The primary difference between acne and fungal acne lies in the causative agent: acne is caused by bacteria, oil, and dead skin cells, while fungal acne is caused by a yeast (a type of fungus).
Understanding Acne
Regular acne, also known as acne vulgaris, occurs when hair follicles become clogged with:
- Dead skin cells: These cells shed naturally, but sometimes accumulate within the follicle.
- Sebum (oil): Produced by sebaceous glands, sebum keeps the skin moisturized. Overproduction can lead to clogged pores.
- Bacteria: Specifically, Cutibacterium acnes (formerly Propionibacterium acnes) which thrives in clogged follicles, causing inflammation.
This blockage leads to the formation of various types of acne lesions, including:
- Whiteheads: Closed comedones (blocked pores)
- Blackheads: Open comedones (blocked pores)
- Papules: Small, raised, inflamed bumps
- Pustules: Papules with pus
- Nodules: Large, painful, solid lumps under the skin
- Cysts: Large, painful, pus-filled lumps under the skin
Understanding Fungal Acne
Fungal acne, or Malassezia folliculitis, arises from an overgrowth of Malassezia yeast within the hair follicles. This yeast is a normal part of the skin's microbiome, but certain conditions can cause it to proliferate excessively. These conditions include:
- Hot and humid environments: Yeast thrives in warm, moist conditions.
- Occlusive clothing: Restricts airflow and traps moisture against the skin.
- Weakened immune system: Makes you more susceptible to fungal overgrowth.
- Antibiotic use: Can disrupt the balance of bacteria on the skin, allowing yeast to thrive.
Fungal acne typically presents as:
- Small, uniform papules: These bumps are often itchy and of similar size.
- Pustules: Similar to bacterial acne, but usually smaller and more uniform.
- Location: Commonly found on the chest, back, and upper arms, but can also appear on the face.
Key Differences in a Table
| Feature | Acne (Acne Vulgaris) | Fungal Acne (Malassezia Folliculitis) |
|---|---|---|
| Cause | Bacteria (Cutibacterium acnes), oil, dead skin | Malassezia yeast |
| Appearance | Varied lesions (whiteheads, blackheads, etc.) | Small, uniform papules and pustules, often itchy |
| Location | Face, neck, chest, back | Chest, back, upper arms, sometimes face |
| Triggers | Hormones, genetics, diet, stress | Heat, humidity, occlusive clothing, antibiotics, immunosuppression |
| Treatment | Topical retinoids, benzoyl peroxide, antibiotics | Antifungal creams or shampoos |
Treatment Considerations
Due to the different causes, treatments for regular acne are often ineffective for fungal acne. In fact, some acne treatments, such as antibiotics, can even worsen fungal acne by killing beneficial bacteria that help keep the yeast in check. Consulting a dermatologist is recommended for accurate diagnosis and appropriate treatment. For fungal acne, antifungal shampoos or topical creams are usually prescribed.
