Fungal Acne vs. Closed Comedones

Bacterial acne is easy to recognize. As soon as you look in the mirror and see a red, swollen patch, you know you’ll be dealing with this for the next few days.

However, not all types of acne are easily distinguishable, and a few strains of this common condition are caused by different factors and require different types of treatments to clear your skin.

An excellent example are those bumpy spots that just seem to pop out of nowhere and increase in numbers, commonly described as fungal acne or closed comedones.

So, how are the two different from one another if they look similar? And how can you tell which one you are dealing with?

For starters, fungal acne (also known as Malassezia folliculitis) is caused by an accumulation of yeast in your hair follicles and is often mistaken for acne because of its similar appearance. It usually appears as tiny bumps on the forehead, back, chest, and shoulders.

Closed comedones, on the other hand, are caused by clogged hair follicles. Unlike fungal acne, these bumps are typically flesh-colored or white and are not painful or itchy.

Also, unlike fungal acne, which can be treated with antifungal medications, closed comedones are typically treated with over-the-counter treatments.

This is why knowing the difference is essential, and in this article, we will explain everything you need to know about fungal acne vs. closed comedones, two conditions that can appear as bumps and breakouts and can look similar in some circumstances but are entirely different from one another, and we will also provide various treatment options that will help you banish them forever.

What is Fungal Acne?

Fungal acne is an inflammatory condition caused by the yeast Malassezia, an endogenous strain that colonizes the skin in a favorable environment and overgrows by using the oils our skin produces naturally as food and fuel to thrive.

Incapable of synthesizing its own fatty acid but needing these components to survive, the Malassezia yeast gets into the hair follicles of our skin and uses our natural oils to build its own mid-length and long-chain fatty acids to thrive and proliferate.

This action usually leads to symptoms on the skin soon after the yeast has colonized and produced its own fatty acids.

Fungal Acne Symptoms

While fungal acne may seem complicated and scary, especially because it’s different from common bacterial acne, it’s still easy to differentiate and recognize.

Fungal acne can be recognized by following the pattern of the growth and placement of the occurring breakout.

For example, areas that are more active in oil production are the ideal placement for the yeast to thrive, so this area tends to be most commonly affected, unlike common bacterial or hormonal acne that typically occurs on the jawline.

With that said, here are a few symptoms to look for that will make it easier to differentiate fungal acne from bacterial acne:

  • Clusters of tiny bumps.
  • Redness.
  • Scaliness.
  • Itchiness.
  • Excessive oiliness.

Best Treatment Options for Fungal Acne

Fungal acne might be a challenging condition to treat, but there are many excellent ways to tackle it.

Here are some of the best treatment options for fungal acne:

Exfoliate Regularly

Regular exfoliation will reduce the yeast’s food source by keeping the pores clear of cellular debris accumulation, thus reducing its food source and eventually starving it.

Try Prescription-Strength Acne Medications

Prescription-strength acne medications such as tretinoin and tazarotene, which is the strongest topical retinoid available that’s primarily used to address skin concerns such as acne and psoriasis and can be effective at reducing the inflammation and redness caused by fungal acne.

Avoid Clogging Ingredients in Cosmetics

Cosmetic products that contain high concentrations of emollients, stearates, silicones, and oils are often behind the formation of fungal acne as these ingredients can get stuck inside the pores, blocking the natural oil flow and contributing to the overgrowth of yeast over time.

Because of this its important to review the cosmetic products you use on your skin and hair, and try to spot potentially fungal acne triggering ingredients that could exacerbate this condition that you might need to remove from your routine. If you want to review the products in your skincare routine to ensure they are safe for fungal acne, you can check them in this fungal acne skincare ingredient analyzer.

Check for Hormonal Changes

Hormonal abnormalities, such as increased androgen activity, can often cause excessive oil production, leading to yeast overgrowth if not addressed.

Therefore, checking for hormonal changes through blood tests may be a good idea if you suspect your skin issues might be related to an internal imbalance.

Avoid Excessive Use of Antibiotics

Antibiotics disrupt the natural balance of the skin microbiome and can contribute to yeast overgrowth by killing off beneficial bacteria that would otherwise keep Malassezia in check.

