Fungal acne is actually a whole other category—and isn’t even acne at all, to begin with. It was given the moniker of “fungal acne” because of the appearance (it looks very similar to acneic breakouts), but as dermatologists will tell you, they’re very different things. Here’s how to spot the difference: “Pityrosporum folliculitis manifest as small red bumps centered around hair follicles,” Marcus explains. “Unlike typical acne, fungal folliculitis can itch.” Another telltale sign is that fungal acne will all appear consistent (or, all the bumps will look alike), which is known as monomorphic. However, traditional acne is often polymorphic, which means there will be many kinds of acne (blackheads, whiteheads, cysts) and they’ll all appear at different stages, notes board-certified dermatologist Cybele Fishman, M.D. The area can also help you decipher if it’s acne or folliculitis: “The breakouts are most commonly seen on the chest, back, and face,” board-certified dermatologist Lian Mack, M.D., FAAD, notes. On the face, it most commonly occurs on the forehead and temples. It also occurs on all skin tones. If you can’t tell (it isn’t always easy), visit your dermatologist. “In the setting of an office visit, a board-certified dermatologist can also perform a scraping of the skin and look under the microscope, which reveals the organism,” Mack says. Fishman notes that “unbreathable” fabrics are to blame, especially those commonly used for workouts, such as spandex. Always get out of sweaty clothes and rinse off after exercise. However, it is important to note that fungal acne (or typical acne) is not related to lack of cleanliness or hygiene. Having it is not a sign that the skin is “dirty.” It is simply that rinsing post sweat can help you manage it. In addition, Fishman notes the use of ketoconazole, which is another common ingredient in anti-fungal shampoos.
“​​In addition, using products to control oil or sebum production may also help,” she notes. Marcus’ go-to: The Kate Somerville EradiKate Daily Foaming Cleanser. This gentle cleanser, “helps fight fungus and also bacteria that cause breakouts,” Marcus says. One way that you can keep your complexion clear is to prioritize keeping your microbiome balanced with a barrier-supporting skin care routine. While this isn’t a treatment, it can help keep your skin healthy long term. “Avoid granular scrubs, which may further irritate and inflame follicles, worsening folliculitis,” Marcus explains. If you use chemical exfoliants or retinol, it’s best to minimize your use if you find them irritating during a breakout. Further, avoid products with fatty acids or oils. “The yeast that causes fungal acne survives on oils and fatty acids, causing the fungal acne to grow and spread,” Mack says. “Some examples include lauric acid, palmitic acid, stearic acid, oleic acid, and linoleic acid.” 

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