malassezia folliculitis, AKA "fungal" acne

malassezia folliculitis, AKA "fungal" acne

malassezia folliculitis, AKA "fungal" acne

* updated june 8 2024 to include SF's foggy climate and resulting mold/mildew in the air


"fungal" acne is a popular (and incorrect) term used to describe a skin condition that looks like acne, but actually isn't. when people talk about "fungal" acne, they are usually actually talking about malassezia follliculitis, or MF for short. 

MF is a type of acneiform: acne-look-alike skin reactions that can look very similar to, but are not your typical acne vulgaris, which clears with the acne-safe lifestyle. acneiforms don't, because they're result of different factors like excess fungus or yeast on the skin or in the body, or are a reaction from medications. to make things a bit more confusing, both can exist on the skin at the same time - so it's best to be both acne- and MF-safe when shopping for skin products. 

MF in particular seems to be influenced by excess fungal + yeast imbalances present either on the skin's surface or within the body. in the skin clinic, we've seen it on the face mostly around the mouth, nostril and nose areas, forehead and temples, and sometimes also on various part of the body (especially within folds of skin like under breasts, inner elbows and underarms). it also seemed to accompany almost every client we also suspected to have a candida albicans yeast overgrowth imbalance.

because it's so often misdiagnosed for and treated like acne vulgaris, it can persist for years until it's properly identified and treated. if you've been doing all the acne-safe things and just can't clear up (especially if you live in a humid climate), this may be the reason why.


a big sign that what you're dealing with is malassezia folliculitis and not just regular acne is if it's itchy. regular acne vulgaris typically isn't itchy, but malassezia folliculitis, which is yeast- and fungus-related, often is. the rash may also have a flat patchy "plaque" type of appearance and texture, versus the more individual bumps that acne vulgaris usually appears as.

another big sign is if you are prone to yeast- or fungal-related infections, like vaginal yeast infections, jock itch, or athlete's foot. if you're getting infections somewhat regularly (or at all, really), get this checked out.

finally, if you live somewhere coastal and muggy where mold in old wooden building frames and such is a thing, these mold and mildew spores are released into the air, possibly affecting your skin topically. after all, the skin IS the body's first line of defense from the world and all its bugs. i'm starting to suspect this may be happening with long-time regular clients of mine who are doing all the acne-safe things. 

if these resonate, it might be best to consult an integrative therapist or holistic naturopathic doctor to help diagnose and support your body for the best results.

special thanks to our resident san francisco esthetician, kerry watson, for compiling most of the information below!



this fungal acne reddit group is a really great online support community for people who suspect they have fungal acne (or malassezia folliculitis). there is some good info here but since it's open to the general public to contribute, there's also some misinformation about skin and acne in general. 

this article about drug induced follicular eruptions from dermnet new zealand takes a very allopathic conventional medicine approach to treatment which we at sS aren't really in alignment with, but the information regarding the cause and identification is useful.

folliculitis scout is an ingredient checker website that works a lot like our product checker, but is focused on ingredients known to aggravate malassezia folliculitis.

you may also want to do some systemic mold testing through an acupuncturist or functional doctor, or home testing with kits available online or through professionals if you suspect mold to be an issue in your particular case. 



after wearing PPE masks in humid tropical climates for long periods of time, i started noticing getting a rash on my upper lip, and tried to figure out where it was from. for someone that eats a relatively low amount of sugar and didn't have the other typical excess yeast- or fungal-related symptoms, i figured the mask and humidity must have been the aggravator.

in addition to a light pink itchy rash spots that appeared on my upper lip, my nostrils also had visibly flaky, dry skin. i mistook the dry nostril skin for just regular, extra dry skin. but as you'll read, it seemed to be part of the same rash as well. 

here are the 2 things that helped me to clear it:

first, the less i wore my mask the better. as much as possible, i tried to spend my time in cool, air conditioned spaces where i could safely be maskless. the concentrated moist heat of my own breath inside the mask and the humid tropical climate directly outside of it really aggravated it, no matter how many times throughout the day i patted my skin dry.

second, sparingly applying a mix of tea tree and lavender essential oils (ever so slightly diluted with our hydrating gel) to the itchy upper lip rash helped it heal quite quickly. using just the essential oils straight (which isn't advised anyway) burned my skin, but using too much hydrating gel prolonged the itching and longevity of the rash, so finding a just-right balance took some time. ultimately, i found that about 1 tablespoon hydrating gel to 1-2 drops each tea tree and lavender oil seemed to work for me.

