In this post, we will be looking at how to treat fungal acne, or Malassezia, naturally. We will cover what fungal acne is, how to diagnose fungal acne and the steps you need to take to treat fungal acne without resorting to harsh or toxic chemicals.
Fungal acne is becoming more and more common in my virtual acne clinic. With adult acne on the rise, more and more people are resorting to harsh medication and skin care products to try and beat acne, which can unfortunately cause fungal acne, or make it worse. Luckily, I’m here to share with you the secrets on how to treat fungal acne naturally, without any harsh treatments or medication!
what is fungal acne?
Fungal acne, or Pityrosporum folliculitis or Malassezia folliculitis, is a skin condition when a specific genus of yeast called Malassezia, which in some individuals, causes an infection within the hair follicles. (1)(2) Unfortunately, Malassezia folliculitis appears very similar to acne so often gets misdiagnosed and can causes years of unnecessary treatment as most cases of fungal acne won’t respond to conventional acne treatment, and many acne treatments will actually make fungal acne worse! (3)
One of the reasons fungal acne can be confused with common acne is because the Malassezia yeast is a polymorphic, lipophilic microorganism. This means that it thrives and feeds on the lipid composition in sebum, in simple terms – it feeds off the oil in your pores! (4) Naturally, these oilier areas are susceptible to bacterial acne too, making it a difficult condition to diagnose.
fungal acne vs bacterial acne
I’ve already mentioned both types of acne, but learning the difference between fungal and bacterial acne is key to being able to treat your acne with the best possible methods for you.
Bacterial acne, also referred to as “hormonal acne” is caused by a strain of bacteria called P.acnes that lives on the skin. Various factors including hormone imbalances, stress and sugar can trigger sebum oxidisation which results in the excess production of keratin which creates a clogged pore that allows the P.acnes bacteria to thrive and result in an inflamed pimple.
Conventional treatments for bacterial acne include benzoyl peroxide, antibiotics and accutane.
Fungal acne, as I’ve mentioned already, is caused by a genus of yeast called Malassezia which also lives on the skin. The factors which can trigger fungal acne include excessive sweating, skin care products and long-term antibiotic use.
I believe that more and more cases of adult acne are a combination of both bacteria and fungal. In most cases, acne will start as bacterial acne but due to the conventional treatment of acne (a.k.a. the overuse of antibiotics and the contraceptive pill which destroy our gut bacteria), more and more women are developing fungal acne too. Luckily more and more of us are becoming aware of the negative impact that the contraceptive pill and antibiotics have on our gut and skin health but unfortunately this realisation usually occurs after years and years of struggling (and failing) to find the answer to our skin problems!
Hopefully this blog post and the rest of my fungal acne series will help you understand this condition and allow you to finally start treating fungal acne for good.
what causes fungal acne?
There are many different factors that can cause fungal acne but the main reasons are:
- Antibiotics (5)
- The contraceptive pill
- High sugar diet
- Extreme heat/sweat
- Certain skin care ingredients
- Non-breathable clothing
- Pregnancy (6)
- Steriod use
- High sebum production (7)
Medication such as steriod use, the pill and antibiotics can all cause fungal acne to develop as it alters the balance of skin flora and bacteria within out gut which can also Malassezia to grow out of control. (5) This is frustrating because the most commonly prescribed medication for bacterial acne is antibiotics! It’s rare that I have a client that HASN’T been on some form of antibiotic for their skin…how crazy is it that the medication prescribed to cure one form of acne could be causing another?!
Extreme heat, sweat and non-breathable clothing can pose a problem for fungal acne sufferers as specific strains of the Malassezia species thrive in hot, humid climates. (4) If you are someone who find their skin gets more congested during the hot summer months or during periods of excess exercise/sweating then you may benefit from implementing some of the natural fungal acne treatments outlined later on.
what does fungal acne look like?
As I’ve briefly mentioned, fungal acne is hard to diagnose because it looks JUST LIKE ACNE! Fungal acne tends to start off as tiny little bumps on oilier areas of the skin or areas that sweat more, remember I told you how Malassezia feeds off the oil in our skin so areas which are prone to oiliness or sweating are usually the first to experience fungal acne. The most common areas for fungal acne flare ups are:
- Hair line
The tiny bumps can develop into red pustules and papules (not cystic) – the kind of spots which are way too tempting to squeeze! So you can see how easy it might be to have both fungal AND bacterial acne. If you’re struggling with all types of spots – cysts AND congestion then some of your acne could be fungal.
how can you diagnose fungal acne?
