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Fungal Acne vs Closed Comedones: What You Need to Know


We all have some sort of skin condition. What! You don’t have, aha, you definitely have. That’s why you are here. Chill, Skin problem is now a very common problem all over the world.

So, when it comes to skincare, it is very important to first understand the different types of skin conditions in order to diagnose and treat different problems.

Nowadays we often suffer from two common skin problems called Fungal Acne vs Closed Comedones. But fear not, there are different ways to cure them.

In this comprehensive guide, we’ll learn about fungal acne and closed comedones, explore their differences, causes, and symptoms, and equip you with the knowledge needed for effective skin care.

What is acne

Acne is a common skin condition that occurs when hair follicles become clogged with oil (sebum) and dead skin cells. It often shows up as various types of blemishes on the skin, including pimples, blackheads, whiteheads, and, in some cases, more serious lesions like cysts and nodules.

Acne most commonly affects the face, but it can also appear on the neck, chest, back, shoulders, and other areas with a high concentration of oil glands.

Acne gets worse over time, starting with some mild blemishes and progressing to more severe forms that can lead to severe scarring if left untreated. Proper skin care, lifestyle adjustments, and in some cases, medical treatments prescribed by a dermatologist can help manage and improve acne.

Depending on the severity of the condition, treatment options may include topical creams, oral medications, chemical peels, and light therapy.

Types of Acne

Acne looks like a common skin condition, but over time, it takes a serious form. There are different types of acne, each has own unique characteristics and causes. Some common types of acne are given below:

  1. Whiteheads (closed comedones):

    Small, flesh-colored bumps with closed pores on the surface of the skin. The primary stimulus behind their formation is the accumulation of sebum and the presence of dead epidermal cells.

  2. Blackheads (Open Comedones):

    Blackheads are similar to whiteheads but have open pores. Skin pores are dark in color which comes from oxidation of oil and debris.

  3. Fungal Acne:

    Also known as “Malassezia folliculitis” or “Pterosporum folliculitis,” mycotic acne is caused by an overgrowth of a yeast-like fungus called Malassezia.

  4. Papules:

    Papule is small, red, swollen bumps without a visible center of pus. Feels soft to the touch.

  5. Pustules:

    Pustules are like papules but filled with pus with white or yellowish center. They are painful and often called “pimples”.

  6. Nodules:

    Nodules are large, painful, hard lumps under the surface of the skin. They are deep and can take a long time to heal.

  7. Cysts:

    Cysts are the most severe form of acne and are large, pus-filled lumps that are very painful. Scars stays even after healing.

  8. Hormonal acne:

    This type of acne is affected by hormonal fluctuations, such as puberty, menstruation, pregnancy, or taking hormonal drugs. It is often seen as deep cysts around the jaw and chin.

  9. Acne Rosacea:

    Rosacea is a chronic skin condition similar to acne, but has different triggers. It often causes visible blood vessels and small, red spots on the face, especially in central areas such as the nose and cheeks.

  10. Acne Mechanics:

    This type of acne is caused by friction or pressure on the skin, tight clothing. This is a common skin problem in athletes.

  11. Acne conglobata:

    This is a serious and rare form of acne characterized by large, interconnected nodules and abscesses. As a result, dark spots appear.

  12. Drug-induced acne:

    Some medications, such as corticosteroids, might produce acne as side effect.

Who Gets Acne

People of all ages experience acne problems at some point in their lives, but the problem is more common among teenagers and young adults. According to various surveys, about 85% of people between the ages of 12 and 24 suffer from some form of acne problems. But acne is not just a problem for young individuals; It can affect adults and, in certain cases, the elderly.

What is Fungal Acne

Fungal acne, scientifically known as Malassezia folliculitis, is a skin condition caused by an overgrowth of a yeast called Malassezia. Malassezia is a fungi genus that is naturally found on the skin surfaces of many animals, and humans.

This yeast is a microorganism found naturally on the surface of the skin, especially in areas rich in sebaceous glands, which produce skin oil (sebum). Normally, Malassezia plays a role in breaking down sebum.

