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Because it doesn’t exist.

What many people refer to as “fungal acne” is actually a condition dermatologists define as Pityrosporum Folliculitis (or Malassezia folliculitis).  This condition is described as an overproduction of Malassezia furfur, a yeast that is naturally part of the skin microbiome. It is completely normal for humans to have this yeast on their bodies as we all have it. Most of the times, the yeast is dormant and just chilling in the hair follicle, not bothering us at all. We mistake it for acne when it changes from yeast to hyphal during its life cycle.

Hot and humid climates, excessive dandruff, or pre-existing skin conditions like sebhorreic dermatitis can exacerbate the appearance of Pityrosporum Folliculitis. The condition most commonly appears on the chest, upper back, arms, and neck. It is less likely to appear on the face though it can surface there occasionally. When it does appear on the face, it’s more common for it to be very close to the hairline (forehead and sideburns) rather than along the cheeks or chin. These types of “breakouts” are also incredibly itchy.  Here is a quick video from an actual Dermatologist trying to explain the condition.

Pityrosporum Folliculitis flare ups can often be attributed to antibiotics and steroids. So if you were recently prescribed any oral acne medications and noticed the above mentioned breakout pattern, you may want to make another visit to your dermatologist to discuss other options. If you aren’t on any oral antibiotics, consider making a change in your shampoo and conditioner. Many people see success in clearing the breakouts with brands like Selsun Blue and Nizoral.

Holistic specialists recommend taking probiotics in addition to supplements such as Apple Cider Vinegar tablets and Oil of Oregano. I cannot confirm or deny if any of this works, however.

If you’ve determined oral antibiotics or  your hair care products weren’t the culprit and don’t want to go the holistic route, mandelic acid cleansers and ketoconazole creams have been proven effective in clearing “fungal acne” (which, again, isn’t actually acne at all).

Most estheticians can spot the difference between an actual acne breakout and Pityrosporum Folliculitis by the way it extracts (looks much different than any other form of actual acne) and by asking you questions about where (else) it appears on your body and any associated symptoms.

So what should you do if you think you may have Pityrosporum Folliculitis? You should try your best to keep the area dry (though I know this may be a big challenge in humid areas). You can even try applying the Gold Bond powder over the area to both keep the area dry and calm any itchiness. Always wear cotton clothing, sleep on cotton bedsheets, and try to avoid fabric softener if possible. Lastly, avoid (or seriously try to limit) sugars and yeasts. This means bread, alcohol, processed/frozen foods, sandwich meat, and dairy is absolutely out for you. Well, at least for a little while.

Have questions about your breakouts? Book an appointment with me and select the C L E A R L Y consultation add-on if you’ve got questions about acne. I’m here to help!