Overview
Acne comes in various forms with unique causes and treatments. Among them, fungal acne and closed comedones are prevalent. This article explores the differences between fungal acne and closed comedones. Unlike clinical acne caused by bacterial overgrowth from clogged pores due to pollution, dead skin cells, sebum, and heavy skincare products, fungal acne is not technically acne. It stems from yeast overgrowth, specifically from Malassezia, a natural skin yeast. This overgrowth can lead to small red pimples on the chest, upper back, forehead, cheeks, or other areas prone to fungal acne.
What are closed comedones?
Closed comedones, or comedonal acne, are characterized by small bumps on the skin. These bumps appear flesh-colored, white, or darker, contributing to a rough texture, especially on the chin, cheeks, and forehead. A solid core is often seen at the center of these bumps, resembling a pustule or whitehead. Closed comedones are commonly found at the openings of skin pores.
What is fungal acne?
Fungal acne, technically known as pityrosporum folliculitis or Malassezia folliculitis, is a type of folliculitis rather than traditional acne. It is caused by an overgrowth of yeast, particularly Malassezia, within the hair follicles. This overgrowth can lead to inflammation and small, red bumps on the skin. Unlike bacterial acne, which is caused by Propionibacterium acnes, fungal acne is characterized by its response to antifungal treatments rather than typical acne medications.
Causes and triggers
Closed comedones, commonly known as whiteheads, form due to various factors related to sebum production and pore blockage.
Hormonal changes
Hormonal fluctuations during puberty, particularly increased testosterone activity, can stimulate excess sebum production. This excess sebum, combined with dead skin cells and surface debris, clogs hair follicles and forms closed comedones. Hormonal changes during pregnancy or menstruation can also contribute to their development.
Diet
Certain dietary factors, such as high intake of sugars, fats, or dairy products, can exacerbate acne, including closed comedones. These substances may trigger inflammatory responses in the skin or disrupt the body’s ability to process nutrients effectively, potentially leading to acne flare-ups.
Oily cosmetic products
Using oily or comedogenic skincare products can contribute to the buildup of sebum and debris on the skin’s surface. This buildup can block pores and contribute to the formation of closed comedones. Choosing non-comedogenic products labeled as oil-free or water-based is essential to minimize pore blockage.
Unhealthy lifestyle choices
Lifestyle factors like smoking, excessive alcohol consumption, or drug use can affect skin health and contribute to the development of closed comedones. These habits can increase inflammation, reduce skin’s natural defences, and impair overall skin health, making it more prone to acne and comedone formation.
Aggressive facial cleansing
Overly harsh facial cleansers or exfoliants can strip the skin of its natural oils and disrupt the skin barrier. This disruption can increase sebum production as the skin compensates for moisture loss, potentially exacerbating closed comedones. Gentle cleansing with mild, non-abrasive products is recommended to maintain skin balance and prevent pore blockage.
Environmental factors
Environmental pollutants, humidity, and lack of sunlight exposure can also influence skin health and contribute to the development of closed comedones. Pollutants can clog pores and trigger inflammatory responses in the skin, while humidity can increase sebum production. Protecting the skin with appropriate skin care and minimizing exposure to environmental pollutants can help reduce the risk of comedone formation.
Common areas affected
By understanding the typical locations where fungal acne and closed comedones appear can help identify and manage these skin conditions effectively.
Fungal acne
Fungal acne can develop anywhere on the body where hair grows, but it most commonly appears on the cheeks, forehead, chest, and upper back. These areas provide an environment conducive to yeast overgrowth within hair follicles, leading to the characteristic small, red bumps associated with fungal acne.
Closed comedones
Closed comedones, or whiteheads, typically form on the chin and forehead, where sebaceous glands are more active. However, they can also develop on other areas of the face, such as the cheeks, and may extend to the neck, chest, and back. These areas are prone to sebum accumulation and pore blockage, contributing to closed comedones’ formation.
How do you treat fungal acne and closed comedones?
Fungal acne and closed comedones can be treated with a mix of dietary changes, oral or topical prescription medications, or over-the-counter topical options such as:
Treatment for closed comedones
Closed comedones can be treated with a range of lifestyle changes, including dietary changes and using prescription medications for effective results as prescribed by your doctor as:
- Dietary changes
Making dietary adjustments can help reduce the appearance of closed comedones. Consuming low-glycemic foods such as fresh vegetables, fruits, beans, and oats can help maintain stable blood sugar levels and reduce sebum production. Limiting sugar, fat, oil, and dairy intake can also be beneficial in managing acne-prone skin.