The only concrete, 100% legit way to diagnose fungal acne is to have a shave biopsy and extraction of the area where you suffer the most. To get the most accurate results, you’ll want your dermatologist or doctor to extract some of the pus to analyse under the microscope, otherwise they’ll just be looking at the yeast growth on the surface of your skin, not what’s lurking deep inside the pore. However, as we’ve already covered a doctor is more likely to take one look at your skin and just prescribe you with antibiotics which will ultimately make your fungal acne worse!
So with this in mind, here are a few at-home tricks to diagnose fungal acne:
- Do you suffer from dandruff? The same genus of yeast that causes fungal acne also causes dandruff!
- Does your acne sometimes itch?
- Does it feel like ALL skin care products cause you to break out?!
- Your acne is so stubborn – you’ve literally tried everything and nothing really works!
- Your skin seems to get worse during the summer?
- Excessive sweating and synthetic clothing causes breakouts?
- Facial oils, especially coconut and olive oil, make your skin go crazy!
- You have “chicken skin” AKA Keratosis Pilaris on the backs of your arms?
All these factors could be a sign that some, or all of your acne is fungal! Not everyone suffers from ALL these symptoms. For me, I have always struggled with wearing synthetic clothing (bra straps are a nightmare for me), my forehead would get incredibly itchy and bumpy during the warmer months, I always had mild Keratosis Pilaris on my arms despite eating plenty of fat and vitamin A and my skin always improved when I removed oils from my skin care routine…but I never get dandruff so just because you might not tick every single box, it doesn’t mean that your acne isn’t fungal.
how do you treat fungal acne?
Conventional treatments for fungal acne include topical anti-fungal cream and using anti-dandruff shampoo on your face that contain either 2% ketoconazole or zinc pyrithione and leaving it on your skin for 4-5 minutes before rinsing off.
However, anti-dandruff shampoos contain a whole host of ingredients that we shouldn’t be putting on our face! From SLS, which destroys our skin barrier to Methylisothiazolinone (MI) and parfum which are known to cause horrific skin allergies (8), I honestly don’t believe that using popular anti-dandruff shampoos are they best way forward when it comes to the treatment of fungal acne. Plus, if you’re still using the same skin care products and not working towards improving your gut microbiome then you’re never going to be in control of your fungal acne, you’ll just be constantly fighting it!
Treating fungal acne naturally and safely is both simple, yet incredibly difficult! It requires a strict regime (that’s the difficult bit) but once implemented, you should start seeing results in a 2-4 weeks!
The main changes are skin care related (yay! shopping time!) but there are dietary and lifestyle factors that should be considered too! As with most skin care concerns, your gut health is absolutely KEY to beautiful, radiant skin and as many cases of fungal acne are triggered by poor gut health due to antibiotic use, it’s important that you start reducing foods that are harmful to the gut, like sugar, refined grains and PUFA and START eating more foods that will heal your gut such as:
- Grass Fed Collagen
- Coconut Oil
- Bone Broth
As mentioned before, excessive sweating can also be a problem as certain strains of Malasezzia thrive in warm, damp conditions so showering as soon as possible after going to the gym or any other activity that gets you sweating is simple technique that may help treat fungal acne and keep it under control.
are there any supplements for fungal acne i can take?
Just like every other type of acne, there isn’t a magical supplement for fungal acne which will clear your skin overnight. Doctors will often prescribe anti-fungals but there are some natural remedies that can help clear up your skin from the inside out!
Probiotics have been used in the natural treatment of acne for years due to their positive effect on gut health and inflammation. However, not all probiotic supplements are created equal, and if you’re buying the cheapest available option then you’re unlikely going to see results!
