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Those Small, Inflamed ‘Pimples’ on Your Back and Chest May Not Be Acne

Sometimes, what you think is acne—you know, those angry bumps speckling your skin—might actually be something entirely different. Fungal acne is one such impostor and a very sneaky one at that.

In fact, fungal acne isn’t really a term dermatologists use, according to board-certified dermatologist Ife J. Rodney, M.D.1, founding director of Eternal Dermatology + Aesthetics and professor of dermatology at Howard University and George Washington University. “It is often confused with acne2, but what’s actually happening is an overgrowth of pityrosporum yeast that lives in our hair follicles,” Dr. Rodney tells SELF. “Sometimes, the overgrowth causes an infection, resulting in little bumps on the chest, back, and face that will look like acne.”

Surviving life as a teenager has taught you how to respond when pimples strike: You go at them with a slew of products designed to obliterate them—but the acne treatments you’ve relied on for years will have zero effect on fungal acne. Here’s why and what you can do to actually get rid of it.

What is fungal acne and how is it related to folliculitis?

Folliculitis is a common skin infection that develops in the hair follicles, according to the American Academy of Dermatology (AAD)3. It can show up anywhere on your skin, except for the palms of your hands and the soles of your feet.

“By definition, folliculitis means an infection of the hair follicles, usually from bacteria,” Dr. Rodney explains. “However, when there is excess pityrosporum yeast within the hair follicles, we call it fungal folliculitis which is sometimes referred to as fungal acne.” 

Basically, fungal acne is just one form of folliculitis. So, despite its resemblance to bacterial acne, fungal acne occurs when yeast (yes, a fungus) inflames the hair follicles on your skin and causes pimple-like bumps. Fungal acne is technically referred to as pityrosporum folliculitis or malassezia folliculitis for the specific type of fungus (malassezia is the more updated term4, but your dermatologist may still call it pityrosporum).

What causes fungal acne, exactly?

For the record, it’s normal for this type of fungus to be living on your skin. But when it gets out of control, it can lead to fungal acne breakouts or other skin conditions, like seborrheic dermatitis.

Under normal conditions, there will be a balance between the bacteria and fungus on our skin, Hye Jin Chung, M.D.5, assistant professor of dermatology at Boston University School of Medicine, tells SELF. But if something happens to wipe out the bacteria (say, you take antibiotics)6, there won’t be anything to keep the fungus in check. As a result, an overgrowth of fungus can develop, which in turn can lead to skin irritation, inflammation, and fungal acne.

Antibiotics aren’t the only factor in developing fungal acne—sometimes our own habits are the culprits. For instance, wearing tight, nonbreathable clothes often contributes to breakouts on your chest, back, or other parts of your body that are prone to breakouts, Dr. Chung says. More specifically, wearing sweaty workout clothes for too long or rewearing fitness gear without washing it can create a very hospitable (read: moist) environment for fungi to grow, Emily C. McKenzie, M.D.7, clinical instructor in the department of dermatology at the University of Utah, tells SELF.

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