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Fungal vs Bacterial Acne

Written by Andrew Le, MD

UpdatedMarch 7, 2024

Acne is a common skin condition that affects millions of people worldwide. While most people are familiar with bacterial acne, fungal acne is lesser known but equally troublesome. In this article, we explain the differences between fungal and bacterial acne, their causes, and how they’re treated.

What Is Acne?

Acne causes pimples and other types of spots., It develops when your pores become clogged with oil, dead skin cells, and bacteria. The inflammation caused by these blockages leads to redness, swelling, and sometimes pain.

There are different forms of acne, including blackheads, whiteheads, papules, pustules, nodules, and cysts. They can appear on your face, back, chest, and other parts of your body. In addition to impacting your physical appearance, acne may affect your self-esteem and confidence.

Practicing a regular effective skincare routine can help reduce acne lesions and promote healthy skin.

What Causes Acne?

Acne is caused by a variety of factors, including hormonal changes, genetics, diet, and some skin care products.

  • Hormonal changes can trigger an increase in sebum (oil) production.
  • Genetic factors can increase your likelihood of getting acne.
  • Diet affects your skin health, and certain foods can worsen inflammation or cause excess sebum.
  • Skincare products with pore-clogging ingredients can cause bacterial growth and disrupt your skin's microbiome.

Hormonal Changes

Hormonal changes can trigger acne, particularly during puberty. Fluctuations in hormone levels can trigger your sebaceous glands to overproduce sebum, your body’s natural oils. This can lead to clogged pores, creating a favorable environment for bacteria and leading to pimples.


Genetic factors can influence your likelihood of developing acne. Research shows that a predisposition to acne is related to genetic variations that can impact your skin’s microbiota (the bacteria and other microbes that live on your skin). Inherited factors also influence your skin barrier’s resilience to infections and other skin issues.


Diet may affect your skin health. Certain foods, such as dairy and foods with a high glycemic index, have been linked to an increased risk of acne in some people. They’re thought to increase sebum production, which can clog pores and lead to acne breakouts. Inflammation, another common trigger for acne, can be exacerbated by foods high in sugars and processed fats.

Skin Care Products

Skin care products that clog pores and those containing harsh ingredients meant to treat acne can actually have the opposite effect. Drying formulations, for example, can make acne worse by increasing sebum production and triggering inflammation. People with acne-prone skin should choose non-comedogenic products, which are specifically designed to not block pores and prevent the build-up of acne-causing bacteria. Look for gentle products to help maintain the skin's natural balance and reduce the risk of developing skin irritation or sensitivities.

What Are the Different Types of Acne?

Acne comes in various forms, including whiteheads, blackheads, papules, pustules, nodules, and cysts, each with distinct characteristics.


Whiteheads, or closed comedones, are small white bumps on the skin. People with oily or combination skin who produce excessive amounts of sebum (oil) tend to develop whiteheads. They occur when pores become clogged with sebum and dead skin cells. The clogged pores create a favorable environment for the overgrowth of acne-causing bacteria, resulting in inflammation and the formation of white pus-filled bumps.


Blackheads are open comedones that have small dark plugs. The dark spots are caused by the oxidation of sebum and debris. The black “head” is due to the exposure of the plug to air, which causes oxidation, turning it dark.


Papules are small, red, inflamed bumps caused by bacterial growth and inflammation in hair follicles. The tiny raised lesions tend to appear on the face, chest, and back. Their inflamed appearance is a result of the immune system's response to acne bacteria, which causes the area to become red and swollen. Unlike blackheads and whiteheads, papules do not contain pus. Keeping your skin clean and using topical antibacterial treatments can help reduce papules and prevent inflammation.


Pustules are pus-filled lesions that appear as red bumps with white or yellow centers. They are a more severe form of acne, which often has an active infection and an inflammatory response. In addition to gentle cleansing, oral antibiotics such as tetracycline or erythromycin, are often prescribed to slow down the proliferation of bacteria.


Nodules are large, painful, solid lesions deep within the skin that are caused by the accumulation of sebum, bacteria, and inflammatory cells. They are a severe and often persistent form of acne that can be particularly challenging to treat and may also cause scarring. Unlike milder forms of acne, nodules often require aggressive treatment, such as prescription medications, corticosteroid injections, or drainage. Without treatment, the inflammation and tenderness associated with untreated nodules may lead to emotional distress and impact self-esteem.


Cysts are deep, inflamed, pus-filled lumps beneath the skin's surface that can be painful and difficult to treat. Cystic acne is a severe condition that requires targeted treatment. The inflammation can cause significant discomfort and if left untreated, can cause permanent scarring. Like nodules, cysts may not affect not only your appearance but also your confidence. Seeing a dermatologist is the best way to manage cystic acne.

What Is Fungal Acne?

