How to get rid of fungal acne

Your clearing plan

Fungal acne (Malassezia folliculitis) is an overgrowth of Malassezia, a yeast that lives on the skin of about 90% of adults, inside the hair follicles. It means small, itchy bumps that are all one size, often on the upper back, chest, forehead and hairline, with no blackheads. Pick your answers below and the plan fills in.

Use Topical Antifungal Treatments

Topical means it goes on the skin: a wash or a cream applied straight to the bumps and the skin around them.

Anti-dandruff shampoos

ketoconazole shampoo is sold without a prescription for dandruff and as a prescription for tinea versicolor (MedlinePlus). selenium sulfide treats dandruff and tinea versicolor, and zinc pyrithione is on the experts' first-line list. Using a shampoo as a body wash for fungal acne is off the label, so ask a pharmacist or doctor how to use it. In one small study, a 2% selenium shampoo once a week cleared 80% of 25 people at 4 weeks and 88% at 8, though many relapsed after stopping.

Over-the-counter antifungal creams

clotrimazole or ketoconazole cream. MedlinePlus says clotrimazole may be used for skin yeast infections; talk to your doctor first. In a Japanese study, ketoconazole cream flattened the bumps in about 27 days on average. For skin fungal infections in general, MedlinePlus lists ketoconazole cream as usually used for 2 to 6 weeks.

If the bumps are on your face as well, a face scan can grade them while you start the wash.

Get Oral Antifungals for Severe Cases

Prescription Medications

Ask your doctor about fluconazole or itraconazole pills, or a Ciclopirox prescription cream. DermNet notes that pills may work better than creams, though trials are mixed, and fluconazole is used more often. In the same Japanese study, itraconazole pills flattened the bumps in about 14 days, against 27 for the cream. A Danish guideline suggests pills plus a wash may work best, and that upkeep is often needed afterward.

Never use ketoconazole tablets on your own. MedlinePlus lists serious liver damage as a risk.

Adjust Your Skincare Routine

Eliminate oils and heavy moisturizers

Thick creams and sunscreens that seal the skin are a known risk factor, and DermNet advises skipping moisturizers on the area during treatment.

Switch to fungal-acne-safe products

Choose light, oil-free textures for anything that touches the bumps. Check sunscreen, moisturizer and makeup alike, since thick sunscreens are on the same DermNet risk list as heavy creams.

Pause traditional acne treatments

Antibiotics can set fungal acne off and hide it for a while. The 2025 review notes that fungal acne is often taken for regular acne, which leads to antibiotics it doesn't need. Ask the doctor who prescribed one before you stop it.

Avoid heavy makeup and occlusives

Heavy layers that seal the skin count as occlusion, the same risk factor as thick creams.

Change Daily Habits

Shower immediately after sweating

Sweating and hot, humid weather are both risk factors, so rinse off after workouts and long hot days. Oily skin, steroids and a weak immune system raise the risk too (DermNet).

Wear loose, breathable clothing

Less friction and less trapped sweat. MedlinePlus advises reducing friction from clothing.

Keep it away

Fungal acne often comes back even after it clears. A weekly topical antifungal is the usual maintenance, but no study has compared maintenance plans head to head. The 2025 review names sweat, skin-sealing products and antibiotics as what brings it back. So every few months, check the usual suspects again: sweat, heat, heavy oils and recent antibiotics.

If it isn't fungal acne

A doctor can confirm yeast with a quick skin scraping. That check matters, because fungal acne is easy to mistake for the others in this table.

After it clears

Hands off while it heals: picking raises the risk of scars and dark spots (AAD). Picked bumps can leave marks, and if older acne left pits or raised scars, acne scar treatment walks through the options. Until then, let the antifungal finish its work and keep your hands off while the bumps flatten.