as far as my flaky nose, applying extra hydrating cream to it didn't help. i somehow started putting the same essential oil blend there and it also finally healed rather quickly. my flaky nose seemed to be the same type of rash on my upper lip that responding to the same topical essential oil combo, that just manifested in different ways.

combining these two strategies, i started to feel relief in just a couple of days and made sure to keep it up until the weather cooled down, so long as my skin stayed clear.


when sourcing products to use on your skin, 1. use as little product (especially makeup) as possible, to allow the skin to breathe as much as possible and 2. check their ingredients to be both acne- and MF-safe. we are working on getting the MF list programmed into our product checker but for now, the analog list is below.

for best results, run your product of choice through both the sS product checker and through the list below.

you can find some recommended skincare regimens we put together below the long list we've researched and compiled below. take note that even some acne-safe ingredients appear on this list, as well as comedogenic ones:

almond/borage/linseed/olive acids glycerides

almond oil

apricot kernel

apricot kernel oil

arachidic acid

argania spinosa

argania spinosa kernel oil

argan oil

ascorbyl palmitate

astrocaryum murumuru seed butter

avocado oil

babassu oil


behenic acid

bis-diglyceryl polyacyladipate

black currant oil

borago officinalis seed oil

brassica campestris

butyrospermum fruit

butyrospermum parkii

butyrospermum parkii (shea butter) unsaponifiables

butyrosperum parkii (shea) butter extract

buxus chinensis

c10-30 cholesterol/lanosterol esters

calophyllum inophyllum seed oil

candelilla/jojoba/rice bran polyglyceryl-3 esters

candelilla wax

canola oil

carnauba wax

carthamus tinctorius oil


carya illinoensis oil

castor isostearate succinate

castor oil

cera alba

cera microcristallina

cetearyl ethylhexanoate

cetearyl octanoate

cetearyl olivate

cetyl esters

cetyl palmitate

cocoa butter



coconut acid

coconut oil

cocus nucifera

coffea arabica (coffee) seed oil

copernicia cerifera wax


corn oil

corylus americana

corylus avellana

cranberry seed oil

decyl oleate

diisopropyl dimer dilinoleate

diisostearyl polyglyceryl-3 dimer dilinoleate

dimer dilinoleyl dimer dilinoleate

dipalmitoyl hydroxyproline

echium plantagineum seed oil

elaeis guineensis oil

emu oil


ethylhexyl olivate

ethylhexyl palmitate

ethylhexyl stearate

ethyl macadamiate

euphorbia cerifera wax

evening primrose oil

flaxseed oil

glycerol monostearate

glyceryl behanate

glyceryl behenate

glyceryl behenate/eicosadioate

glyceryl cocoate

glyceryl dibehanate

glyceryl distearate

glyceryl ester

glyceryl isostearate

glyceryl oleate

glyceryl stearate

glyceryl stearate citrate

glyceryl stearate se

glycine soja (soybean) oil

glycine soja sterols

glycol stearate

gossypium herbacuem seed oil

grape seed oil

helianthus annuus (sunflower) seed oil

helianthus oil

hexyl laurate

hydrogenated coco-glyceride

hydrogenated olive oil

hydrogenated palm glycerides

hydrogenated rapeseed oil

hydrogenated soybean oil

hydrolyzed jojoba esters

hydrolyzed pumpkin seedcake

hydroxystearic acid

isoamyl cocoate

isoamyl laurate

isopropyl isostearate

isopropyl lanolate

isopropyl myristate

isopropyl palmitate

isopropyl titanium triisostearte/triethoxycaprylylsilane crosspolymer

isostearic acid

japan wax

jojoba esters

jojoba oil

jojoba wax

kojic dipalmitate


lauric acid

lauryl laurate

linoleic acid

linolenic acid

linum usitatissimum (linseed) seed oil


lupinus albus (white lupine) seed oil

mangifera indica (mango) seed butter

melia azadirachta oil

methyl glucose sesquistearate

microcrystalline wax

moringa oleifera seed oil

murumuru seed butter

myristic acid

myristoyl pentapeptide-17

myristyl myristate

neem oil

octyl palmitate

octyl stearate

oenothera biennis oil

olea europaea fruit oil

