This post was reviewed and updated by Sarah Otto, Dermatology Nurse Practitioner and Founder of Otto Skin Goods on August 27, 2026.
We've all experienced it: you glance in the mirror one morning and spot the beginnings of a breakout. The instinct is to reach for acne-fighting ingredients—exfoliants, oil-reducing formulas, bacteria-fighting treatments. It seems like the logical response.
But it isn't always the right one. Applying a full arsenal of acne products can actually make things worse, depending on the underlying cause. The culprit may not be bacteria at all. It may be fungal acne.
Conventional and hormonal acne are both triggered by bacterial activity. Fungal acne is different. Though it can look nearly identical to bacterial breakouts, it's actually caused by an overgrowth of malassezia, a naturally occurring yeast on the skin. This overgrowth is often triggered by a warm, moist environment, like a sweaty workout, or by a disruption to the bacteria that normally keeps yeast levels in balance. Because the cause is different, most over-the-counter acne treatments won't resolve it, and can sometimes aggravate it further.
So how can you tell the difference between the two? Below, we break down what to look for.
Although the two conditions can look eerily similar, there are a few key distinctions to keep in mind:
- Shape and size. Fungal acne tends to be more uniform in appearance, typically around one millimeter in size.
- Texture. It often appears as red or white bumps that can be pus-filled, but unlike bacterial acne, they rarely come to a head—so resist the urge to pop them.
- Location. While fungal acne can appear on the face, it's more commonly found on the chest, shoulders, and back, often in clusters.
- Sensation. Fungal acne tends to be itchy, whereas bacterial acne is typically more painful than itchy.
If this sounds like it could be describing your skin, don't worry—fungal acne is very manageable once you know what you're dealing with. Here are a few ways to prevent and treat it.
1. Add sulfur.
Sulfur has long been a reliable remedy for acne, though it rarely gets the recognition of more popular ingredients like salicylic acid or benzoyl peroxide. Here's why it deserves more credit: sulfur is one of the few acne-fighting ingredients effective against both bacterial and fungal breakouts. Look for an acne-drying treatment with 20% sulfur, or a formula combining colloidal sulfur with salicylic acid.
2. Consider cleansing with a dandruff shampoo.
Ketoconazole is an over-the-counter topical antifungal, typically found in dandruff shampoo at a 1% concentration. Try cleansing affected areas a few times a week with Nizoral, which contains 1% ketoconazole. Head and Shoulders and Selsun Blue are also worth considering, as both contain pyrithione zinc or selenium sulfide—ingredients known to help keep yeast overgrowth in check.
3. Keep up with exfoliating.
Because fungal acne originates in the hair follicles, regular exfoliation is essential to prevent fungus from becoming trapped and triggering new breakouts. Our Multitasker Night Serum is an effective option, and incorporating exfoliating wipes with 20% glycolic acid can help as well. Since moisture tends to worsen fungal acne, timing matters: apply the Multitasker before a workout, or use an exfoliating pad afterward, to help keep sweat from settling into the hair follicles.
If breakouts haven't improved within three weeks, it's worth consulting a dermatologist. Fungal infections within the hair follicle can sometimes be resistant to topical treatment alone, and a doctor may recommend an oral medication instead. Because recurrence is common, continuing to use a dandruff shampoo periodically as a cleanser can help keep it from coming back.
The bottom line: the biggest mistake you can make with fungal acne is treating it like bacterial acne, since conventional acne products can make the condition worse. When in doubt, see a dermatologist for an accurate diagnosis and treatment plan.
Frequently Asked Questions
How do I know if it's fungal acne or bacterial acne?
Fungal acne tends to appear as small, uniform bumps, about one millimeter, that are often itchy rather than painful. It's more common on the chest, back, and shoulders, and typically shows up in clusters. Bacterial acne varies more in size and shape, is usually more painful than itchy, and often comes to a head. If you're unsure, a dermatologist can confirm the cause.
What causes fungal acne?
Fungal acne is caused by an overgrowth of malassezia, a yeast that naturally lives on the skin. This overgrowth is often triggered by a warm, moist environment, like sweat from a workout, or by a disruption to the skin's natural bacteria, which normally helps keep yeast levels balanced.
Why don't regular acne products work on fungal acne?
Most over-the-counter acne treatments are designed to target bacteria, not yeast. Since fungal acne has a different underlying cause, these products often don't resolve it—and in some cases, can make it worse.
Can I treat fungal acne at home?
Yes, in many cases. Ingredients like sulfur, ketoconazole (found in dandruff shampoos like Nizoral), and gentle exfoliants can help manage fungal acne. Cleansing affected areas with a dandruff shampoo a few times a week and maintaining a consistent exfoliation routine are both effective starting points.
When should I see a dermatologist?
If your breakouts haven't improved after about three weeks of at-home treatment, it's a good idea to check in with a dermatologist. Fungal infections in the hair follicle can sometimes require an oral medication rather than a topical treatment alone.
Does fungal acne come back?
It can. Recurrence is common, especially in warm or humid conditions. Periodically using a dandruff shampoo as a cleanser, even after symptoms clear, can help reduce the chances of it returning.
Can I pop fungal acne bumps?
No. Unlike bacterial acne, fungal acne bumps typically don't come to a head, so popping them won't help and may irritate the skin further.