Causes of Fungal Acne

Malassezia overgrowth is the main reason of fungal acne. The exact causes of this excess growth are often related to:

  • Warm and humid environment (regions of South and North Southeast Asia) influence the spread of Malassezia.
  • Malassezia can be caused by sweat and moisture on the skin. As a result, acne occurs.
  • Some skin care and cosmetic products may contain ingredients (oils, fatty acids) that promote the growth of Malassezia.
  • Tight clothing, especially those made from non-breathable materials, traps sweat and heat against the skin. As a result, fungal acne attacks are seen in various places, especially on the chest, back and shoulders.
  • Hair products, such as conditioners and styling products, when in contact with the skin often provide nutrients for Malassezia yeast, which can cause acne on the forehead, neck and back.
  • Sometimes hormonal fluctuations, such as puberty, menstruation, pregnancy, or taking certain medications, can affect the skin’s oil production, resulting in skin becoming more susceptible to acne breakouts.
  • People with weak immune system are at higher risk of fungal acne infection.

Symptoms of Fungal Acne

Fungal acne or Pterosporum folliculitis can cause the following symptoms:

  • Very itchy skin
  • Small red bump clusters
  • Blemishes on your eyebrows, chin and sides of your face

What is Closed Comedones 

Closed comedones, commonly known as “whiteheads,” are a type of acne lesion that occurs when a hair follicle becomes clogged with oil (sebum), dead skin cells (keratinocytes), and other debris in the skin. It is a common occurrence in acne-prone people and can appear on different parts of the body, usually on the face.

Closed comedones appear as small, round or oval bumps on the surface of the skin. They are usually flesh-colored or slightly white and may appear as small raised bumps.

Fungal Acne vs Closed Comedones 2

Causes of Closed Comedones 

Several alarming factors contribute to the formation of closed comedones:

  • When the skin produces too much sebum (a natural oil produced by the sebaceous glands), combined with other factors, clogs the hair follicles.
  • In some cases, when the skin cell shedding process in our body becomes irregular or excessive, dead skin cells accumulate, blocking the follicular.
  • A combination of excess sebum and dead skin cells clogs pores on the skin’s surface. The result is the formation of closed comedones.
  • Sometimes, Propionibacterium acnes (P. acnes) contributes to inflammation and slowly causes lesions to turn into closed comedones.
  • Lastly, A variety of genetic factors can increase your chances of developing acne.

Symptoms of Closed Comedones 

Closed comedones manifest as small, raised, flesh-colored, or whitish bumps on the skin’s surface. Closed comedones are non-inflammatory, meaning they do not typically cause redness, swelling, or pain, and don’t look like inflamed acne lesions like papules and pustules.

Closed comedones often appear on the face, especially in areas with a high concentration of oil glands (commonly referred to as the “T-zone”), such as the forehead, nose, and chin. However, they can also appear on the chest, back, and shoulders.

Key Difference Between Fungal Acne and Closed Comedones

There are multiple differences between closed comedones and fungal acne.

Firstly, fungal infection is the main cause of this acne. On the other hand, closed comedones are acne lesions that occur when sebum, and keratinocytes, are accumulate in the hair follicle.

The second and most important difference is that comedones are not inflamed or painful. They appear on the skin as little white, red, or flesh-colored pimples. On the other hand, fungal acne causes itchy skin.

Traditional Treatments of Fungal Acne

A traditional treatment for fungal acne, also known as Malassezia folliculitis or Pterosporum folliculitis, which prevents overgrowth of the underlying fungus on the skin. Here are common methods to treat fungal acne:

  1. Antifungal Creams or Lotions:
    Over-the-counter or prescription antifungal creams containing ingredients like ketoconazole, clotrimazole, or miconazole can be applied directly to the affected areas.
  2. Selenium sulfide shampoos:

    Selenium sulfide shampoos (commonly used for dandruff) can be used as body washes to treat fungal acne on the chest, back, and shoulders.