- Products for closed comedones
Effective topical treatments for closed comedones include:
- Benzoyl peroxide: Known for its antibacterial properties, benzoyl peroxide reduces acne-causing bacteria and promotes exfoliation, helping to clear pores and prevent future breakouts.
- Differin (adapalene): A topical retinoid derived from vitamin A, Differin regulates skin cell turnover and reduces inflammation, effectively treating and preventing acne lesions.
- Retinol: Similar to adapalene, retinol promotes skin cell turnover and unclogs pores, improving overall skin texture and reducing the formation of closed comedones.
- Procedures
Various skincare procedures can effectively treat closed comedones:
- Chemical peels: Utilizing solutions like salicylic, azelaic, and glycolic acids, chemical peels remove the outermost layer of skin, revealing smoother, clearer skin with reduced imperfections and improved texture.
- Microdermabrasion: This treatment involves exfoliating the skin’s outer layer to promote collagen production and reduce skin concerns. Options like Crystal Peel, SilkPeel, and SonoPeel offer different techniques for achieving smoother skin.
- Blue light therapy: By targeting acne-causing bacteria deep within the skin’s layers, blue light therapy helps reduce inflammation and control acne outbreaks. Combining it with Alpha Levulinic Acid (ALA) enhances its effectiveness in treating moderate to severe acne.
Treatment for fungal acne
Fungal acne is treated depending upon the severity of infection with either oral antifungals or topical antifungal medications or sometimes a mix of both.
Topical medication
- Ketoconazole Cream: An antifungal cream that effectively treats fungal acne by reducing the yeast that causes the condition.
- Clotrimazole Cream: Another antifungal option that helps clear fungal acne by targeting the underlying yeast infection.
Oral medication
- Fluconazole: An oral antifungal medication that treats severe cases of fungal acne by reducing yeast growth from within.
- Itraconazole: Another oral antifungal used for more persistent or severe fungal acne.
How can you tell the difference between milia and acne?
Milia and closed comedones (whiteheads) are distinct skin blemishes with different characteristics and causes. Understanding their differences can help identify and treat them effectively.
- Appearance: Milia are typically small, hard, and white or yellow in color, appearing in clusters. They are often mistaken for whiteheads but cannot be popped like traditional acne.
- Areas affected: Milia can appear on various parts of the face and occasionally on the body, whereas closed comedones are more localized to specific facial areas prone to sebum buildup.
- Causes: Milia are caused by improper shedding of dead skin cells, while closed comedones result from excess sebum production and pore blockage.
If unsure, consulting with a dermatologist can provide clarity and tailored treatment options.
Consult a doctor
If you have numerous closed comedones or have been struggling with them for an extended period, it is advisable to consult a dermatologist. Dermatologists specialize in skin care and can provide tailored treatments, including prescription medications, to manage acne effectively.
For severe cases of fungal acne, dermatologists may prescribe oral anti-fungal medications such as itraconazole or ketoconazole. These medications are typically taken for one to three weeks to combat fungal infections effectively.
If you suspect you have fungal acne or are experiencing a persistent outbreak, seeking advice from a dermatologist is crucial. They can accurately diagnose your condition and recommend appropriate treatment options to achieve clearer, healthier skin.
FAQs about fungal acne and closed comedones
Fungal acne typically presents as uniform pimple-like bumps between 1 and 4 millimeters in size. Unlike other skin conditions, which may have varying sizes and characteristics, fungal acne bumps are usually consistent and may contain pus.
Several factors can exacerbate fungal acne, including hot and humid climates and trapped moisture. Yeast thrives in warm, moist environments, making individuals in hot, humid climates more susceptible to fungal acne. Wearing sweaty clothing for prolonged periods or reusing damp workout gear can trap moisture on the skin, creating an ideal environment for fungal growth.
Topical antifungal creams like ketoconazole, clotrimazole, and ciclopirox cream are effective in treating fungal acne on the face. Your doctor may prescribe you a suitable antifungal cream as per your medical issue.
Closed comedones may persist or worsen due to several reasons including inadequate exfoliation and overuse of drying products. Failure to remove dead skin cells can lead to pore blockage and the formation of closed comedones. Using too many harsh or drying skincare products simultaneously can irritate the skin and exacerbate comedonal acne.
Factors that can aggravate comedonal acne include contact with certain chemicals like oily pomades, isopropyl myristate, propylene glycol, and cosmetic dyes can clog pores and worsen acne. Also, picking or squeezing pimples, abrasive washing, and aggressive treatments like chemical peels or laser procedures can damage the skin and exacerbate acne. Smoking is another factor that has been linked to increased severity of comedonal acne compared to non-smokers.
