is also common to develop fungal acne from sweating a lot. “Fungal acne tends to occur more frequently in hot, humid weather when there are more sweat and oil on the skin,” explains Dr. Zeichner. “This creates an environment that allows yeast to grow to higher than normal levels.”
But anything that stresses your hair follicles-wearing tight clothes, rubbing your skin often, rubbing, shaving, or relaxing in a not-so-clean hot tub-can result in folliculitis.
How to get rid of fungal acne
Fungal acne is usually diagnosed by exclusion, which means your doctor may suspect it after other traditional acne treatments, such as products, including salicylic acid or benzoyl peroxide, have not led to an improvement in your skin, says Dr. Day.
If your doctor determines that you have fungal acne, they will usually recommend topical treatment. A popular recommendation? Use an anti-dandruff shampoo as a facial and body cleanser. It sounds a little strange, but “anti-dandruff shampoos are essentially anti-yeast,” says Jules Lipoff, MD, assistant professor of dermatology at the University of Pennsylvania, Perelman School of Medicine. Lather with shampoo and let stand for a minute before rinsing to make sure the product has time to do its job.
No luck with the shampoo?
Your doctor may recommend a topical anti-fungal cream called nystatin, and if that doesn’t work, they can increase things up to oral anti-fungal medication.
If you think your antibiotics are causing the problem, talk to your doctor about how your medication is progressing. Typically, bumps will disappear once you stop taking the medication (although you still need antifungal medications to clear things up), says Dr. Goldenberg.
Sweat and moisture could also trigger your fungal acne, so Dr. Day recommends wearing looser clothes when you’re out and about to see if it helps reduce the problem. Be sure to change your clothes and wash your face and body well after working OR be particularly moist.
All in all, if you have bumps on your body, you’re not sure what’s behind them, and nothing you try does make them disappear, call your doctor. “This is not a diagnosis that most non-dermatologists are going to be able to make,” says Dr. Lipoff.