Fungal acne is one of the most persistent types of acne to treat because of its stubborn nature. It is often mistaken for other types of acne and can be easily misdiagnosed. If you are treating your skin for a month with no success, it might be your confirmation that you are indeed dealing with Malassezia folliculitis (commonly called fungal acne).
Common products and medications are ineffective against it. In my case, it took around 3 months to fully get rid of fungal acne with a consistent skincare routine, diet and lifestyle changes. And now I will teach you how to treat it successfully for good.
Table of Contents
- What Is Fungal Acne?
- What Causes Fungal Acne?
- What Does Fungal Acne Look Like?
- How I Realised It Was Fungal Acne
- Dermatologist-Recommended Ingredients for Each Type
- How to Get Rid of Fungal Acne: Fungal Acne-Safe Skincare Routine
What Is Fungal Acne?
Fungal acne is not acne. It looks similar; it acts like it, but it’s actually a skin condition caused by Malassezia yeast overgrowth. And it’s happening in hair follicles. The proper name for it is Malassezia folliculitis or Pityrosporum folliculitis.
The overgrowth often leads to inflammation, which can result in small, itchy and red bumps. And then people mistake them for regular acne. But unlike bacterial acne, the fungal acne needs specific conditions to thrive in. If you would like to learn more about that, check my other post, “These 50+ Products Make Your Fungal Acne Worse Daily“.
What Causes Fungal Acne?
How did you even get here? The answer might surprise you. Malassezia yeast is naturally resting on our skin. Certain factors might disrupt the natural balance and cause yeast overgrowth. The most common triggers for fungal acne are:
- Heat and humidity
- Excessive sweating (and not showering quickly after)
- Tight, non-breathable clothing
- Heavy, occlusive skincare or makeup
- Prolonged antibiotic use or immune suppression
But there are also other factors, such as your diet (consuming the wrong probiotics, for example, that kill the good bacteria and support yeast growth) or the use of skincare or makeup that literally feeds the Malassezia. I regularly post long lists of products that will make your fungal acne worse, so please check those out.
While hormones play a role in all acne, fungal acne flares are more directly driven by skin yeast imbalances. And sometimes it can be combined with other types of acne, which makes the whole process of determining your condition even harder.
What Does Fungal Acne Look Like?
To identify fungal acne, you have to look for specific signs, such as small bumps that are itchy and filled with white paste that often smells foul when you push them out. It typically appears on the forehead, chest, and back and shoulders, but some people like me have it all over their face or even on their buttocks. Here are some pictures to help you get the idea.
How I Realised It Was Fungal Acne
In my previous article, “How to Get Rid of Acne Fast: Heal Acne in Two Weeks“, I mentioned an important key in my discovery of having fungal acne. I was misdiagnosed by several dermatologists, who thought I had severe cystic acne. But even after pumping my body with contraceptive pills and other medication for hormonal imbalances, my problem persisted.
So I stopped with contraception, and my GP gave me a new prescription for a higher dose of benzoyl peroxide that you can normally purchase over the counter. I was thrilled to use the new product. But it made my skin worse. SO MUCH WORSE! Now, this would be a normal reaction of your skin testing a new product. Except in my case, the yeast hated it so much!
The purge
My skin got super itchy and irritated. I wanted to rip my face off! The breakouts were horrible, especially on my back and forehead. So I started to go down the rabbit hole and Google itchy spots on the forehead.
That’s where I stumbled across multiple suggestions for Malassezia folliculitis. The photos, the symptoms described…everything was suggesting that I’m dealing with fungal acne. How could it be? I never heard of it before. But the photos on Reddit and stories of other people began to look too familiar. So I tried the one product everyone was recommending – Nizoral Anti-Dandruff Shampoo (ketoconazole 2%).
I used it as a face and body wash and normally left it on for about 5-10 minutes each time. Within several weeks, the itchiness disappeared, and my bumps started to flatten. My skin cleared up, and I’m not talking about a miracle but about a very visible turning point. Those annoying bumps were gone. It all clicked. Suddenly, I knew exactly what I had been dealing with for years.
Moral of the story? Sometimes, you know your skin better than anyone else.
