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: 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: As 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.