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Dr. Alpana Mohta Ranka, MD, DNB, IFAAD, is a triple-board-certified dermatologist with over 100 research publications in peer-reviewed scientific journals.

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Comedones vs Fungal Acne: Differences and Effective Treatment Approaches

Updated: May 18

When it comes to skin concerns, acne is one of the most prevalent issues people face. However, not all acne is created equal. There are various types of acne, and two commonly misunderstood varieties are comedones and fungal acne.


Understanding the differences between these conditions is crucial for accurate diagnosis and effective treatment. In this article, we'll delve into the distinctions, causes, symptoms, and evidence-based treatment approaches for comedones and fungal acne.


What are Comedones?


Comedones are a fundamental type of acne lesion that forms when hair follicles become clogged with oil, dead skin cells, and bacteria. There are two primary types of comedones: whiteheads and blackheads.


Whiteheads

These are closed comedones characterized by small, flesh-colored bumps on the skin's surface. The clogged pore remains closed, preventing the oxidization of the trapped material. Whiteheads are non-inflammatory and can be managed with appropriate skin care routines.


Blackheads

Blackheads are open comedones that appear as small, dark spots on the skin. The trapped debris is exposed to air, causing oxidation and the characteristic dark color. While they are also non-inflammatory, they can be visually bothersome.


What is Fungal Acne


Fungal acne, scientifically known as Pityrosporum folliculitis, is often mistaken for traditional acne due to its similar appearance. However, its underlying cause is entirely different. Fungal acne arises from an overgrowth of yeast on the skin, specifically the Malassezia species. This overgrowth can lead to inflamed pustules and papules that mimic traditional acne.


Distinguishing Factors: Comedones vs Fungal Acne


Appearance

Comedones are typically small, non-inflamed bumps, whereas fungal acne presents as red, itchy pustules that may resemble traditional acne but often appear uniform in size.

Location

Comedones are commonly found on the forehead, nose, and chin (the T-zone), while fungal acne often appears on the chest, back, and shoulders.

Itchiness

Fungal acne tends to be intensely itchy, which is not a characteristic of traditional acne.


Here's a table summarizing the difference between comedones and fungal acne:


Differences between comedones and fungal acne

Causes and Triggers

Comedones are primarily caused by excess sebum production, hormonal imbalances, and the accumulation of dead skin cells. Fungal acne, on the other hand, arises due to the overgrowth of Malassezia yeast, which thrives in humid environments.


 
 

Effective Treatment Approaches


Comedones Treatment

For whiteheads and blackheads, a consistent skincare routine involving gentle exfoliation, oil-free products, and non-comedogenic makeup can help manage these conditions.


Read the article on best spot treatment for acne to learn about the spot treatment approaches you can take.


In more severe cases, dermatologist-prescribed topical treatments like retinoids may be recommended.

Fungal Acne Treatment

Antifungal treatments are the cornerstone for managing fungal acne. Over-the-counter antifungal creams containing ingredients like ketoconazole or pyrithione zinc can be effective. In severe cases, oral antifungal medications may be prescribed by a dermatologist.


Closed Comedones vs Fungal Acne: What's the difference?

The differences between comedones and fungal acne have already been highlighted above. However, there's often confusion between a specific type of comedone, i.e., closed comedones (AKA whiteheads), and fungal acne.


The confusion often stems from the fact that both conditions result in flesh-colored or tiny white raised bumps on the skin's surface.


Fungal acne is a skin infection caused by the dandruff-inducing fungus known as Malassezia. This type of acne tends to appear near the hairline, especially along the forehead, and can also crop up in areas where dandruff scales typically fall, such as the chest and shoulders. The affected areas are often accompanied by itchiness and may display subtle, delicate scales. These fungal acne lesions tend to cluster together, although individual ones usually fade within 5-7 days.


On the other hand, closed comedones or whiteheads are most commonly found in oil-prone regions of the face, particularly the T-zone encompassing the forehead, nose, and chin. Unlike fungal acne, these comedones are generally asymptomatic and do not induce any itching. Furthermore, there's no presence of surrounding scaling. These white or skin-colored bumps tend to linger on the face for a period of 2-3 months before spontaneously resolving. However, in certain cases, these closed comedones might prove stubborn and necessitate extraction to clear up.


Prevention and Self-Care


Preventing comedones involves keeping the skin clean, avoiding pore-clogging products, and maintaining a balanced diet. Fungal acne can be prevented by practicing good hygiene, wearing breathable clothing, and using antifungal body washes in humid climates.



Distinguishing between comedones and fungal acne is essential for tailored treatment and effective management. While both conditions share some visual similarities, understanding their root causes and distinctive features enables individuals to make informed choices about their skincare routines and seek timely medical assistance if needed.


If you have other questions or concerns about acne or their after-effects, you can read the following articles:

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