Dermatologist-Recommended Ingredients for Each Type
I took my discovery back to my dermatologist and insisted on having it looked into. She came up with a few solutions (around that time, we also determined I have severe comedonal acne):
For Closed Comedones:
- Salicylic Acid (BHA): Penetrates pores, dissolves oil and dead skin cell buildup.
- Retinoids (e.g., adapalene): Increase skin cell turnover, preventing clogged pores.
- Azelaic Acid: Gentle exfoliation, reduces inflammation, fades pigmentation.
- Alpha Hydroxy Acids (AHAs): Smooth skin texture and remove surface dead skin cells.
- Benzoyl Peroxide: Kills acne bacteria (not effective for fungal acne).
For Fungal Acne:
- Ketoconazole 2%: Antifungal treatment (shampoo or cream).
- Sulphur: Dries out yeast and unclogs pores.
- Zinc Pyrithione: Reduces yeast overgrowth.
- Selenium Sulphide: Antifungal and anti-inflammatory.
How to Get Rid of Fungal Acne: Fungal Acne-Safe Skincare Routine
After years of trial and error, I now have a 100% fungal acne-safe, non-comedogenic skincare routine that works for me. Of course, your skin might look completely different, and that’s simply because not everyone tolerates the same products or ingredients. There are, however, some steps that you should follow regardless.
Switch to Fungal Acne-Safe Products
Avoid products that feed Malassezia for miles! The most problematic ingredients are fatty acids (oleic, lauric, and myristic acids), oils (plant-derived oils, coconut oil, etc.), and esters and polysorbates (common in moisturisers and creams). Your best shot is non-comedogenic, oil-free, sulphate-free, alcohol-free, and fungal-acne-safe products. Visit https://folliculitisscout.com/ or https://sezia.co/ to check common fungal acne triggers.
Go For Antifungal Ingredients
Start by applying topical antifungal treatment today. Your goal should be to reduce the yeast overgrowth immediately. You have to starve it in order to see improvements. The best options are ketoconazole 2% cream or shampoo (don’t be scared to apply it on your face and leave it on for a while), selenium sulphide shampoo (use as a body wash), and zinc pyrithione soap (always check the ingredients list). For persistent cases, oral antifungal medications like fluconazole or itraconazole may be prescribed by a dermatologist.
My Top Picks for Skincare: Morning
I would like to share with you my skincare. It’s very simple but extremely effective. In the morning, I cleanse my skin with the Malezia Hyaluronic Acid Cleanser or Ziaja Cleansing Foam Face Wash For Dry Skin (a very affordable one).
Then I use the Avène Thermal Spring Water, and I immediately follow with either The Ordinary Niacinamide 10% + Zinc 1% or SVR, [B3] Hydra Essence, Fragrance-Free, 5.1 fl oz (150 ml). I want to point out that what I choose for the day depends on the condition of my skin. Some days I need more moisture or brightening; other days, more sebum-controlling ingredients.
Afterwards, I follow with either La Roche-Posay Toleriane Sensitive Fluide, PURITO Oat-In Calming Gel Cream or SebaMed Clear Face Care Gel (depending on how much moisture my skin needs). If you are also using a sunscreen, please look for a mineral sunscreen with zinc oxide or titanium dioxide. And please make sure it is fungal acne safe.
Evening
For my evening routine, I do double cleansing, first with Garnier Micellar Cleansing Water 3-in-1 (it’s the one with a pink cap) and then with any of the cleansers mentioned above. I used Nizoral Anti-Dandruff Shampoo nearly daily before, when I struggled with the fungal acne, but stopped as it can be very irritating and harsh for your skin barrier. I also recommend avoiding cleansing oil completely.
After cleansing my skin properly, I use the Anua BHA 2% Gentle Exfoliating Toner (BE AWARE AS THEY CHANGED THE FORMULA AND INGREDIENTS LIST!) . This toner alone helped me clear out all closed and opened comedones (my holy grail!). If you are looking for a cheaper alternative, the PanOxyl Clarifying Exfoliant, 2% Salicylic Acid, 4 fl oz (118 ml) is also great.