Both short and long-term use of antibiotics can lead to fungal overgrowth; therefore, if your skin started flaring up after a course of antibiotics, this might’ve triggered the condition.

Best Active Ingredients for Treating Fungal Acne

Fungal acne can be stubborn and difficult to treat and can take a long time to go away.

However, luckily, there are quite a few ingredients found in common over-the-counter and prescription products that can help soothe and reduce its severity.

Here are the best active ingredients for treating fungal acne:

  • Ketoconazole: an antifungal agent found in prescription-strength and over-the-counter shampoos and ointments that destroys yeast by causing holes in their cell membranes, essentially allowing vital constituents of the cells to leak out.
  • Glycolic Acid: an exfoliating acid that dissolves the proteins that hold dead skin cells together on the skin’s surface, causing them to shed rapidly and preventing the buildup of dead skin cells to relieve inflammation caused by yeast overgrowth.
  • Salicylic Acid: an oil-soluble component that penetrates the skin and dissolves the accumulated debris, which is responsible for clogging the pores and enabling the formation of fungal acne.
  • Adapalene: an over-the-counter retinoid specifically formulated to tackle acne, adapalene works by binding with retinoid receptors in the skin and promoting increased cellular turnover, which helps reduce the accumulation of dead skin cells inside the pores and reduces the chances for comedones and fungal acne.

Best Way to Prevent Fungal Acne

Preventing fungal acne is definitely easier than treating it once it appears, and following a few simple rules will help you maintain healthy and balanced skin that won’t become a favorable environment for yeast to grow.

One of the first things you need to pay attention to is having excellent hygiene and keeping your skin clean at all times.

This means washing your face twice daily using a gentle cleanser that suits your skin and doesn’t leave it feeling stripped, tight, and dry after cleansing.

Additionally, introducing a hydrating moisturizer that will replenish some of that lost hydration after cleansing is another excellent way to keep your skin plump and supple without adding too much oil and making it look and feel greasy.

Furthermore, avoid cosmetic products that contain comedogenic ingredients, as these can often create a favorable environment for yeast to grow and proliferate.

Finally, try to steer clear of using antibiotics and other medications for a prolonged period as they are known contributors to fungal overgrowth and infections.

By following these simple steps, you should be able to maintain clear and healthy skin and keep fungal acne away for good!

What Are Closed Comedones?

Closed comedones are commonly known as whiteheads and occur when the plug inside the pores made of cellular debris and excess oil becomes stuck and can’t push through to the skin’s surface because there’s a thin layer of skin covering it and causing it to look like a bump rather than a pimple.

Closed comedones can become inflamed pimples if not treated in time, but they can also dissolve on their own and disappear after a while.

Types of Comedones

Besides closed comedones, there are two other types of comedones that frequently appear on the skin in the case of cellular debris inside the pores.

The two other types of comedones include:

  • Microcomedones: comedones that cannot be seen with the naked eye and occur with minor clogging of the hair follicles with oil, dead skin cells, and other forms of cellular debris.
  • Open comedones: commonly known as blackheads that occur when the plug inside the pores made of sebum, dead skin cells, and other cellular debris oxidizes at the tip and becomes black through being exposed to air.

Like closed comedones, both microcomedones and open comedones can develop into inflamed acne lesions if not addressed adequately and in time through an efficient skincare routine or medications.

How to Treat Closed Comedones?

Closed comedones can be treated in several different ways, and here are the most effective ways to tackle them:

Exfoliate Regularly

Regular exfoliation is the best way to treat closed comedones because most exfoliating agents, such as acids and enzymes, have excellent debris-dissolving properties that will help remove the cellular debris causing the closed comedones and prevent future buildup.

Try Prescription-Strength Acne Medications

Prescription-strength acne medications such as tretinoin, tazarotene, and even antibiotics such as clindamycin ointments can be highly effective at treating closed comedones, especially if they are clustered or become inflamed quickly.

