Bacterial vs fungal acne - how to spot the difference
Fungal acne and bacterial acne are two distinct skin conditions that are often confused due to their similar appearances. It's important to know the difference between the two for a more targeted approach to treatment.
The main differences
Fungal acne, scientifically known as Malassezia folliculitis, is caused by an overgrowth of yeast that naturally resides on the skin, particularly in warm and humid environments. This condition presents as small, itchy, red or flesh-coloured bumps that may resemble traditional acne, but are often more uniform in appearance. Unlike bacterial acne, which typically features pustules and cysts, fungal acne tends to occur in clusters, which can be exacerbated by occlusive creams or certain medications that alter the skin microbiome.
On the other hand, bacterial acne, often referred to simply as acne vulgaris, arises from the proliferation of bacteria, particularly Propionibacterium acnes, in clogged hair follicles. This leads to the formation of whiteheads, blackheads, papules, and cysts, usually seen on the face and jaw, which can be inflamed and painful.
Causes
Fungal acne is influenced by a compromised immune system, nutritional deficiencies, antibiotic or steroid use, and damage to the follicles. Bacterial acne is influenced by factors such as hormonal fluctuations, diet, digestion, and stress, and it tends to be more common during puberty when oil production increases. Both may involve a microbial imbalance in the gut.
Treatment
Common medical treatments for bacterial acne often include topical and oral antibiotics, retinoids, and benzoyl peroxide. Complementary or alternative treatments may involve diet and lifestyle changes based on general and hormonal blood work, topical and internal herbal and nutritional compounds, such as saw palmetto, green tea, zinc, fish oil, and vitamin A. For fungal acne, the principles are the same, but focus needs to be on antifungal rather than antibacterial compounds, while also addressing the root cause, which may involve looking at gut and immune health. Some helpful topical compounds may be aloe vera, tea tree, MCT oil, myrrh, and oregano oil.
In summary, fungal acne and bacterial acne can look similar, but they have some key differences:
Appearance
Fungal acne usually appears as small, uniform red bumps that are often itchy.
Bacterial acne can occur in various lesions, including whiteheads, blackheads, pus-filled pimples, and deeper cystic lesions.
Location
Fungal acne often appears on the arms, chest, and back.
Bacterial acne is most common on the face.
Itching
Fungal acne often causes itching, which rarely occurs in bacterial acne.
Grouping
Fungal acne often appears in clusters of small bumps.
Bacterial acne rarely clusters.
Cause
Fungal acne is caused by an overgrowth of yeast in the hair follicles, often due to antibiotic use, nutritional deficiencies, or an impacted immune system.
Bacterial acne is usually related to inflammation, excess sebum production due to hormonal fluctuations, and an imbalance of the skin microbiome.
Treatment
Bacterial acne requires anti-bacterial support along with hormonal, dietary, and lifestyle assessment and treatment.
Fungal acne needs a targeted anti-fungal approach, along with immune system and general microbiome support.
Differentiating between fungal and bacterial acne is crucial for effective treatment. While topical antifungals can be used for fungal acne, treatments designed for bacterial acne could worsen a fungal condition. Therefore, anyone experiencing persistent acne-like symptoms should seek guidance from a qualified professional to ensure they receive a proper assessment and a tailored treatment plan that addresses the underlying causes of their skin issues. Understanding the differences between these two types of acne not only helps in achieving clearer skin but also prevents the potential worsening of the condition.
