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Fungal Acne vs Hormonal Acne

Written by Andrew Le, MD

UpdatedMarch 3, 2024

Acne is a common skin condition that is caused by a combination of oily skin, clogged pores, and bacteria. But there are a couple of types of acne that have more specific causes and treatments. These are called fungal acne and hormonal acne.

In this article, we will explore the differences between fungal acne and hormonal acne, including their causes, symptoms, and treatment options.

What Is Acne?

Acne is a common skin condition that causes breakouts on the skin's surface.

It is an umbrella term for pimples, blackheads, whiteheads, and cystic acne. It is usually caused by blocked hair follicles with oil and dead skin cells. These breakouts often cause inflammation, leading to redness, swelling, and discomfort. Acne not only affects skin health but can also impact your self-esteem, especially when breakouts are persistent.

What Are the Different Types of Acne?

Different types of acne include:

  • Bacterial acne, which is when skin bacteria contributes to pimples and inflammation.
  • Cystic acne causes deep, painful cysts beneath the skin's surface.
  • Nodular acne looks like large, inflamed lesions that can be severe.
  • Papules, which are small, red bumps on the skin.

Each type varies in severity; while bacterial acne can often be managed with topical treatments, cystic and nodular acne may require prescription medications like isotretinoin for effective treatment.

What Is Fungal Acne?

Fungal acne is a skin condition caused by an overgrowth of fungus that causes breakouts on the skin.

The fungus thrives on oily skin, created by the body's sebaceous glands, which produce natural oils to keep the skin moisturized. When these oils get trapped in clogged pores, it provides the perfect breeding ground for fungal acne to develop.

Fungal acne typically looks like small, uniform bumps on the skin that may itch or burn,

Unlike bacterial acne, fungal acne does not respond well to traditional acne treatments because it is not caused by bacteria. It's important to get an accurate diagnosis if you think you have fungal acne, so that you can get an effective treatment.

What Causes Fungal Acne?

Fungal acne is caused by excess sebum production and fungal overgrowth on the skin's surface. It is often triggered by environmental factors like humidity and excessive sweating, creating an ideal breeding ground for fungal infections. Poor skin care practices may worsen the issue.

How Is Fungal Acne Different from Bacterial Acne?

Fungal acne, also known as Malassezia (Pityrosporum) folliculitis, is triggered by an excess of yeast on the skin. Unlike bacterial acne, which looks like inflamed red bumps, fungal acne typically looks like uniform, tiny, itchy papules. Fungal acne is treated with antifungal medications such as ketoconazole, while bacterial acne is commonly treated with antibiotics like clindamycin or benzoyl peroxide.

What Is Hormonal Acne?

Hormonal acne is a skin condition often triggered by hormonal imbalances in the body.

These fluctuations in hormones, particularly androgens like testosterone, can lead to an increase in sebum (oil) production, clogging pores and causing acne breakouts. It tends to occur on the jawline and chin, which have a higher concentration of oil glands.

Factors such as stress, poor diet, and hormonal changes during puberty or menstruation can cause hormonal acne. It is helpful to be aware of these underlying causes so that you can make lifestyle modifications and adjust your skincare routines to help.

What Causes Hormonal Acne?

Hormonal acne is linked to hormonal fluctuations that can disrupt sebum production and lead to acne breakouts.

Hormonal acne can often be triggered by the body's natural processes during puberty, menstruation, or periods of high stress. These fluctuations in hormones can stimulate the sebaceous (oil) glands to produce excess oil, leading to clogged pores and inflammation.

Managing hormonal acne may include various treatments such as hormonal therapy, like oral contraceptives, which help stabilize hormone levels to reduce acne flare-ups.

How Is Hormonal Acne Different from Fungal Acne?

Hormonal acne is caused by hormonal imbalances while fungal acne is triggered by fungal overgrowth.

Hormonal acne typically causes deep, cystic breakouts mostly on the chin, jawline, and lower cheeks.

Fungal acne appears as small, uniform bumps with a texture resembling clusters of whiteheads or even pustules, often occurring on the forehead, upper back, and chest.

While hormonal acne treatment can be treated with hormonal therapies, fungal acne requires antifungal products to combat the overgrowth of yeast on the skin.

How to Tell the Difference Between Fungal Acne and Hormonal Acne?

A dermatologist can usually tell the difference between fungal acne and hormonal acne.

Fungal acne typically looks like small, itchy bumps that resemble acne but do not respond to traditional acne treatments.

On the other hand, hormonal acne tends to cause deep, cystic lesions along the jawline and chin. Understanding the triggers is also helpful in the diagnosis; fungal acne is exacerbated by factors like humidity and sweat, while hormonal acne may worsen during menstruation or periods of stress.