oleic acid

oleyl erucate

olive oil peg-7 esters

orbignya oleifera seed oil

oryza sativa oil

palmitic acid

palmitoyl hexapeptide-12

palmitoyl oligopeptide

palmitoyl pentapeptide-4

palmitoyl tetrapeptide-7

palmitoyl tripeptide-1

palmitoyl tripeptide-38

palmitoyl tripeptide-5

palmitoyl tripeptide-8

palm oil

peanut oil

pecan oil

peg-100 stearate

peg-10 rapeseed sterol

peg-120 methyl glucose dioleate

peg-150 distearate

peg-20 glyceryl triisostearate

peg-20 methyl glucose sesquistearate

peg-40 hydrogenated castor oil

peg-40 stearate

peg-60 almond glycerides

peg-60 hydrogenated castor oil

peg-75 stearate

peg-7 glyceryl cocoate

peg-80 sorbitan laurate

pentaerythrityl tetraisostearate

persea gratissima (avocado) oil

pistachio seed oil

pistacia vera seed oil

polyglyceryl-10 dioleate

polyglyceryl-10 laurate

polyglyceryl-10 stearate

polyglyceryl 2 triisostearate

polyglyceryl-3 beeswax

polyglyceryl-3 methylglucose distearate

polyglyceryl-3 stearate

polyglyceryl-4 isostearate

polyglyceryl-4 laurate

polyglyceryl-4 olivate

polyglyceryl-6 isostearate

polyhydroxystearic acid

polysorbate 20

polysorbate 60

polysorbate 80


pongamia glabra seed oil

propylene glycol isostearate

propylene glycol stearate

prunus amygdalus dulcis

prunus armeniaca (apricot) kernel oil

prunus dulcis


rapeseed oil

raspberry seed oil

retinyl palmitate

rice bran oil

rice oil


ricinus communis (castor) seed oil

rosa canina

rosa mosqueta

rosa rubiginosa

rose hip

rose hip oil

safflower seed oil

salvia hispanica (chia) seed oil

sclerocarya birrea

sea buckthorn

sesamum indicum

sesamum indicum (sesame) seed oil


shea butter

silybum marianum seed oil

simmondsia chinensis (jojoba) seed oil

sorbeth-230 tetraoleate

sorbitan isostearate

sorbitan laurate

sorbitan oleate

sorbitan olivate

sorbitan sesquioleate

sorbitan stearate

soy oil



stearic acid

stearyl stearate

sucrose cocoate

sunflower seed oil

sweet almond

sweet almond oil


tamanu oil

theobroma cacao (cocoa) seed butter

thyme oil

thymus vulgaris

thymus vulgaris oil


tridecyl stearate



triticum vulgare germ oil

vitamin a

vitamin c

vitamin f

vitis vinifera

wheat germ oil




  • mandelic acid

  • bp

  • squalane oil

  • tea tree oil and lavender oil (organic if possible, diluted as little as possible with a hydrating gel or serum)








that have had acne-safe looking ingredients in the past, but formulations may have changed since our last research, and also have not been tested on acneic skin:

    • lotrimin powder spray
    • selsun blue max strength
    • kamedis anti-dandruff shampoo - fragrance
    • acnedot cleanser  


    • squalane oil (very low in comedogencity like a 1, maybe ok if skin is only fungal acne and no comedones are present)
    • The Tolerance Extreme Emulsion from La Roche Posay




  • cleanse

    • skinsalvation charcoal wash OR

    • beyond complexion mandelic gel cleanser

  • ice

  • exfoliate

    • salicylic 2% OR

    • glycolic 10% serum OR

    • skinsalvation mandelic toner

  • moisturize

    • a natural difference rejuvenation concentrate serum OR

    • squalane oil 

  • protect

    • tizo 2 or 3 sunscreen OR

    • la bella donna spf 50 powder


  • cleanse
    • skinsalvation charcoal wash OR
    • beyond complexion mandelic gel cleanser
  • ice
  • exfoliate
    • skinsalvation salicylic 2% OR
    • skinsalvation glycolic 10% serum OR
    • skinsalvation mandelic toner
  • treat
    • skinsalvation 5% benzoyl peroxide gel 


  • moisturize

    • a natural difference rejuvenation concentrate serum OR

    • squalane oil 

we hope this information on topical ideas helps, do keep in mind candida yeast overgrowth may be some thing to address as well. you can search "candida" on our lifestyle library blog to learn our thoughts on the topic, and the acne-safe way we've guided our clients to do the cleanse.

please keep us posted on your progress and discoveries!

Not sure where to start?