Then I follow with either Dr C. Tuna Vitamin C Glow Serum, De La Cruz Acne Treatment Ointment with 10% Sulphur Maximum Strength, 0.21 oz (6 g), and moisturiser. Again, the choice depends on what my skin needs that day, and I rotate all products.
There are other products in my rotation (and I also like to test new ones): Beauty of Joseon, Ginseng Essence Water (be careful with this one; if you notice it’s breaking you out, stop using it immediately), Purito Oat-In Calming Gel Cream, Saloos Clay Mask Kaolinite, Paula’s Choice 10% Niacinamide Booster and Torriden DIVE-IN Low Molecule Hyaluronic Acid Mask.
Be careful not to overdo it and mix different products together. You need to rotate them and make sure not to combine active ingredients that could cause further problems. Always patch test new products and never combine different acids. Make sure to apply sunscreen, because some products increase sun sensitivity. And most importantly, BE PATIENT – your fungal acne can dramatically improve within the first four weeks if you stay consistent.
UPDATE: In 2025, I would not recommend purchasing the Anua BHA 2% Gentle Exfoliating Toner as they changed the formula and ingredients, and it’s not fungal acne-triggering! Use it ONLY if you manage to find the old formula.
Here is how my routine looks every week:
| Time of Day | Cleanser | Toner / Mist | Serum / Treatment | Moisturizer | Notes |
|---|---|---|---|---|---|
| Morning | Malezia Hyaluronic Acid Cleanser or Ziaja Cleansing Foam Face Wash (Dry Skin) | Avène Thermal Spring Water | The Ordinary Niacinamide 10% + Zinc 1% or SVR [B3] Hydra Essence | La Roche-Posay Toleriane Sensitive Fluide or PURITO Oat-In Calming Gel Cream or SebaMed Clear Face Care Gel | Choose serum & moisturizer based on skin needs (hydration vs oil control). Always finish with a fungal acne–safe mineral sunscreen (zinc oxide or titanium dioxide). |
| Evening | Step 1: Garnier Micellar Cleansing Water (pink cap) → Step 2: Malezia Cleanser or Ziaja Cleanser | Anua BHA 2% Gentle Exfoliating Toner (holy grail) or PanOxyl Clarifying Exfoliant 2% SA | Dr. C. Tuna Vitamin C Glow Serum or De La Cruz 10% Sulphur Ointment | Any of the morning moisturizers | Avoid cleansing oils. Nizoral can be used occasionally for fungal acne flare-ups, but not daily (too harsh). Rotate treatments depending on skin condition. |
| Rotation / Extras | – | – | Beauty of Joseon Ginseng Essence Water (stop if breakouts), Paula’s Choice 10% Niacinamide Booster | PURITO Oat-In Calming Gel Cream, Torriden DIVE-IN Hyaluronic Acid Mask, Saloos Clay Mask Kaolinite | Use 1–2× per week or when skin needs extra soothing, hydration, or purifying. |
My Top Picks for Makeup
You will need to test a few makeup products before you find those that don’t break you horribly. Honestly, I managed to find only ONE liquid foundation so far that is 100% fungal acne safe, and that’s the L’Oréal True Match Super-Blendable Foundation, W2 Warm Light, 1 fl oz (30 ml).
I’m not really into makeup; in my bag you will find a foundation, concealer, setting powder, mascara, eyebrow products and lip gloss. But I’m on the constant hunt for fungal acne-safe cosmetics. I found out that mineral-based products work the best for my situation. If you are interested in what I use, here is a detailed list:
- L’Oréal True Match Super-Blendable Foundation, W2 Warm Light, 1 fl oz (30 ml)
- Lily Lolo Mineral Foundation (does not protect reefs)
- Lily Lolo Mineral Concealer
- COSRX Ultra-Light Invisible Sunscreen SPF 50 PA++++
Adjust Diet and Lifestyle
None of the products above would work if I carried on with my unhealthy diet. You don’t have to give up on your favourite food and become the perfect Pinterest, clean-eating person. For obvious reasons, I cut out dairy (although I go for the cheese board every now and then), sugar and processed food. The goal is to create a balance, clear your guts and give your body what it needs.