  3. Oral antifungal drugs:

    In more severe cases, dermatologists recommend oral antifungal medications such as fluconazole or itraconazole to prevent overgrowth of the fungus from within the body.

Natural Remedies for Fungal Acne

Natural remedies can complement traditional treatments for fungal acne, but they should not replace prescribed antifungal medications. Here are some natural remedies and preventive measures that may help manage and prevent fungal acne:

  • Apple cider vinegar with water (1:1)
  • Tea Tree Oil
  • Aloe Vera
  • Coconut Oil
  • Turmeric
  • Baking Soda
  • probiotic-rich foods or supplements

Traditional Treatments of Closed Comedones

Traditional treatments for closed comedones (whiteheads) focus on unclogging pores, preventing their formation, and promoting healthy skin turnover.

Here are some common traditional treatments for closed comedones:

  1. Topical Retinoids:
    Topical retinoids such as tretinoin, adapalene or tazarotene are derived from vitamin A and help promote skin cell turnover. They are effective in preventing closed comedone formation and improving overall skin texture.
  2. Salicylic Acid:

    Salicylic acid is a beta-hydroxy acid (BHA) that penetrates pores to help dissolve oil and dead skin cells that contribute to clogged comedones It is available in a variety of over-the-counter products, including cleansers, toners, and spot treatments.

  3. Benzoyl Peroxide:
    Benzoyl peroxide is an antibacterial agent that can help reduce the presence of P. acnes bacteria on the skin and prevent new comedone formation. It is available in various strengths in over-the-counter and prescription products.
  4. Glycolic Acid and Alpha Hydroxy Acids (AHAs):
    AHAs like glycolic acid can help exfoliate the skin’s surface, improve skin texture, and reduce the formation of closed comedones. These acids are often found in chemical exfoliants and peels.
Fungal Acne vs Closed Comedones

Natural Remedies for Closed Comedones

Here are some natural remedies and preventive measures that may help manage and prevent closed comedones:

  • Aloe Vera
  • Green tea extract
  • honey
  • Ginseng extract
  • Tea tree oil
  • witch hazel

Before applying any natural skin remedy, test it on a small area of your body and wait a few hours to see if have any reaction. Keep in mind, that just because a product is natural doesn’t mean it’s safe for all people.

Common mistakes to avoid when dealing with fungal acne and closed comedones

There are some mistakes we often make when dealing with fungal acne and closed comedones. Some of them are mentioned here:

For fungal acne:

  1. Misdiagnosis:

    If fungal acne and bacterial acne are treated as the same, treatment may be ineffective. Get a proper diagnosis from a dermatologist to confirm the condition.

  2. Using traditional acne treatments:

    Traditional acne products containing benzoyl peroxide or salicylic acid can make fungal acne worse. It is better to use antifungal treatment instead.

  3. Not treating the source:

    Address the underlying cause of fungal acne using antifungal medications. Only topical treatment may not be sufficient in severe cases.

  4. Overuse of antifungal products:

    Using antifungal products too frequently or in high concentrations can cause skin irritation. Follow your dermatologist’s recommendations.

For closed comedones:

  1. Excessive scrubbing:

    Aggressive scrubbing or using harsh exfoliants can irritate the skin and make closed comedones worse. Use gentle exfoliation.

  2. Picking or Squeezing:
    Squeezing or trying to pop a closed comedone can lead to infection and scarring.
  3. Using heavy or pore-clogging products:
    Cosmetics and skin care products with pore-clogging ingredients can aggravate clogged comedones. Use non-comedogenic products.
  4. Skipping sunscreen:
    Skipping sunscreen can damage the skin and worsen the appearance of closed comedones. Use a broad-spectrum sunscreen daily.
  5. Not consulting a dermatologist:
    If closed comedones persist after OTC treatment, consult a dermatologist. They may prescribe stronger drugs or treatments.

Keep in mind, that treatment response can vary by condition. So, it’s essential to be patient and follow a Healthcare Professional’s guidance for the most effective management of fungal acne and closed comedones.


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