Fungal Acne vs Closed Comedones: Differences and Treatments

29 Mar 2024, by

Dr. Anna Nersisyan

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Fungal acne and closed comedones are two distinct skin conditions often confused due to their similar appearance. Fungal acne, caused by yeast overgrowth, manifests as itchy, uniform pustules, primarily affecting the chest and back. In contrast, closed comedones or whiteheads, arise when pores clog with sebum and dead skin cells, typically appearing on the face's T-zone. This article delves into their causes, symptoms, and effective treatment strategies, offering insights for individuals aiming to differentiate and tackle these conditions.

fungal acne vs closed comedones

What is Fungal Acne?

Fungal acne, often mistaken for traditional acne, is not acne at all in the usual sense. This misleading term refers to a condition known officially as Pityrosporum folliculitis or Malassezia folliculitis. Unlike typical acne that results from clogged pores, fungal acne is caused by an overgrowth of yeast, a type of fungus, within the hair follicles. This yeast is part of the skin's natural microbiome, but problems arise when it grows excessively, leading to inflammation, redness, and pimple-like bumps.

Surprisingly, yeast, the root cause of fungal acne, is not an uncommon inhabitant of our skin. The PubMed research indicates that yeast may be found on the skin of 75-98% of healthy individuals. Understanding what is fungal acne is crucial because its treatment significantly differs from that of traditional acne.

Causes of Fungal Acne

Several factors contribute to the overgrowth of yeast leading to fungal acne. Identifying these can help in managing and preventing the condition effectively. Key contributors include:

  • Excessive Humidity and Heat: Warm, moist environments are ideal for yeast growth.
  • Tight Clothing: Clothes that don't allow your skin to breathe can trap moisture and heat, fostering yeast proliferation.
  • Sweating: Heavy perspiration, especially if left on the skin for prolonged periods, can escalate yeast growth.
  • Oily Skin: Excess oil can create a favorable environment for yeast.
  • Imbalanced Skin Microbiome: Disruption in the natural balance of skin flora can allow yeast to dominate.
  • Use of Antibiotics: While beneficial for bacterial infections, antibiotics can disrupt the skin's natural defenses, promoting yeast overgrowth.


These factors highlight the importance of understanding your skin and the environment you're exposing it to. Simple changes in daily habits and attire can significantly impact managing fungal acne.

Symptoms and Diagnosis of Fungal Acne

Recognizing the symptoms of fungal acne is the first step toward proper treatment. Despite its appearance, fungal acne is distinct from bacterial acne in several key ways:

  • Appearance: Fungal acne presents as small, uniform pustules or bumps, which are often itchy, rather than the varied sizes of pimples seen in traditional acne.
  • Affected Areas: While traditional acne commonly affects the face, fungal acne is more likely to appear on the body parts like the chest, back, and upper arms.
  • Itchiness: A hallmark of fungal acne is persistent itchiness, something not typically associated with bacterial acne.


Diagnosing fungal acne often involves a dermatologist taking a skin culture or examining the affected skin under a microscope. Because how to get rid of fungal acne requires a different approach than bacterial acne, accurate diagnosis is key. Treatments usually involve antifungal medications rather than the antibacterials or retinoids used for traditional acne.


In distinguishing between fungal acne and other skin conditions, remember that online tools and resources, like the Symptom Checker, can provide preliminary insights. However, they're not a substitute for professional diagnosis. If you suspect you have fungal acne, consulting with a healthcare provider is essential to receive an accurate diagnosis and appropriate treatment.

Understanding Closed Comedones

Closed comedones, often a perplexing term for many, refer to a type of acne that doesn't quite make it to the surface of the skin. In simpler terms, imagine them as pimples that haven't popped yet. They're also widely recognized as whiteheads. Unlike their more notorious counterpart, the blackhead, these blemishes remain covered by a thin layer of skin, keeping their contents hidden and giving them a white appearance on the surface. So, when we delve into the question of what closed comedones are, we're essentially exploring these shy, hidden forms of acne that prefer to stay under the radar.

Causes and Development of Closed Comedones

The journey of a closed comedone from an invisible foe to a visible concern is quite fascinating. Several factors play a pivotal role in their formation:

  • Excess Sebum Production: The skin's natural oil, known as sebum, is meant to protect and hydrate the skin. However, an overproduction can lead to clogged pores, setting the stage for comedones.
  • Dead Skin Cell Accumulation: Our skin is constantly renewing itself, shedding old cells to make way for the new. Sometimes, these cells don't shed properly and accumulate, plugging the follicle.
  • Bacterial Growth: The skin harbors various bacteria, some of which can contribute to acne when they proliferate within clogged pores.
  • Hormonal Fluctuations: Hormones can significantly impact sebum production. Periods of hormonal change, such as puberty or pregnancy, can thus increase the likelihood of developing closed comedones.
  • Cosmetic Products: Certain makeup and skincare products can exacerbate or lead to the formation of closed comedones by further clogging the pores.