My first tip is to reduce yeast-feeding food such as carbs and sugar. A high glycaemic diet will make your fungal acne worse. It’s okay to have a sweet treat or drink sometimes if you balance your gut microbiome and reduce the overgrowth of bad fungi. The best food to add to your diet is probiotic-rich food (plain Greek yoghurt, kimchi, miso). prebiotic fibres (oats, flaxseeds, garlic, leeks, bananas), anti-inflammatory foods and natural antifungals.
I know that, ideally, you should eat clean. But I’m not aiming at my fitness-friendly readers only. Let’s be realistic; most people don’t follow any diet rules. However, if you would love to and are simply confused about what to eat, follow my Pinterest account, “Danny&Life”, for acne-safe food and recipes. And don’t forget to hydrate; it truly matters!
Other crucial changes include showering immediately after excessive sweating, for example, after an active workout; changing pillowcases and towels regularly; wearing loose and breathable clothes; limiting stress; and avoiding over-washing your face. Don’t resist seeking professional help either, especially if the fungal acne persists no matter what you do.
Final Thoughts
Even though I managed to get rid of fungal acne, I continuously learn about this topic. And it’s a good thing to constantly update your knowledge about products that you use or plan to use (companies change ingredients all the time!). When it comes to fungal acne, your patience will be tested time and time again.
But if you remain consistent with your new routine, keep learning about the fungal acne and stay vigilant for any changes, then your skin will reward you. Sometimes I still experience a few bumps, especially when my skin is exposed to humid weather. But from personal experience, I can guarantee that fungal acne is treatable and possible to be put under control.
Share your own experience in the comments below so other readers find the courage, inspiration and knowledge they might seek. You never know what product, supplement or lifestyle change might help someone else!
Frequently Asked Questions About Fungal Acne
How do I know if I have fungal acne or regular acne?
Fungal acne (Malassezia folliculitis) often looks like small, uniform, itchy bumps, typically on the forehead, chest, or back. Unlike bacterial acne, it doesn’t respond to standard acne treatments like benzoyl peroxide or salicylic acid. If you’ve been treating “acne” for months with no improvement, and it worsens with sweating or humidity, it might be fungal.
Can a dermatologist misdiagnose fungal acne?
Yes. Many dermatologists initially diagnose it as hormonal or bacterial acne because the symptoms can look very similar. Unless a fungal cause is suspected, a doctor might not prescribe antifungals like ketoconazole or do a proper skin scraping/culture.
What instantly kills fungal acne?
Ketoconazole 2% shampoo (like Nizoral) used as a face and body wash is highly effective. Apply and leave it on for 3–5 minutes, then rinse. Combine this with a fungal-acne-safe skincare routine and avoid ingredients that feed yeast.
What ingredients should I avoid with fungal acne?
Avoid fatty acids, esters, polysorbates, and oils like olive oil, shea butter, coconut oil, isopropyl myristate, and lauric acid. These can feed Malassezia yeast and worsen breakouts.
Can diet affect fungal acne?
Yes. High-sugar and high-carb diets can encourage fungal overgrowth. Reducing sugar, alcohol, and dairy while increasing antifungal foods (like garlic, coconut oil, and probiotics) may improve your skin. Many people see improvement when supporting their gut health.
Is fungal acne contagious?
Fungal acne itself isn’t contagious, but the yeast that causes it (Malassezia) naturally lives on everyone’s skin. Flare-ups happen when the yeast overgrows due to imbalances in oil, humidity, or skin barrier issues, not because it was “caught” from someone else.
How long does it take to clear fungal acne?
With consistent treatment (e.g., antifungal shampoo, proper skincare, diet changes), visible improvement can occur in 2 to 4 weeks. Complete healing may take longer depending on severity and lifestyle factors.
Can I wear makeup with fungal acne?
Yes — but choose fungal-acne-safe makeup. Look for non-comedogenic, oil-free formulas that don’t contain esters or polysorbates. Mineral makeup is usually safer. Always double cleanse and avoid sleeping in makeup.
Can fungal acne come back?
Unfortunately, yes. Fungal acne often recurs if your routine includes yeast-feeding ingredients or if your skin is exposed to heat, sweat, and occlusion often. Maintenance with antifungal treatments (like Nizoral once a week) and a safe routine can help prevent relapses.
