Fungal vs. Bacterial Acne

Acne is a common skin condition that affects people of all ages.

And while there are different grades by which severity of acne is measured, there are two most common types that often look similar to one another but are caused by two different strains of living organisms.

These two are known as fungal and bacterial acne, and besides being caused by different components, they also require different therapies to be treated.

Therefore, in this article, we will discuss the differences between fungal and bacterial acne, how to differentiate them, and what are the best available treatments for both conditions.

What is Fungal Acne?

Fungal acne or Malassezia folliculitis is caused by an inflammatory reaction to Malassezia yeasts. Besides “fungal acne,” this condition also has another name: Pityrosporum folliculitis.

Pityrosporum folliculitis means “inflammation of the hair follicles,” and this condition occurs when yeast molecules of the genus Malassezia get into the hair follicles and proliferate, creating an acne-like rash on the skin.

The Malassezia yeast is naturally present on the skin of an estimated 92% of the world’s population.

Therefore, besides being capable of causing some skin concerns, the yeast is actually a neutral component until certain factors such as changes in the skin’s pH cause it to become opportunistically harmful.

This condition is relatively rare compared to bacterial acne and can often be mistaken for regular acne because it shares a few of the same symptoms.

Fungal acne usually appears on the face, chest, and back as small red bumps that are often itchy. The bumps can also be filled with pus but are generally painless.

Fungal acne breakouts are most commonly seen in people who have oily skin but can also occur in people with dry or normal skin types that have underlying skin conditions such as diabetes, HIV, Hodgkin’s disease, as well as those with nutritional disorders and immunologic deficiencies.

What is Bacterial Acne?

Bacterial acne is a type of acne that is caused by an inflammatory reaction to an overgrowth of a bacteria strain known as Cutibacterium acnes inside the pores.

When the pores get clogged with a buildup of sebum and dead skin cells, this specific strain of bacteria that already lives on healthy skin finds its perfect conditions where it can feed on the cellular debris and proliferate in the airless environment.

Once your immune system detects the overgrowth of bacteria, it recognizes it as something harmful and starts fighting against it by creating inflammation and sending white blood cells to the inflamed area.

This “fight” manifests itself on the skin as larger, often pus-filled pimples.

However, when this gets out of hand, the problem starts going deeper, resulting in large, painful cysts that don’t have a pus-filed head but instead appear as discolored lumps under the skin.

Bacterial acne, much like fungal acne, usually appears on the face, chest, and back and affects people of all ages and skin types.

However, people with oily skin and those with underlying conditions such as hormonal imbalances, nutritional deficiencies, diabetes, and food intolerances usually have a higher predisposition to experiencing bacterial acne.

Bacterial lesions will usually be inflamed and redder around the edges, and it also appears somewhat flatter than fungal acne.

What is The Difference Between Fungal and Bacterial Acne?

There are several differences between fungal and bacterial acne, but the main ones include the components that cause them and the appearance of the lesions.

As we already mentioned above, fungal acne is caused by an overgrowth of yeast inside the pores, while bacterial acne is caused by an overgrowth of bacteria inside the pores.

Additionally, fungal acne often appears in clusters and manifests itself as small, itchy bumps.

Bacterial acne, on the other hand, can be non-inflammatory (such as open and closed comedones,) pustular (an inflamed pimple with a white head,) papular (an inflamed pimple without a white head,) and cystic (larger and often discolored lump.)

How Do You Know Which Type of Acne You Have?

Understanding the difference between bacterial acne and fungal acne mainly requires you to be able to spot the differences in their appearance.

However, if you’re not sure which type of acne you have by just looking at it, there are other ways to determine the condition you may be dealing with.

The most commonly applied method to determine the type of acne would be performed by a doctor and involves scraping the flared-up areas and sending a sample to a lab.

Another, more accurate way to determine your condition is to have a microbiologist extract a comedone and analyze the DNA using a real-time PCR system.

All that said, the two types of acne often travel together, so there is a good possibility that you have a combination of both, especially if you are dealing with moderate or severe acne that spans over larger areas of the face and body.

Best Treatments for Bacterial Acne

Bacterial acne can be treated with various antibiotics, but it’s also manageable with topically-applied products.

The best over-the-counter treatments for bacterial acne include:

Salicylic Acid

Salicylic acid is an exfoliating acid and a keratolytic agent that travels deep inside the pores to dissolve the cellular debris that’s causing bacterial overgrowth.

But besides that, salicylic acid also has anti-inflammatory and soothing properties that can help relieve redness and irritation caused by inflammation.

Benzoyl Peroxide

Benzoyl peroxide is an oxygenating agent that infuses the clogged pore with oxygen and thus destroys the airless environment bacteria need to survive.