What Are the Signs and Symptoms of Fungal Acne?

Fungal acne looks like small, itchy bumps, and often causes uniform redness and can be incredibly itchy, causing discomfort and irritation. If your acne is not responding to typical acne products, it may be a sign that it’s fungal acne.

It helps to use fungal acne-safe products, such as a fungal acne mask containing ingredients like sulfur, tea tree oil, or niacinamide. Topical treatments like antifungal creams or lotions are often recommended in cases of persistent fungal acne.

What Are the Signs and Symptoms of Hormonal Acne?

Symptoms of hormonal acne often include inflammation, cystic pimples, and cyclical breakouts around the jawline and chin. Hormonal acne tends to cause deeper, more painful cysts that are often harder to treat with typical over-the-counter remedies. It tends to occur around the menstrual cycle and can also be triggered by stress and diet.

How to Treat Fungal Acne?

Fungal acne is usually treated with antifungal medications and by adjusting your skincare routine to help restore your skin’s balance.

What Are the Topical Treatments for Fungal Acne?

Topical (applied to the skin) treatments for fungal acne typically include ingredients like tea tree oil, salicylic acid, and benzoyl peroxide that target fungal overgrowth and reduce inflammation.

Tea tree oil, known for its antifungal properties, works by disrupting the cell membranes of fungi, inhibiting their growth. Salicylic acid exfoliates the skin, unclogs pores, and helps remove dead skin cells. Benzoyl peroxide reduces acne-causing bacteria and can be effective against fungal acne when used in combination with other antifungal ingredients. It's important to choose non-comedogenic and fungal acne-safe products to avoid worsening the condition.

What Are the Oral Treatments for Fungal Acne?

Oral treatments for fungal acne may include prescription medications that target systemic fungal overgrowth and regulate oil glands to prevent future breakouts. They work by inhibiting the growth of fungi on the skin, reducing inflammation, and balancing the skin's microbiome. Dermatologists often recommend a combination of oral antifungal agents and topical treatments.

It is important to consult a dermatologist to treat fungal acne.

How to Treat Hormonal Acne?

Managing hormonal acne often involves targeted treatments such as hormonal therapy to regulate hormone levels and minimize acne flare-ups.

Treatments include hormonal medications and birth control pills. Incorporating lifestyle changes to address hormonal imbalances may also help. Simple changes in diet, such as reducing sugar and dairy consumption, can help manage hormonal changes that trigger acne.

It is important to consult with a healthcare provider to determine the best treatment for hormonal acne.

What Are the Topical Treatments for Hormonal Acne?

Topical treatments for hormonal acne encompass a range of acne products containing ingredients like salicylic acid, benzoyl peroxide, and retinoids that target acne-prone areas affected by hormonal fluctuations.

These treatments work by unclogging pores, reducing inflammation, and regulating sebum production. In addition to traditional acne products, skin products with niacinamide and hyaluronic acid can help balance skin hydration and reduce redness. Spot treatments, such as sulfur-based solutions, are also effective in targeting specific hormonal breakouts.

What Are the Oral Treatments for Hormonal Acne?

Oral treatments for hormonal acne may involve prescription medications, such as hormonal regulators or systemic acne treatments.

  1. Oral medications include spironolactone, isotretinoin, and hormonal contraceptives.
  2. Spironolactone, a popular choice, works by reducing excess sebum production and blocking androgen receptors. Isotretinoin, on the other hand, targets acne-causing factors deep within the skin, although it may come with potential side effects that need monitoring.
  3. Hormonal contraceptives, like birth control pills, can help stabilize hormone levels through the menstrual cycle.

Frequently Asked Questions

What is the difference between fungal acne and hormonal acne?

Fungal acne is caused by an overgrowth of yeast on the skin, while hormonal acne is caused by fluctuations in hormone levels.

How can I determine if I have fungal acne or hormonal acne?

Fungal acne typically appears as small, uniform bumps on the skin, while hormonal acne often presents as larger, cystic breakouts.

What are the common triggers for fungal acne?

Fungal acne is commonly triggered by warm, humid environments, excessive sweating, and the use of occlusive skincare products.

Can hormonal acne be treated with topical products?

Topical treatments such as benzoyl peroxide and salicylic acid can help manage hormonal acne, but they may not fully eliminate it. Oral medications may be necessary for more severe cases.

How can I treat fungal acne?

Fungal acne can be treated with antifungal creams or oral medications, as well as avoiding triggers and incorporating gentle, non-comedogenic skincare products into your routine.

Is it possible to have both fungal acne and hormonal acne at the same time?

Yes, it is possible to have both fungal acne and hormonal acne at the same time. It is important to consult with a dermatologist for an accurate diagnosis and personalized treatment plan.