The Definitive Guide to Fungal Acne Treatment

by | Sep 11, 2020

Many people say that they have been suffering from acne on the chest, back, and shoulders for many years, but they cannot be cured. You should seriously consider whether you have fungal acne.

In many cases, it is easy for people to mistake fungal acne for “acne” or “bacterial folliculitis”. Then the treatment direction is wrong, and of course, it cannot be cured.

Fungal acne, or Malassezia folliculitis, is caused by an overgrowth of yeast (a type of fungus) that resides on the skin. This yeast, known as Malassezia, usually is present on our skin and doesn’t cause any problems. However, when conditions are right – such as excessive sweating, increased oil production, or a compromised immune system – the yeast can multiply and cause an infection.

The Difference Between Fungal Acne And Acne Vulgaris

Most of the acne on people’s face is acne vulgaris. Acne vulgaris is divided into inflammatory acne and non-inflammatory acne. Most of the acne on our back is fungal acne. About 90% of people’s back acne are fungal acne, and 10% of people are acne vulgaris.

90% fungal acne on the back and 10% acne vulgaris.

However, there are some key differences that can help distinguish between the two.

1. Appearance: Fungal acne usually appears as uniform small red bumps and white pustules on the skin. These bumps are often filled with pus and are usually the same size, diameter is usually one to two millimeters. On the other hand, common acne is not uniform in size, and acne types vary from blackheads, whiteheads, cysts, nodules, etc.

2. Location: Fungal acne is most commonly found on the chest, back and upper arms where there is a high concentration of sebaceous glands. Fungal acne can also appear on the forehead and along the hairline. Regular acne is more common on the face ( cheeks, chin), but can also appear anywhere on the body.

3. Itching: One of the key differences between fungal acne and regular acne is that fungal acne often comes with itching or a slight burning sensation, while regular acne does not typically cause itching.

4. Response to Treatment: Fungal acne does not respond to typical over-the-counter or prescription treatments for regular acne. Instead, it requires antifungal treatments to clear up.

5. Pattern: Fungal acne tends to appear in clusters or a uniform pattern whereas regular acne does not have a specific pattern.

Remember that while these signs can help you distinguish between fungal and common acne at home, it’s always best to consult with a dermatologist for an accurate diagnosis and treatment plan.

Some acne vulgaris in the back

Acne vulgaris

The chest suffers from severe fungal acne. Fungal acne spreads across the chest and neck. These acne are the size of a rice grain and manifest in the form of pustules and nodules.

Very severe fungal acne

What Causes Fungal Acne?

Under normal circumstances, the number of bacteria and fungi on our skin is relatively balanced. If for some reason the number of a certain flora surges, it will cause a series of skin problems. These reasons include:

1. Excessive Sweating: The yeast thrives in warm, moist environments. Therefore, people who sweat a lot, such as athletes or those living in humid climates, are more prone to fungal acne.

2. Oily Skin: The Malassezia yeast feeds on the oils (sebum) produced by our skin. So people with oily skin or those using oily skincare products are more susceptible.

3. Weakened Immune System: People with compromised immune systems are more likely to develop fungal acne as their bodies may struggle to keep the yeast growth in check.

4. Antibiotic Use: Long-term use of antibiotics can disrupt the balance of microorganisms on your skin and in your body, potentially leading to an overgrowth of the Malassezia yeast.

5. Tight Clothing: Wearing tight clothing that traps heat and sweat against your skin can create an ideal environment for the yeast to multiply.

6. Hormonal Changes: Hormonal imbalances or sudden changes can increase oil production in the skin, providing more food for the yeast and potentially leading to fungal acne. It’s important to note that while anyone can develop fungal acne under the right conditions, it’s not contagious and cannot be passed from person to person.

7. Damaged skin barrier. A compromised skin barrier makes it easier for fungi to invade the inner skin and cause inflammation.

8. Improper diet. Eating sweets, refined carbohydrates (bread, cakes), and high-fat foods can also indirectly promote the growth of Malassezia.

Fungal Acne Treatment

To treat fungal acne, we can go directly to the dermatology department of the hospital and ask a professional dermatologist to prescribe the corresponding medicine for you.

If you are reluctant to go to the hospital and suffer from mild fungal folliculitis, you can try to treat fungal folliculitis first. Because most people’s back acne is caused by fungal folliculitis. Even if it is not fungal acne, the method of treating fungal folliculitis has a certain effect on bacterial folliculitis and acne.