Identifying Closed Comedones

Recognizing closed comedones is the first step toward addressing them. These blemishes are typically small, flesh-colored bumps that feel slightly raised to the touch. They're most commonly found in areas where the skin tends to produce more oil, such as:

  • The forehead
  • The nose
  • The chin


However, they can also appear in other oil-prone areas, like the back and chest. Unlike open comedones (blackheads), which are characterized by their dark appearance due to oxidation, closed comedones do not have a darkened surface. This is because the pore is completely enclosed by skin, preventing air from reaching the trapped sebum and dead skin cells.


Spotting these comedones early and understanding what causes them can be instrumental in preventing a mild annoyance from becoming a more significant issue. Incorporating a skincare routine that addresses these root causes can help manage and reduce the appearance of closed comedones.

Closed Comedones vs Fungal Acne: Key Differences

When navigating the complex world of skin concerns, it's crucial to distinguish between conditions that may appear similar but require different approaches for effective treatment. Closed comedones and fungal acne are two such conditions. Understanding the key differences between them can guide more targeted and successful skincare strategies.

  • Appearance: Closed comedones, or whiteheads, present as small, flesh-colored bumps without inflammation. Fungal acne, on the other hand, manifests as uniform small red bumps that are often mistaken for bacterial acne but are notably itchy.
  • Itchiness: A distinguishing feature of fungal acne is its itchiness, which can range from mild to severe. Closed comedones typically do not cause itching.
  • Typical Locations: Closed comedones are commonly found on the face, particularly in the T-zone area (forehead, nose, and chin), where oil production is higher. Fungal acne tends to appear in areas where sweat accumulates, like the chest, back, and shoulders.


Recognizing these differences is crucial for anyone struggling to manage their skin condition effectively, leading us to explore appropriate treatment methods for each.

Treating Fungal Acne and Closed Comedones

Fungal Acne Treatment Options

Fungal acne requires a treatment approach that targets the yeast overgrowth contributing to the condition. Here are effective treatments and preventative measures:

  • Antifungal Creams: Over-the-counter antifungal creams containing ketoconazole or clotrimazole can be directly applied to the affected areas to reduce yeast growth.
  • Oral Antifungals: In more severe cases, a dermatologist might prescribe oral antifungal medications. These are typically used when topical treatments are insufficient.
  • Shampoo with Antifungal Properties: Using an antifungal shampoo as a body wash in affected areas can help control yeast growth, especially in hot and humid climates.
  • Preventative Measures: To prevent recurrence, it's advisable to wear loose-fitting clothing, shower immediately after sweating, and incorporate antifungal body washes into your routine.

Strategies for Managing Closed Comedones

Addressing closed comedones involves a combination of proper skincare practices and, when necessary, professional treatments:

  • Gentle Cleansing: Use a gentle, non-comedogenic cleanser twice daily to remove excess oil and debris without over-drying the skin.
  • Exfoliation: Regular exfoliation with products containing salicylic acid can help dissolve the plug within the pore. However, it's essential to avoid over-exfoliation, which can irritate the skin and worsen acne.
  • Retinoids: Over-the-counter or prescription retinoids can be highly effective in preventing clogged pores by accelerating cell turnover.
  • Professional Treatments: If closed comedones persist, treatments like chemical peels or manual extractions by a certified dermatologist or esthetician might be necessary.


By understanding the specific needs and differences between fungal acne and closed comedones, individuals can adopt a more tailored and effective approach to skincare. Remember, when in doubt or if the condition persists, seeking professional advice is always recommended. For a more in-depth understanding of your symptoms and to explore potential conditions, consider using an online tool like a Symptom Checker as a preliminary step before consulting a healthcare provider.

Preventing Future Breakouts

Preventing future breakouts, whether it's the mysterious fungal acne or the stubborn closed comedones, hinges on understanding your skin and the daily habits that can influence its health. Here are some lifestyle and skincare tips designed to keep both conditions at bay, emphasizing the crucial role of knowing and catering to your specific skin type.

