Demodex Mites, Skin Concerns

What is Fungal Acne and how It is Related to Demodex

Fungal Acne Signs, Causes
Reading Time: 7 minutes

Acne is one of the most common skin issues that we all face at least once in our lives. Antibiotics are often beneficial in treating most kinds of pimples. However, if you’re diagnosed with acne which does not respond to typical treatments, you may not have acne after all! Fungal acne – which indeed is not categorized as acne – may be the cause of your pimple-like problem.

OZiDEX may help you get a remedy from fungal acne signs and symptoms if it is related to Demodex mite

What Is Fungal Acne?

Fungal acne is very similar to hormonal and bacterial acne, but with a slight difference: as we mentioned, it does not actually fall into the acne category. Although bacteria often have a proactive role in causing pimples, fungal acne is caused by an abnormal growth of the skin fungi flora; a particular type of fungus known as Malassezia, which is naturally present in the skin of 92% of people.

Malassezia feeds on oil, which may be the skin sebum or oils and fats in the cosmetics we wear. The human skin natural oil is a combination of different lipids, including triglycerides, fatty acids, wax esters, sterol esters, cholesterol, and cholesteryl esters. This fungus uses sebum after breaking down its triglycerides and esters into diglycerides, monoglycerides, and free fatty acids.

This is why Pityrosporum Folliculitis or Malassezia folliculitis (other names for fungi acne) is more likely to occur in areas where the sebaceous glands are more active (which means more oily). These are areas such as the t-zone of the face, the forehead, shoulders, chest, and back.

Unfortunately, fungal acne is often confused with common bacterial acne, which leads to the intense, long-term antibiotics treatment that often exacerbates the lesions. This dermatological issue is often misdiagnosed as acne vulgaris and can last for years because it does not respond to antibiotic treatments.

Knowing the difference between these two conditions can help you avoid taking antibiotics for no reason.

What Is Demodex?

Humans can be great hosts for many microscopic organisms, including fungus, mites, and bacteria. An example of these uninvited guests on our skin is a mite known as Demodex. Almost all adult human beings in existence have a number of these creatures living, crawling, and wiggling on their skin. However, as long as they are low in density, they usually remain asymptomatic. But when they increase in number, many skin and hair problems may begin to get worse.

Rosacea, dandruff, seborrheic dermatitis, nocturnal pruritus, and acne are some of the clinical manifestations that Demodex has been implicated in mimicking, exacerbating, or even causing them.

Fungal Acne Signs and Symptoms vs. Regular Acne

Fungal Acne Symptoms vs. Regular Acne Demodex and Fungal Acne
Demodex and Fungal Acne Demodex treatment-ozidex

Fungal acne is usually an itchy condition. Blackheads and whiteheads (which are called comedones) are very common in regular (bacterial) acne. The other differences between fungal and regular acne are as follows:

• Size:

Vulgaris acne lesions can occur in different sizes, while bumps caused by fungal acne are usually uniform.

• Location:

 Bacterial acne commonly affects the face’s skin, while lesions caused by fungal acne are more common in areas such as the arms, back, and chest.

• Accumulation:

Bacterial pimples can be scattered, but fungal acne lesions are usually clustered and grow in one area.

If Fungal Acne Is Not Acne, Why Is It Known as Acne?

Well, quite simply… Because it looks like acne! Excessive growth of Malassezia can cause an infection of the hair follicles, giving them an acne-like appearance. These monomorphic follicular papules are known as fungal acne.

In addition to Malassezia folliculitis, the fungi overgrowth may lead to other skin issues that we will mention in this section.

Skin Issues Associated with Malassezia

The consequences of Malassezia overgrowth are not limited to fungal acne. Research shows that this type of lipophilic fungus is also involved in other common skin problems and diseases such as:

  • Atopic dermatitis or eczema
  • Dandruff
  • Psoriasis
  • Seborrheic dermatitis
  • Pityriasis Versicolor (a kind of baldness and discoloration of the skin)

That is why standard treatments for fungal pimples also apply to the above dermatological issues.

Interestingly, many people who battle with the aforementioned health conditions also have Demodex-related pathology. In other words, both Demodex and Malassezia are involved in the clinical manifestation of dermatitis, dandruff, and seborrheic dermatitis. This linkage leads to the hypothesis that suggests the role of Demodex in the development and exacerbation of fungal acne.

