What does Fungal Acne Look Like?

type of Acne

You may have heard of fungal acne, also known as Malassezia folliculitis and Pityrosporum folliculitis previously, and you briefly learned about what causes fungal acne, but what does fungal acne look like? This article can hopefully illustrate some features that are commonly found in this condition.

Fungal acne is defined by what it does not have

It is different than run of the mill teenage acne (acne vulgaris). The cartoon titled “Types of Acne,” illustrates the anatomy of acne that commonly occurs in adolescents. Fungal acne does NOT leave scars, and consists of similar appearing papules or pustules that occur around hair follicles. When evaluating what does fungal acne look like, it should notably NOT have black heads (open comedones), and the condition can frequently be itchy.

What does fungal acne look like in a picture:

Papules and Pustules


Here is what a picture of uniform pink papules looks like in real life:

pimples on head

On the forehead and other areas these little bumps, called papules, can be the same color of your skin or the papules can be pink or red, and can look something like this:


Here is what a picture of a pustules in a follicular distribution looks like in real life:

skin-pilo-sebaceousAs mentioned above, the papules and pustules of fungal acne occur around the hair follicle. This is what we mean by the word “follicular distribution.” Fungal acne can occur anywhere on the face, the upper back, chest, and even on the arms.

Anatomy of a pilosebaceous unit

The hair shaft, the hair follicle, and the skin and hair lubricating apparatus known as the sebaceous gland, make up the “pilosebaceous unit.” The pilosebaceous unit is the flashpoint of this condition.

A fungus that colonizes most human beings, from the species Malassezia, accumulates here and when too much of the fungus breaches the walls of this pilosebaceous unit the immune system attacks and this is what causes the irritation around the hair shafts seen in the pictures above.

Now that you know what does fungal acne look like, what to do about it?

As mentioned above, fungus is the main problem. Using products that have anti-fungal properties can help alleviate the symptoms of fungal acne.

Your doctor may prescribe an anti-fungal agent, which is appropriate. However many people before, during or after consultation with a physician also turn to OTC (over-the-counter) anti-dandruff and anti-seborrheic dermatitis shampoos because they contain active ingredients with anti-fungal properties like pyrithione zinc (also known as zinc pyrithione) or ketoconazole.

Many people with fungal acne are quite concerned that the cosmetics they use may worsen their fungal acne. As mentioned in a previous article there are entire websites dedicated to this topic of crowd sourced Malassezia folliculitis friendly products.

Many people with sensitive skin have fungal acne. If this is the case, you should use a fungal acne friendly anti-dandruff shampoo formulated for people with sensitive skin that contains an active ingredient like pyrithione zinc but avoids fragrance, dyes and harsh surfactants.

Happy Cappy Medicated Shampoo and Body Wash is one such example of a gently formulated anti-dandruff and anti-seborrheic dermatitis product that can be safely applied and left on the face for several minutes before rinsing.


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Dr. Eddie Valenzuela is an award winning pediatrician and the founder and CEO of Pediatric Solutions, LLC.

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What causes keratosis pilaris?

The exact cause of keratosis pilaris is still unknown, but it is believed to be caused by dry skin, essential fatty acids, and vitamin A deficiency. It is most common in people with asthma and allergies.

How can I get rid of keratosis pilaris?

It will be better to use corticosteroids in the affected areas where the affected person feels bumps on the skin.

Can babies get keratosis pilaris?

Yes, it is widespread in babies, toddlers, and teenagers. If someone in the family already has it, you become more prone to it.

What are the familiar places for keratosis pilaris to appear?

The most common places where it appears are upper arms, cheeks, and thighs. But if the condition worsens, it can spread to the forearms and lower legs.

Is keratosis pilaris genetic?

It is not solely caused by genetics, but it has a genetic factor. If anyone in the family had it, you may be more prone to it. People with allergies, eczema, and asthma are also at a risk of developing keratosis pilaris.

Can keratosis pilaris cause hair loss?

Yes, it is directly related to the hair follicles and can cause temporary hair loss. The hair that you lose during the condition will grow back naturally once the condition is treated.

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