But if it is moderate and severe fungal acne, please go to the hospital to find a dermatologist for a prescription.


  • Cleansing with just water won’t get rid of fungal acne
  • Do not use BHA products for the treatment of fungal acne, BHA products have only side effects for the treatment of fungal acne.

1. Mild fungal folliculitis

A woman pointed her index finger to her back. Her back was suffering from mild fungal acne.

For mild folliculitis, we only need to pay attention to daily cleaning work to inhibit the growth of fungi.

  • Take a shower frequently, change sheets, sheets, and pillowcases to give yourself a clean and comfortable body.
  • You can also use ketoconazole lotion instead of shower gel to take a bath. Use it once a day, leave it on the skin surface for 5 minutes, and then rinse it off with water. Ketoconazole lotion has a good inhibitory effect on fungi, and it has a good therapeutic effect on back acne (note: Ketoconazole lotion should not be used on damaged skin)
  • Use shower gel with lower cleaning power to clean your back, or sulfur soap. Sulfur soap will cause certain damage to the skin barrier, so the frequency of use of sulfur soap should be as low as possible.

2. Moderate fungal folliculitis

A woman hugs her back, and her back has many fungal acne.

For the treatment of moderate fungal folliculitis, the mild folliculitis treatment method described above should still be used. Pay attention to washing and hygiene.

Besides, you can also apply some anti-fungal drugs appropriately. E.g: Ketoconazole cream, miconazole nitrate cream, bifonazole cream, econazole cream.

Just choose one of these ointments and use them.

3. Severe fungal folliculitis

The chest suffered from a very severe case of fungal acne. The fungal acne was all over the chest and neck and some of the acne developed into nodules, cysts, and flesh patches.

Severe fungal folliculitis is not only an infection of fungal bacteria but also often accompanied by abnormal keratosis of hair follicles.

At this time you must go to a dermatologist to prescribe oral medicine.

At this time, acne will not only appear single or densely, but also form purple-red nodules. These acne felt like a large piece of meat.

If the acne on your back has been severe to this level, at this time, in addition to the above treatment, you need to take some antifungal drugs, such as ketoconazole tablets, itraconazole tablets, and fluconazole tablets. These drugs have some side effects, such as damage to the liver. Before taking the medicine, go to the hospital for a liver function test.

How To Prevent Fungal Acne?

Avoid using shower gels with strong cleansing power to prevent damage to the body’s skin barrier and prevent inflammation from getting worse.

Use some body lotions with anti-inflammatory ingredients to repair the skin barrier and suppress inflammation.

It is not recommended to use vegetable fats other than jojoba oil. Squalene and fatty acid ester skin care products are also not recommended.

Keep the living environment ventilated daily.

Avoid wearing tight clothing.

Change and wash your clothes frequently after sweating.

Change pillowcase sheets and towels frequently.

Exercise more to enhance body resistance.

Supplement B vitamins and eat less high-sugar and high-fat foods.

How Long Does It Take For Fungal Acne To Clear?

The length of time it takes for fungal acne to clear can vary greatly depending on the severity of the condition and the effectiveness of the treatment being used. Generally, with the right treatment, you may start to see improvement within a few weeks. However, it’s not uncommon for the condition to take several months to fully clear up.

It’s important to continue the treatment as directed by your dermatologist, even if the symptoms start to improve, to ensure that the infection is completely eliminated and to prevent recurrence.

Remember, everyone’s skin is different and responds differently to treatments. If you don’t see improvement after several weeks of treatment, or if your symptoms worsen, it’s important to follow up with your dermatologist. They may need to adjust your treatment plan or explore other potential causes of your symptoms.

Can Tea Tree Oil Get Rid of Fungal acne?

On the table is a bottle of tea tree essential oil, chess and a bottle of wheat

Tea tree essential oil contains about 50% of monoterpene alcohols, of which terpineol accounts for about 45%, and a small amount of thujone alcohol, which has a very powerful bactericidal ability, including bacteria and fungi.

5% concentration of tea tree essential oil can kill 90% of fungi, which is very suitable for acne caused by the imbalance of facial flora.

Tea tree essential oil has an excellent effect on antibacterial folliculitis and fungal folliculitis.

How to use:

Apply moisturizing cream to the face, then dip a cotton swab into the mixture and apply it directly to the acne.