Fungal Acne Skin (Part 1)

For 2 years, I had struggled with acne and nothing worked. I cut out possible triggers: certain ingredients, products, and food. It didn't feel like regular acne since I've always had the same type and this looked different. I had cystic acne as a teenager and mostly clear skin by my early 20's without any assistance. Not even a facial cleanser. I was lazy but I only had to deal with some hormonal bumps or whiteheads that would disappear the next day. I rarely ever broke out on my forehead. Those bumps would remain there for up to a week.

I believe the cause was due to switching to a different birth control pill. I immediately got bumps/whiteheads all over my forehead. I assumed it was a side effect and waited out 3 months with no improvement. I switched back to my regular pill and thought it would turn my skin back to normal. Nope! This was so itchy that I had to take Benadryl often.

My theories were adult acne, niacinamide allergy, dairy sensitivity or some other unknown allergies. I stopped the skincare routine I was doing (Cerave products, Retinol, BHA, sunscreens, serums) and only used super gentle products (Neutrogena, Hado Labo, and Vanicream). The bumps never went away but it was becoming less intense towards the last year. I kept using products that I had no issues with prior to the breakouts so nothing ever clicked.

I've been following r/skincareaddiction for years. It's where I found all the best product recommendations and routines. One day I stumbled upon a post about fungal acne but I never once thought it applied to me. It's not something you can easily search for pictures of and most websites said it was *only* closed comedones on the forehead. (I would get clusters of whiteheads on my forehead, temples, cheeks, jawline, and neck.) Eventually, it was my last resort because I had tried everything with no sustainable improvement.

I came across this post: Pityrosporum (Malassezia) Folliculitis Treatment: Kick Fungal Acne’s Ass (How to). There are many things that are considered triggers: fatty acids, oils, polysorbates, esters, yeast ferments, squalene,  amino acids + lipids together, and benzoyl peroxide. Possible triggers were ceramides, glycerin, and your own sweat!

*Some people reported that their diet was also a trigger. So it is possible that dairy was one for me.

This was extremely problematic because the majority of my skincare products contained those ingredients. Cerave moisturizers have fatty acids, ceramides, and esters while their cleanser had polysorbates. My gentle Neutrogena cleanser that I bought twice had esters/polysorbate. I started looking up the ingredients in everything else: sunscreens, body soap, shampoo, conditioner, and makeup.

Why was my acne improving during certain times?

Apparently, I already owned some fungal acne safe products. It's difficult to find products that are 100% safe to use. So it's a YMMV situation. I made a document to track all of my products. My favorite moisturizers, cleansers, and sunscreens had to go. Baby wipes that I sometimes used to remove my makeup were bad. This finally made sense why my skin would improve then later get worse.

How do you get it?

It's not acne since it's actually Pitoyrosporum Follculitis (Malassezia). It's caused by a yeast infection. It's also possible to get other skin conditions like dandruff, psoriasis, eczema, etc.

Prolonged use of antibiotics, steroid use, birth control pills 🙄, stress, fatigue, high humidity, hot weather, sweat, excessive occlusion and more.

If you have fungal acne, you can use Head & Shoulders shampoo as a facial cleanser. I decided to try out Nizoral Anti-Dandruff shampoo with Ketoconazole 1% since people had great results. There was an improvement by the next day so I kept it up. After digging around, I have noticed some people ruined their skin by using this product.

I made the mistake of using this too much. It irritated my skin so badly that it got dehydrated. Guess what? Damaging the skin barrier can induce growth for fungal acne.

The top photo shows a typical breakout on my face and neck. The second photo is a few days of doing treatments including Nizoral. THEN I dehydrated my skin so both sides of my face were badly inflamed, dry and covered more in bumps. This whole process took nearly 2 weeks. I tried some new products which ended up saving my skin within 3 days!

My skin has been itch free since January 3rd. Part 2 will be coming soon! I'm going to share what products I used to get those after results.

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