Besides that, benzoyl peroxide is a mildly keratolytic agent that helps stabilize the cellular turnover and prevent excess dead skin cells from clogging up the pores.

Retinoids

Retinoids are a class of chemical compounds derived from vitamin A that have been used in dermatology in various strengths to treat a wide range of skin concerns, including bacterial acne.

Retinoids work by speeding up the cellular turnover and pushing the dead skin cells to the skin’s surface at a faster rate, thus preventing them from stagnating and remaining stuck inside the pores where they would serve as food for bacteria.

Best Treatments for Fungal Acne

Fungal acne is a much more challenging condition to tackle with topicals due to its ability to resist standard acne treatments.

Anyone who reads this blog knows we advocate improving your nutrition to clear your skin before buying any products or paying anyone for a medical procedure. Fungal acne is no different, however, there are several types of facial cleansers that can help clear fungal acne breakouts. These cleansers will help stop the spread of yeast overgrowth on your skin, which will speed up the healing and recovery process for your fungal acne

However, besides its tough and durable nature, yeast overgrowth can be neutralized with several ingredients, including:

Sulfur

Sulfur is naturally antibacterial and anti-fungal, allowing it to regulate fungal or yeast production and remove it from the clogged pores.

Sulfur usually comes in products intended for short-contact therapy, such as cleansers, facial pads, and masks, and should be left on the skin for a short time due to its potential to cause irritation on an already compromised skin.

Ketoconazole

Ketoconazole is an anti-fungal component found in shampoos that are used to neutralize the overgrowth of fungus or yeast on the scalp.

These shampoos can also be used on the face as a short-contact therapy to decrease yeast overgrowth.

However, even though they are generally considered safe, shampoos that contain ketoconazole can be too drying for the face, so it’s best to proceed with caution and not overdo this treatment.

Additionally, make sure to always follow up with a lightweight, non-comedogenic moisturizer that will protect your skin from becoming dry and irritated.

Anti-Fungal Lotions & Moisturizers

Anti-fungal lotions are prescription products that contain at least one or a combination of anti-fungal components such as econazole, clotrimazole, ciclopirox olamine, and selenium sulfide.

Your doctor will likely advise you to use one of these once or twice a day for a short period before starting you on oral anti-fungal therapy if the topical option gives unsatisfactory results.

If you are looking for a fungal acne-safe moisturizer it is important that you use a moisturizer that is also compatible with your default skin type.

Are There Any Home Remedies for Treating Fungal and Bacterial Acne?

Both fungal and bacterial acne can be challenging conditions to deal with, and they can persist for a long time if not adequately addressed.

However, besides many over-the-counter and prescription options, you can also look into these home remedies for treating fungal and bacterial acne:

Zinc

Zinc can be an effective treatment for fungal and bacterial acne due to its ability to minimize irritation, strengthen the skin barrier, and help it defend itself better from inflammatory flare-ups.

Zinc can be beneficial in both supplement and topical form; therefore, it’s really up to you to choose the option that works better for your individual needs.

Witch Hazel

Witch hazel is an effective anti-bacterial ingredient found in many skincare products. It helps balance out oil production and thus slow down the food supply for the acne-causing bacteria.

Additionally, witch hazel contains antioxidant components that protect the skin oil from oxidation and help stabilize the skin’s pH.

This will also help neutralize the overgrowth of the Malassezia yeast since this particular strain needs oxidized oil in order to survive and proliferate.

Honey

Honey is another excellent home remedy for acne. Its antibacterial and anti-inflammatory properties help soothe inflammation on the skin and minimize those angry, irritated pimples caused by both bacteria and yeast overgrowth.

Honey is abundant in fatty acids, amino acids, peptides, antioxidants, and B vitamins, which are all components the skin needs in order to remain clear, balanced, and healthy.

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Analyzed by Simone Sydel

I am a certified Esthetician as well as a skincare, beauty, and wellness writer, and an expert in oily and acne-prone skin. Having been through the struggles of having acne for a good portion of my life, I understand exactly what needs to be done to achieve an acne-free, flawless complexion and change the perspective through which we see acne. I am a firm believer that acne doesn't show up on our skin to destroy our lives but to teach us important lessons on stepping back, being patient, and treating our skin with kindness before everything else. This is why I've made it my life's mission to educate people on taking good care of their skin and achieving their skin goals. I am passionate about sharing my professional and personal insights with those struggling with problematic and acne-prone skin, and I have helped hundreds of clients and thousands of readers make better choices with their skincare products through my private practice and my online platforms. Read more of Simone's articles.


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