It’s important that you choose the right type of probiotic for your skin, strains of probiotic which are scientifically proven to fight bacterial acne (in some cases more effective that antibiotics!) include Lactobacillus Acidophilus, Bifidobacterium bifidum and Lactobacillus reuteri. (9)
For fungal acne, the probiotic strain Lactobacillus paracasei has been studied and reported to be effective at reducing fungal acne and Malassezia that causes it. (10) With this information, you can now choose the right type of probiotic to treat acne! Below are a few recommendations which include the four strains of beneficial bacteria for fungal acne:
- Hyper Biotics Pro-15 (L.Acidophilus, B.Bifidum, L.Reuteri & L.Paracasei)
- Garden of Life for Women (L.Acidophilus, B.Bifidum, L.Reuteri & L.Paracasei)
- Ancient Nutrition SBO Probiotic (L.Paracasei)
- Kiki Health Body Biotics (L.Acidophilus & B.Bifidum)
- Elixir Probiotic (L.Acidophilus, B.Bifidum & L.Reuteri)
oil of oregano
Wild oil of Oregano is an ancient remedy that is highly effective against fungal infections such as athletes foot, ring worm, candida and oral thrush. Although there are no scientific studies that look specifically into oil of oregano for fungal acne, there is this study that shows improvement in dandruff when treated with oil of Oregano shampoo (11), as as we already know, dandruff and fungal acne are caused by the SAME genus of yeast! Plus, if it is effective on all these other fungal conditions then it must have some positive effect on fungal acne too.
Before you go and rub oil of oregano oil on your skin, DO YOUR RESEARCH! This stuff is highly potent and will causes severe burns and irritation if not used properly. Personally, I would be very wary of using oil of Oregano topically (there are much more effective topical solutions for fungal acne) and instead, take it as a supplement to treat fungal acne overgrowth from the inside out!
what skin care products are safe to use for fungal acne?
While we’ve covered gut health and some simple lifetsyle tweaks, the key change that is going to improve your fungal acne is upgrading your skin care routine. Now, if you are a skin care maven that is obsessed with trying out the latest beauty product, you may want to walk away and forget you ever started reading this post… Why? Because dealing with fungal acne from a topical perspective is pretty limited to say the least… I’m afraid to say that your favourite foundation or serum is likely going to be contributing to the bumps on your skin and in some cases may be the ONLY cause of your acne!
Your skin care routine is SO important for healing fungal acne that I’m actually writing an entire blog post just about skin care for malassezia. However, until that’s ready to go live, here is a quick round up!
Malasezzia, or fungal acne, is excruciatingly picky when it comes to skin care! You name it, fungal acne hates it! Oils? No way! Polysorbates? Definitely not! Fatty acids? Hell no! PEGs? Na-ah!
If you’re a long term sufferer of acne then it’s likely that you’ve explored using ‘oil-free’ skin care. Most of these skin care products will still contain ingredients that feed fungal acne such as:
- Sucrose Stearate
- Glyceryl Stearate
- Stearic Acid
- Palmitic Acid
- Myristic Acid
- PEG-100 Stearate
- Behenic Acid
- Sodium Cocoyl Isethionate
- Sodium Methyl Cocoyl Taurate
- Ethyl Linoleate
- Polysorbate 20
- Polysorbate 80
This is by NO MEANS a full list of danger ingredients, this is literally just a random selection of problematic ingredients I found in 10 popular skin care products that are “oil-free” and claim to be suitable for acne! It took me about 10 minutes to find those ingredients online so I can guarantee some will be hiding in your routine too and we haven’t even covered OILS yet!
Unfortunately, pretty much all base oils are an issue if you have fungal acne, regardless of whether they score 1 or 3 on the comedogenic chart. There are two (yes…only two!) plant-based oils which are suitable for fungal acne and they are:
- Squalane (my favourite!)
- MCT Oil (C8/C10)
So…you can see how finding suitable skin care for fungal acne can be tricky! Luckily, I’ve started compiling a resource of non-toxic skin care products that ARE totally and 100% safe for treating fungal acne. You can find this page here.
I will be going into more details on all these ingredients in my dedicated skin care post but in the meantime, you can check out my list of tried and trusted skin care products that are 100% fungal acne safe – view this post here.
Are you currently struggling with Malassezia? What natural methods are you exploring to treat fungal acne? Let me know in the comments below!
Peace, Love & Clear Skin
- The Malassezia Genus in Skin and Systemic Diseases, G, Gaitanis
- Immunology of Diseases Associated with Malassezia Species, H, Ashbee
- Acneform Eruption Resulting From Antibiotic Administration, P, Weary
- Malassezia—Can it be Ignored?
- Malassezia (Pityrosporum) Folliculitis Treatment & Management
- Malassezia (Pityrosporon) Folliculitis Occurring During Pregnancy
- Malassezia folliculitis, Dr A Oakley
- Contact dermatitis to methylisothiazolinone
- The effect of probiotics on immune regulation, acne, and photoaging
- The positive benefit of Lactobacillus paracasei NCC2461 ST11 in healthy volunteers with moderate to severe dandruff