What Causes Fungal Acne (Malassezia Folliculitis) & How to Treat It

Fungal acne—clinically known as Malassezia folliculitis—is one of the most misunderstood skin conditions. It looks like acne, behaves differently than acne, and often gets worse with traditional acne treatments. If your breakouts are itchy, uniform, and resistant to typical acne products, fungal acne may be the real cause.

This guide explains what causes fungal acne, how it differs from bacterial and hormonal acne, and how to treat fungal acne safely without damaging your skin barrier.

This article is part of our Acne Education Series and supports our core guide: Hormonal vs Fungal vs Bacterial Acne .

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What Is Fungal Acne?

Fungal acne is caused by an overgrowth of Malassezia yeast, a microorganism that naturally lives on the skin. Unlike bacterial acne, fungal acne is not caused by clogged pores—it develops when yeast multiplies excessively inside hair follicles.

Because it mimics acne, fungal acne is frequently misdiagnosed and mistreated. Using the wrong products can make it significantly worse.

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What Causes Fungal Acne?

Fungal acne thrives in environments that are warm, moist, and oil-rich. Several factors can trigger yeast overgrowth:

• Excess sweat and humidity
• Occlusive skincare products or heavy oils
• Overuse of antibiotics (oral or topical)
• Tight clothing or prolonged moisture on the skin
• A compromised skin barrier
• Harsh exfoliation that disrupts the microbiome

Antibiotics are a major contributor—while they kill bacteria, they do not kill yeast, allowing Malassezia to overgrow unchecked.

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What Can Be Mistaken for Fungal Acne?

Fungal acne is commonly confused with other conditions, including:

• Hormonal acne
• Bacterial acne
• Closed comedones
• Heat rash
• Perioral dermatitis
• Damaged skin barrier breakouts

Key differences:

• Bumps are small and uniform (same size)
• Often itchy or prickly
• Common on the forehead, chest, back, shoulders, and hairline
• Does not respond to benzoyl peroxide or typical acne treatments

If acne treatments make your skin worse, fungal acne should be considered.

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What Is the Fastest Way to Get Rid of Fungal Acne?

The quickest way to clear fungal acne is to remove the yeast’s food source while supporting the skin barrier.

Step-by-Step Fungal Acne Treatment

1. Eliminate yeast-feeding ingredients
   Avoid heavy oils, esters, polysorbates, and fermented ingredients.
2. Simplify your routine
   Use a gentle cleanser, lightweight hydration, and barrier-supportive moisturizers.
3. Use antifungal support when needed
   Zinc-based products, sulfur, or prescription antifungals may be recommended in persistent cases.
4. Restore the skin barrier
   Barrier damage makes fungal acne harder to resolve and more likely to recur.
5. Avoid unnecessary antibiotics
   They often worsen fungal acne by disrupting the microbiome.

Most people see improvement within 7–14 days once the correct approach is used.

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What NOT to Do If You Have Fungal Acne

• Do not over-exfoliate
• Do not rely on benzoyl peroxide
• Do not layer heavy oils to “repair” the skin
• Do not treat it like hormonal acne

Fungal acne requires a targeted, microbiome-aware approach.

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How Fungal Acne Relates to Skin Barrier Damage

A weakened skin barrier allows yeast to proliferate more easily. If fungal acne keeps returning, barrier repair is essential.

For a complete barrier-safe approach, follow: Skin Barrier Repair Creams and our Acne vs Damaged Skin Barrier guide.

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Frequently Asked Questions: Fungal Acne

What causes fungal acne?

Fungal acne is caused by an overgrowth of Malassezia yeast, often triggered by humidity, sweat, occlusive products, antibiotics, and a damaged skin barrier.

What can be mistaken for fungal acne?

Hormonal acne, bacterial acne, closed comedones, heat rash, and damaged skin barrier breakouts are commonly mistaken for fungal acne.

What is the quickest way to get rid of fungal acne?

Eliminate yeast-feeding ingredients, simplify your routine, support the skin barrier, and use antifungal support if needed.

Does fungal acne itch?

Yes. Itchiness is one of the most common distinguishing features of fungal acne.

References

• Cleveland Clinic — Malassezia folliculitis overview
• American Academy of Dermatology — Fungal acne and folliculitis
• DermNet — Malassezia-related skin conditions
• PubMed — Skin microbiome and fungal overgrowth research

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Recommended Reads

• Hormonal vs Fungal vs Bacterial Acne
• Acne vs Damaged Skin Barrier
• Skin Barrier Repair Creams

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