What Is Fungal Acne
Treatment of Fungal Acne Demodex and Fungal Acne

Causes of Fungal Acne

It is not yet fully understood why in some individuals Malassezia fungi overgrow and cause complications. However, it is known that various internal and external (environmental) factors predispose people to this problem:

Internal factors:

It seems fungal acne is more common in people with the following health issues:

  • Diabetes
  • HIV
  • Hodgkin’s disease
  • Organ transplants
  • Malnutrition
  • Neurological disorders
  • Immunodeficiency or weakened immune systems

Another risk factor for fungal acne is the overuse of antibiotics. Long-term use of antibiotics (such as tetracycline) destroys the skin’s microbial flora, as well as other typical skin microorganisms such as bacteria, fungi, etc. All of these microorganisms are extremely beneficial to our body, and without them, can lead to the uncontrolled growth of Malassezia. Finally, obesity, pregnancy, use of steroid hormones (estrogen, progesterone), birth control pills, and stress have also been other predisposing conditions that may lead to fungal acne.  

External factors:

In short, a combination of certain skincare products, humid weather, sweating, and clogging of skin pores can cause fungal acne. In the Philippines, fungal acne accounts for 56% of acne cases, which can be related to the region’s type of climate.  

Fungal Acne Diagnosis:

If you have too much Malassezia under the microscope, you may have fungal acne. For this purpose, the dermatologist takes a sample of your skin for viewing under a microscope. This procedure gets done in two ways:

1. Scraping the skin:

This method is painless. The surface of the affected skin is scraped, and a sample is sent to the laboratory to find Malassezia fungi.

 In this method, the provider removes a thin layer of the skin to check fungi’s presence. Although observing skin cells under a microscope is one of the best ways to diagnose fungal acne, since the main site of fungi accumulation is in the hair follicles, testing for pus in the pimples is associated with more reliable results. In addition to sampling, clinical signs are evidence that helps a dermatologist diagnose fungal acne:

  • How long have you had acne symptoms?
  • When does your acne get worse?
  • What are your symptoms?
  • Do your pimples get worse after using some healthcare products?
  • Do you feel itchy?
  • Which areas of your body have the most pimples?

These are some questions that help your doctor diagnose your condition.

Demodex Mites Online Quiz
Find Your Results in Just 5 Minutes! Most people have found the results of their Demodex population density by answering these carefully crafted questions.

How Does Demodex Relate to Fungal Acne?

Demodex mites are microscopic mites that inhabit human skin, and they have a known role in the cause and exacerbation of various dermatological disorders including; rosacea, acne, seborrheic dermatitis, and dandruff. The role of Demodex in fungal acne is an emerging topic that has only received little research.

In one recent study, the microscopic skin examination of a person with symptoms of fungal acne, actually revealed that the lesions were caused by a buildup of Demodex mites, not Malassezia! In other words, this study showed that not only do Demodex mites mimic signs of rosacea but they also mimic that of fungal acne. In this case, standard treatments for fungal acne will not work, and you will require a Demodex mite treatment.

Another study in this field showed that both Demodex mites and fungi are more common in people with acne. Although these findings do not establish a specific relationship between these two, they nevertheless reinforce the hypothesis that Demodex mite may play a role in fungal diseases.

One of the mechanisms that connect Demodex and Pityrosporum Folliculitis is the body content of Demodex mite!

Demodex is like a bus full of microorganisms. When they die, these microscopic organisms (including fungi) are released onto the skin. The more Demodex there are, the higher the amount of harmful substances they cast on the skin. However, more research is needed to make the results more definitive.

Treatment of Fungal Acne

Hygiene is essential for treating and avoiding this skin problem. As fungi grow more in humid environments, you should avoid moisture:

Sun exposure prevents the fungus from growing
  • Keep your skin dry and clean. To do this, you can use body washes.
  • Wash your sports clothes before wearing them again. The fungus may have grown in the clothes moisture and retransfer to your body.
  • Avoid wearing tight clothing that makes your skin sweat.
  • Take a shower immediately after exercise and change your clothes.
  • Sun exposure prevents the fungus from growing.


  • Use over-the-counter antifungal medication and shampoos.
  • Perform the treatments prescribed by your doctor.

OZiDEX and Fungal Acne

PROCUTiN is an Australian product made by OZiDEX that contains antifungal compounds such as glycerin, tea tree oil, and coconut oil. These ingredients can kill fungi and prevent them from growing.

Although the main goal of OZiDEX is to destroy Demodex, like we mentioned, these mites can play a role in fungal conditions, including fungal acne, This is through the possibility that they may act as a fungal transport mechanism. Although more studies are needed in this area, PROCUTiN may be an influential factor in helping to treat fungal issues such as fungal acne by eliminating Demodex. 

Just as some studies have shown, Demodex can actually mimic the symptoms of fungal acne, in which case PROCUTiN will be an essential aid in treating this infection.


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