Fungal acne, also known as Malassezia folliculitis, is a specific type of acne caused by fungal overgrowth on the skin, leading to uniform pustules and whitehead-like bumps. Unlike bacterial acne, fungal acne is triggered by yeast that naturally lives on the skin's surface. When these yeast multiply rapidly, they can invade hair follicles, causing bumps and pustules. Fungal acne thrives in humid environments and often is itchy

How Is Fungal Acne Different From Bacterial Acne?

Fungal acne and bacterial acne have different causes. Fungal acne is triggered by yeast overgrowth whereas bacterial acne is primarily caused by acne-causing bacteria Fungal acne thrives in humid environments, such as sweaty gym clothes, and tends to appear as small, uniform bumps with minimal inflammation.Bacterial acne often looks like red, inflamed pimples and pustules, indicating an inflammatory response.

Antifungal agents like ketoconazole are effective for treating fungal acne, whereas bacterial acne typically responds to antibacterial medications, such as benzoyl peroxide or antibiotics.

What Causes Fungal Acne?

Fungal acne, also known as pityrosporum folliculitis, is caused by the overgrowth of Malassezia yeast, which is naturally found on your skin. When too much yeast grows, it disrupts the balance of your skin’s microbiota, which can lead to inflammation, causing fungal acne.

Research suggests that people with seborrheic dermatitis are more prone to developing fungal acne due to the overproduction of sebum, which creates an ideal environment for the yeast to thrive.

Excessive sweating and environmental factors such as humidity and certain skincare products that disrupt the skin's natural microbiome can further contribute to yeast overgrowth and fungal infection.

Overgrowth of Fungus on Skin

Malassezia yeast, normally present on the skin, can grow out of balance due to factors like humidity, sweat, or a compromised skin barrier. These conditions can lead to fungal spores which can trigger an inflammatory response. As the yeast multiplies, it releases enzymes that break down skin oils, causing irritation, redness, and acne-like bumps.

Excessive Sweating

Excessive sweating can allow Malassezia yeast to multiply and increase the risk of fungal acne flare-ups. When sweat mixes with the skin’s sebum and bacteria, it forms a breeding ground for fungus.

Following a consistent skincare routine of gentle cleansing and exfoliation can help reduce the risk of fungal infections from excessive sweating. Incorporating anti-fungal ingredients like tea tree oil, salicylic acid, or sulfur can help to keep fungal acne at bay.

What Is Bacterial Acne?

Bacterial acne is an umbrella term used to describe the pustules, whiteheads, blackheads, and other acne lesions that are caused by an overgrowth of bacteria that normally lives on the skin, such as Propionibacterium acnes. When the natural balance of bacteria on the skin is disrupted, these harmful bacteria can proliferate and cause acne. Antibiotics are commonly prescribed to combat bacterial acne.

How Is Bacterial Acne Different From Fungal Acne?

It’s important to distinguish fungal and bacterial acne, because they are caused by different microbes that affect the skin microbiota differently, and traditional treatments used for bacterial acne don’t work on fungal acne. Using them may exacerbate fungal acne by further disturbing the skin microbiota.

What Causes Bacterial Acne?

Bacterial acne is caused when acne-causing bacteria come into contact with excess sebum, the oily substance secreted by the skin, creating an ideal environment for bacterial growth. This process triggers an inflammatory response in the skin, causing redness and swelling.

Frequently Asked Questions

What is the difference between fungal and bacterial acne?

Fungal acne is caused by an overgrowth of yeast on the skin, while bacterial acne is caused by an overgrowth of bacteria.

How can I tell if I have fungal or bacterial acne?

Fungal acne typically appears as small, itchy bumps that are more likely to be found on the chest, back, and shoulders. Bacterial acne, on the other hand, usually looks like inflamed, pus-filled pimples on the face, neck, and back.

What causes fungal acne?

Fungal acne is caused by an overgrowth of yeast that is naturally present on the skin. This can be triggered by various factors such as a weakened immune system, excessive sweating, and the use of antibiotics or steroids.

Can fungal acne be treated with the same products as bacterial acne?

No, fungal acne requires a different treatment approach than bacterial acne. While bacterial acne can be treated with traditional acne products containing salicylic acid or benzoyl peroxide, fungal acne is best treated with antifungal ingredients like ketoconazole or sulfur.

Are there any natural remedies for fungal or bacterial acne?

Yes, some natural remedies can help with both fungal and bacterial acne. Tea tree oil has both antifungal and antibacterial properties and can be applied topically. Apple cider vinegar also contains antifungal and antibacterial properties and is effective as a toner for the skin.

Can fungal and bacterial acne occur at the same time?

Yes, it is possible to have both fungal and bacterial acne at the same time. This can happen if the overgrowth of yeast and bacteria occurs simultaneously, leading to a combination of symptoms such as small bumps and inflamed pimples on the skin.