Avoid Clogging Ingredients in Cosmetics

Avoiding clogging ingredients in cosmetics might not be the treatment that will work the quickest, but it is the best long-term option for getting rid of existing clogged comedones and preventing the formation of new ones.

Clogging ingredients in cosmetics can not only contribute to the formation of non-inflamed bumps, such as closed comedones but can also exacerbate the inflammation process and lead to inflamed pimples and cysts.

Therefore, removing products containing ingredients such as stearates, silicones, and oils from your routine can normalize the skin’s oil flow and encourage closed comedones to dissolve on their own while minimizing the chances of new ones forming in the future.

Best Way to Prevent Closed Comedones

The best way to prevent closed comedones is to adopt a gentle, non-stripping skincare routine consisting of ingredients such as exfoliating acids and enzymes that regulate the skin’s oil production and dissolve the cellular debris that gets stuck inside the pores.

Additionally, lightweight and non-comedogenic moisturizers are also needed, as dehydration can be a common trigger for closed comedones; therefore, hydrating your skin without potentially clogging the pores is another excellent way to keep this pesky condition at bay.

Finally, applying a protective layer of sunscreen daily can be another great way to prevent closed comedones, as this condition can also be triggered by environmental pollutants that stick to the skin and remain inside the pores, contributing to the formation of clogs.

A sunscreen can counteract this by creating a physical barrier between the skin and pollutants, thus preventing them from sticking to your complexion and reducing the chances of closed comedones forming in the first place.

Fungal Acne vs. Closed Comedones

Fungal acne and closed comedones are often confusing to tell apart because when the skin doesn’t look red and inflamed, the bumps can look very similar.

However, these two conditions are entirely different and thus require different treatment approaches to be eliminated.

Fungal acne is an inflammatory skin condition caused by an imbalance in the skin’s microbiome and overgrowth of yeast, while closed comedones are usually caused by a buildup of cellular debris inside the pores.

Now, while closed comedones frequently accompany fungal acne due to buildup inside the pores, this condition usually requires the use of antifungal treatments along with a very diligent skincare routine and even the use of oral antifungals to be treated.

On the other hand, closed comedones, although they might accompany fungal acne in some cases, usually show up on their own and require making much less complex tweaks in your beauty routine, such as avoiding pore-clogging ingredients in cosmetics and using products with exfoliating acids to dissolve the cellular debris that gets stuck inside the pores.

Ultimately, both conditions require a highly customized approach depending on one’s skin type and condition, so learning to identify them correctly is essential as it will help you tackle them effectively with over-the-counter products or professional treatments.

Frequently Asked Questions

Can You Have Fungal Acne and Closed Comedones at The Same Time?

Fungal acne may often be accompanied by closed comedones, which is a sign of clogged pores and plays a role in exacerbating the condition.

Can You Squeeze Fungal Acne?

Fungal acne might look like red or white bumps that can be pus-filled but squeezing them won’t work because they don’t typically come to a head, as opposed to other forms of acne.
This means that addressing the underlying cause of fungal acne, which is an overgrowth of yeast, is a more efficient action plan, as squeezing can not only be frustrating but can lead to bruising, bleeding, inflammation, and infections.

How to Tell The Difference Between Fungal Acne and Clogged Pores?

The biggest difference between fungal acne and clogged pores is that fungal acne is usually itchy and looks inflamed compared to clogged pores that may look bumpy but generally don’t itch and doesn’t usually have redness and inflammation.

Can You Squeeze Closed Comedones?

Closed comedones should never be squeezed because the bumps are covered by a layer of skin that needs to rupture for the cellular debris to spill out.
This means that once ruptured, the skin will have an open wound, making it easy for other strains of bacteria to enter and cause even more inflammation and infections.

Originally Published: April 19, 2023

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Analyzed by Simone Sydel

Hi, I’m Simone Sydel, a licensed esthetician and acne expert dedicated to helping others solve their skin issues including acne, eczema, and UV damage. I specialize in testing and reviewing the latest acne treatments and beauty products, offering honest, practical advice for skincare. I’ve helped hundreds of clients clear their skin and my skincare product reviews have been read by several hundred thousand people. Thanks for visiting!

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