What Is Fungal Acne?

Medically Reviewed by Stephanie S. Gardner, MD on May 04, 2023
4 min read

Fungal acne is not acne. It is a skin condition called pityrosporum folliculitis. It is one of many types of folliculitis, a skin condition that causes an infection in your hair follicle. It can look like pimples and is often confused with acne.

Folliculitis causes your hair follicle to become inflamed and infected, which causes pustules on the skin. You can get folliculitis anywhere you have hair.‌

Sometimes people think they have acne, but it doesn’t seem to get better with treatment. This is usually a sign that you don’t have acne, but a fungal infection in your hair follicle.

This is called pityrosporum folliculitis. It is caused by the Malassezia species and usually affects teenagers because of extra oil production in the skin. It typically is found on your shoulders, back, and neck and can be caused by sweating. It is often referred to as a yeast infection.

This type of yeast infection is often confused with acne, but it might also be misdiagnosed as superficial bacterial folliculitis, too.  There are many types of folliculitis. These include:‌

Superficial bacterial folliculitis. This type is the most common type of folliculitis. It is caused by a Staphylococcus aureus bacterial infection. Your skin normally has this bacteria. If you damage the hair follicle, the follicle becomes irritated, then the bacteria can get into the area and cause an infection. ‌

Viral folliculitis. Herpes viruses can cause folliculitis. Viral folliculitis often looks like bacterial folliculitis, but it has clusters of spots and plaques. Molluscum contagiosum can sometimes cause viral folliculitis, too, but it’s not as common. ‌

Gram-negative bacterial folliculitis. Also called hot tub folliculitis, this is caused by Pseudomonas aeruginosa bacteria. It comes from being in contaminated water or a poorly treated hot tub or swimming pool. ‌Klebsiella and Enterobacter bacteria species can also cause this type of folliculitis. These usually happen after taking antibiotic medicines for a long time. ‌

Demodex folliculitis. The Demodex folliculorum mite causes this type of folliculitis. Most people have this mite on their skin without developing folliculitis, but some people with weakened immune systems or pre-existing skin conditions react differently.‌

Eosinophilic folliculitis.  If you have HIV, you might get this type of folliculitis. It’s not clear exactly what causes it, but it can also be a side effect of chemotherapy. It usually shows up on the scalp, face, and neck and might look like hives. ‌

Pseudofolliculitis barbae. This kind of folliculitis is also called razor bumps, and it doesn’t always cause a skin infection. This usually happens to people who have curly-haired beards. After shaving, the hair curls back into the skin and grows into the skin, causing inflammation and bumps. ‌

While it mostly affects beard hair, this type of folliculitis can affect anywhere you shave. It’s common to have ingrown hairs in the groin. 

When your skin is hot and damp, it is more likely to be damaged. This can happen when you’re exercising for long periods of time or if you live in a hot, humid area. 

Damage or irritation to the hair follicle causes inflammation. This lets germs get into the area and cause an infection.  This is what usually causes pityrosporum folliculitis, or fungal acne.  

This might happen from:

  • Sweating
  • Exercise
  • Tight clothing
  • Tight equipment
  • Skin rubbing on skin

Fungal acne affects boys and men more than it does women.

Symptoms of fungal acne or pityrosporum folliculitis can include:

  • Very itchy skin
  • Clusters of small red bumps
  • Spots on your forehead and chin, and the sides of your face
  • Spots on your chest, back, neck, and arms
  • Acne that doesn’t respond to treatment
  • Irritated hair follicles

Sometimes people who have pityrosporum folliculitis also have acne and other types of fungal infections like seborrheic dermatitis and tinea versicolor

Fungal acne can last for a long time, especially if it's been misdiagnosed as acne. 

The best way to treat the yeast infection is with antifungal pills or a cream. Antibiotics don’t help, which is how your doctor might recognize the problem. They might also swab your skin to verify the yeast infection. 

Your doctor might also suggest other self-care and hygiene practices to help your skin. You can:

  • Change out of sweaty exercise clothes right away
  • Shower right after your workout
  • Wear loose clothing made of natural fibers such as cotton, silk, or bamboo
  • Apply your medication the way your hair grows‌

Make sure not to scratch or pick at any infected areas as this can spread the infection and make it worse.

If you have a skin condition that doesn’t clear up, or you have a rash with a fever and feel unwell, make sure to see your doctor right away.