Could You Have “Fungal Acne?”

“Fungal Acne” has several names in the dermatology community. It is also known as Pityrosporum folliculitis and Malassezia folliculitis to clinicians. While this isn’t considered true acne, it is something we commonly see in our clinic. Our goal with this blog will be to help familiarize you with the signs, symptoms, and common treatment options for this condition.

What does it look like?

Pityrosporum folliculitis tends to occur on the face and upper trunk of the body, generally in young and middle-aged adults. Females are usually affected more than males. The hallmark of this condition is the appearance of small, uniform, and often itchy red bumps that may resemble acne. One of the most important factors is that it tends to be resistant to usual acne treatments. As clinicians, we look for lesions that are about 1mm in diameter and lack features of blackheads and whiteheads (comedonal acne). One of the frustrating factors of Pityrosporum folliculitis is its persistent and recurrent nature.

What causes it?

The risk factors for Pityrosporum folliculitis include over treatment with broad-spectrum antibiotics, steroids, systemic chemotherapy, diabetes, and immunosuppression with HIV. Since this condition is caused by follicular occlusion and yeast overgrowth, it is thought that sweating, humidity, and heat are also risk factors. It is even believed that the condition may be contagious with skin-to-skin contact from an affected individual. One of the ways to diagnose this condition is by visual inspection, considering what treatment has already been done, and sometimes an in-office test called a KOH prep, which is a skin scraping viewed under a microscope to check for the presence of yeast.

How can we treat it?

If acne has been suspected and there has been treatment with an oral antibiotic, the first step would be to stop the antibiotic. Topical antifungal medications can be prescribed to help clear the bumps. Over-the-counter options include selenium sulfide shampoo (Selsun) with short-contact-therapy by leaving it on the affected area for twenty minutes prior to rinsing off daily for three days and then once weekly to prevent recurrence. In resistant cases, prescription oral antifungal medications such as fluconazole can be given. In extreme cases, isotretinoin (Accutane) can be helpful. It may take three to four weeks for the bumps to clear, however we know that treatment is working when a relief from the itching has been experienced.

The Derm NP Can Help

The Derm NP is a unique dermatology practice. Our provider, Laura Collins, APRN, ANP-BC, DCNP, ACTTP, has an extensive array of experience and education in the field of dermatology. She started her career in dermatology in 2005 and has been a speaker for numerous community and community hospital events. Laura loves the practice of dermatology and strives to provide her patients with the best care possible.

We provide care for non-urgent dermatological conditions via telehealth visits, through which we provide top-notch, affordable care. No membership is required! Contact us at (630) 233-9767 or for an appointment so we may help you with your skin concern.

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The Derm NP will be out of the office from 

3/24/2024 – 3/31/2024

If you have an urgent matter during this time, please call us at (630) 233-9767 and leave a message with your concern.

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