Know Your Skin Type

Identifying whether you have oily, dry, combination, or sensitive skin is the first step. Each type requires a different approach; what works for dry skin might not suit oily skin, and vice versa.

Maintain a Consistent Skincare Routine

Stick to a regimen that includes cleansing, moisturizing, and applying sunscreen daily. Use products formulated for your skin type and avoid those that contain irritants or comedogenic ingredients.

Exfoliate Regularly but Gently

Exfoliation can help remove dead skin cells that clog pores. However, overdoing it or using harsh scrubs can damage your skin barrier and exacerbate acne problems. Opt for gentle, chemical exfoliants like AHAs or BHAs.

Keep Hydrated and Eat a Balanced Diet

Your skin reflects what you eat and how much water you drink. A diet rich in fruits, vegetables, and lean proteins, along with plenty of water, can help your skin stay healthy.

Wear Breathable Fabrics

This is especially important if you're prone to fungal acne, as yeast thrives in moist, warm environments. Choose loose, breathable clothing to allow your skin to stay dry and cool.

Change Out of Sweaty Clothes

After exercising or sweating, change and shower as soon as possible to prevent yeast and bacteria from proliferating on your skin.

Review Your Products

Regularly assess your skincare and makeup products to ensure they're non-comedogenic and suitable for your skin type. This includes your laundry detergent, which can also affect your skin.

When to Seek Professional Help

Understanding when to tackle acne with home remedies and when to consult a dermatologist can save you from unnecessary distress and lead to better skin health.

  • Persistent Acne: If your acne doesn't improve with over-the-counter treatments within a few weeks, it might be time to seek professional advice. Persistent acne can be a sign of underlying issues that require a targeted approach.
  • Severe Breakouts: Severe acne, especially if it's painful or leading to scarring, needs medical intervention. A dermatologist can offer treatments such as prescription creams, oral medications, or even procedures like chemical peels and laser therapy.
  • Unsure About Your Diagnosis: If you're unsure whether you're dealing with fungal acne, closed comedones, or another skin condition, a professional diagnosis is crucial. Misdiagnosing your acne can lead to ineffective or even harmful treatment strategies.
  • Personalized Treatment Plans: Every skin is unique, and what works for one person might not work for another. Dermatologists can create a personalized treatment plan tailored to your specific needs and skin type.


Remember, while seeking help from online resources like Symptom Checker can provide valuable insights, it's not a substitute for professional medical advice. If your skin concerns persist or worsen, consulting with a healthcare provider is always the best course of action.


In navigating the complex landscape of skin conditions, understanding the differences between fungal acne and closed comedones is paramount. Each condition requires a nuanced approach to treatment and prevention. Here are the key takeaways to remember:

  • Fungal acne and closed comedones may appear similar but have different underlying causes and treatments.
  • Identifying your skin type and adapting your skincare routine accordingly can significantly prevent future breakouts.
  • Lifestyle changes, such as maintaining a healthy diet and wearing breathable fabrics, play a crucial role in managing both conditions.
  • Seeking professional help for persistent or severe acne ensures a tailored treatment plan, optimizing your path to clearer skin.

Frequently Asked Questions

How do I distinguish between fungal acne and closed comedones?

Understanding the differences is crucial for effective treatment. Fungal acne typically presents as uniform, itchy, red pustules, often on the chest and back, while closed comedones appear as small, flesh-colored bumps, primarily on the face's T-zone.

What are the main differences in appearance between fungal acne and closed comedones?

Fungal acne is characterized by clusters of small, red, itchy bumps. In contrast, closed comedones are non-itchy, flesh-colored bumps that do not have a head or pus.

What exactly are closed comedones, and why do they form?

Closed comedones, or whiteheads, are formed when pores are clogged with sebum and dead skin cells, creating small, flesh-colored bumps on the skin.

What are the most effective treatments for fungal acne?

Fungal acne treatment often involves antifungal creams or shampoos containing ketoconazole or pyrithione zinc. In more severe cases, oral antifungal medication may be prescribed by a dermatologist.

How can I effectively get rid of fungal acne?

Treating fungal acne includes using antifungal medications and making lifestyle adjustments, such as changing out of sweaty clothes quickly and using non-occlusive skincare products.

What distinguishes fungal acne from other acne types?

Fungal acne arises from an overgrowth of yeast on the skin, leading to inflamed pustules that resemble bacterial acne but differ in cause and treatment. Unlike traditional acne, which can result from bacteria, excess oil, and dead skin cells clogging pores, fungal acne is specifically tied to yeast proliferation and requires targeted antifungal treatment.

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