Fungal Acne vs Acne: How to Tell the Difference

Not every breakout is actually acne. A condition commonly referred to as fungal acne is often mistaken for acne vulgaris because the bumps can look similar at first glance. However, despite its name, fungal acne is not true acne.

Knowing the difference is important because fungal acne and acne are caused by different processes and require different approaches. If you've been treating what you believe is acne without seeing improvement, it's worth considering whether another condition could be responsible.

What is fungal acne?

Fungal acne is not actually acne.

Its medical name is Malassezia folliculitis, a form of folliculitis caused by an overgrowth of yeast that naturally lives on the skin.

Unlike acne vulgaris, fungal acne is not caused by blocked pores, excess oil and inflammation. Instead, it develops when yeast overgrows within the hair follicles, producing clusters of small bumps.

Although the two conditions can look alike, they behave very differently.

What is true acne?

True acne develops when hair follicles become blocked with:

• Excess oil (sebum).
• Dead skin cells.
• Naturally occurring bacteria.
• Inflammation.

This process leads to a mixture of blackheads, whiteheads, inflamed spots and, in more severe cases, nodules or cysts.

Unlike fungal acne, true acne often varies considerably in appearance from one spot to another.

How can I tell the difference?

There are several features that can help distinguish fungal acne from acne vulgaris.

Fungal acne often:

• Produces small bumps that are all a very similar size.
• Feels itchy.
• Appears on the forehead, chest or upper back.
• Becomes worse with heat and sweating.

True acne often:

• Includes blackheads and whiteheads.
• Produces spots of different sizes.
• May include larger inflamed lesions.
• Is usually not itchy.

Although these differences can be helpful, the two conditions can look remarkably similar and may even occur together.

Can you have both fungal acne and acne?

Yes.

Some people experience both conditions at the same time.

For example, someone may have true acne affecting the face while also developing fungal folliculitis across the forehead or upper back.

Because the two conditions require different management approaches, recognising when both are present is important.

Why does the difference matter?

Treating fungal acne as though it were ordinary acne may not lead to improvement.

Similarly, assuming true acne is fungal acne may delay appropriate assessment.

If your bumps are:

• Very uniform in size.
• Persistently itchy.
• Not responding to typical acne care.

…it is sensible to seek an assessment so the correct diagnosis can be made.

Frequently Asked Questions

Is fungal acne actually acne?

No. Fungal acne is a form of folliculitis caused by an overgrowth of yeast rather than the blocked pore process responsible for acne vulgaris.

How do I know whether I have fungal acne or acne?

Fungal acne usually causes small, itchy bumps that are all a similar size, while acne produces a mixture of blackheads, whiteheads and inflamed spots of varying sizes. A proper assessment can confirm the diagnosis.

Can I have both conditions?

Yes. It is possible to have fungal folliculitis and acne at the same time, which can make diagnosis more difficult.

Why isn't my acne treatment working?

If your bumps are actually fungal folliculitis rather than acne, treatments designed for acne may not be effective. This is one reason why an accurate assessment is important.

Should I seek assessment if I'm unsure?

Yes. If your skin is not responding as expected or you are unsure what type of breakout you have, a professional assessment can help identify the underlying condition.

Reviewed by Dr Tara Treacy, GP with a special interest in dermatology (IMC 411337).

Last reviewed: 16/07/2026.

General information only. It does not replace an individual medical assessment.