Skin Care

Malassezia Folliculitis vs Regular Acne: What’s The Difference?

Sabrina Perkins

Malassezia folliculitis, more commonly referred to as ‘fungal acne’ is a skin condition caused by an overgrowth of a dimorphic yeast called Malassezia. Although it’s normal to have these fungi living on our skin, for some people it can manifest in different types of skin conditions.

In this blog post, we’ll be talking about the difference between malassezia folliculitis and regular acne, what causes it, how it presents, and how to treat it.

What is Malassezia?

Malassezia is a dimorphic yeast that lives on our skin. If you were to take a sample of skin and look at it under a microscope, you’d be able to see this organism, which also goes by other names such as Malassezia furfur, Malassezia globosa, and Piterosporum ovale. Although it’s normal to have these organisms living on our skin, they can cause problems for some people.

What Skin Conditions Are Related to Malassezia?

Two of the most common skin conditions related to malassezia are seborrheic dermatitis and tinea versicolor.

Seborrheic dermatitis is essentially like dandruff plus a little more, while tinea versicolor is a fungal infection that causes lighter or darker patches of skin on the trunk, usually noticed in the summer. There are also other uncommon entities that have been implicated as well.

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How Do You Treat Fungal Acne?

If you’ve been dealing with acne, it may be time to reconsider or rethink your approach. Acne can be caused by a variety of factors, including fungal acne or malassezia folliculitis. It’s important to understand the difference between regular acne and malassezia folliculitis in order to properly treat it.

Step 1: Get Proper Diagnosis

Fungal acne is uncommon enough that it’s important to let a doctor make the diagnosis. In the office, the doctor can scrape the area and add a little potassium hydroxide to the slide to visualize the yeast on the skin.

Step 2: Start Treatment

Once the diagnosis has been made, it’s time to start treatment. A good first attempt is to use a 1% over-the-counter ketoconazole shampoo. If the problem is widespread, it’s best to use an oral anti-fungal medication, such as fluconazole.

Step 3: Use Maintenance

After the oral therapy, most people can back down and then use topical treatments as maintenance. It’s important to treat your acne on top of it, as you may need to do something to keep it at bay.

If you’re still unsure of how to treat your fungal acne, be sure to talk to a board certified dermatologist. For more information, check out Hiram’s video on fungal acne or malassezia folliculitis.


What is fungal acne?

Fungal acne, also known as malassezia folliculitis, is a skin condition caused by an overgrowth of the yeast malassezia, which is found naturally on the skin. It can cause red, itchy bumps on the skin, usually on the chest, back, and shoulders. It is important to note that fungal acne is not the same as regular acne and requires different treatment.

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How do you treat fungal acne?

The most common treatment for fungal acne is an antifungal medication, such as ketoconazole or fluconazole. Topical treatments such as ketoconazole shampoo and creams may also be used. Additionally, a doctor may recommend using a topical retinoid or antibiotic to help reduce inflammation and prevent further infection.

How can I prevent fungal acne?

The best way to prevent fungal acne is to keep your skin clean and dry. Avoid using harsh soaps or cleansers that can strip away the skin's natural oils. Wear breathable clothing and avoid wearing tight fitting clothing that can trap sweat and moisture against the skin. Additionally, showering after sweating can help to keep skin clean and dry.

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