BEAUTY IN THE SKIN 

Many factors, such as genetics, hormonal imbalance, stress, smoking, and comedogenic cosmetics, can cause or intensify acne. While acne is usually associated with bacteria and inflammation, many people wonder if candida causes acne. I will share my experience with acne patients and proven scientific knowledge about thrush pimples, yeast forehead bumps, candida, and cystic acne in this article. We will also discuss other fungal acne causes. Let’s dive in and find the answer to the question, can candida cause acne?

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Can Candida Cause Acne?


Unlike many other microbes, Candida is a yeast that can live in the outer layer of the skin and is considered the skin’s natural flora. In some cases, Candida may outgrow other bacteria and become a dominant species on the skin. This happens when other microbes are killed and can’t multiply.

Usually, overuse of antibiotics and bacteria-killing cosmetics causes the disbalance of the natural skin’s microflora and outgrowth of Candida. Candida becomes the dominant microbe in the skin. This is a reason for persistent acne and failure to treat it with antibiotics (because antibiotics kill ONLY the bacteria and not fungi).

Also, other factors can cause yeast infection. Candida requires carbohydrates (Sweets!) to live and proliferate. So, any condition that creates a high sugar environment for the yeast may contribute to Candida infection:

  • High amounts of sweets and carbohydrates intake;
  • Diabetes;
  • Uncontrolled insulin resistance;
  • Overweight.

The third reason for Candida thriving is a weak or weakened immune system. Various infections, viruses (such as flu and HIV), stress and lack of sleep, smoking, poor nutrition, and lack of vitamins can weaken the immune system. In addition, pregnancy can also lower the immune system. Also, some people are born with immunodeficiency.

Fungal Candida Acne Rash on a woman's neck and chest
Fungal Acne – Candida Rash (Shutterstock)

One more factor contributing to Candida’s overgrowth is estrogen dominance. It happens naturally during pregnancy (one more reason to develop Candida infection during pregnancy), during perimenopause, or when hormones are imbalanced.

Low progesterone, relatively high estrogen, is detected when a woman is not ovulating or has polycystic ovary syndrome. The only way to produce progesterone naturally is to ovulate and develop the corpus luteum (a temporary endocrine gland in the second half of the menstrual cycle) in the ovaries. No ovulation means no corpus luteum and no progesterone (although adrenal glands secrete small amounts of progesterone either).

Estrogen dominance may be created artificially. Taking oral contraceptive pills containing estradiol and consuming bisphenol. Bisphenol A (BPA) is a synthetic compound that can mimic the functions of estrogen. It is one of the highest volume chemicals produced worldwide. Bisphenol is found in certain plastics and plastic products, such as water bottles, plastic cans, and even toys.

Also, wearing a tight face mask, greasy skin, excessive sweating, sweaty workout clothes, hot, humid weather, over-moisturizing your skin, or using too much sunscreen may contribute to the overgrowth of Candida.

All these causes lead to Candida overgrowth, which may lead to thrush pimples.

So, the answer to the question, can Candida cause acne, is YES, it can cause or worsen your acne. It will be called fungal folliculitis, in scientific terms, not acne.

How Do Thrush Pimples, Caused by Candida, Look Like?


Thrush pimples may look like acne with small bumps and be mistaken for acne. The difference between Candida-caused thrush pimples and acne is that acne may have various symptoms (blackheads, whiteheads, papules, pustules, even cysts), varying in sizes, and thrush acne pimples are usually reddish or whitish bumps of a similar size, 1 – 2 mm.

Candida cause acne - woman's forehead with fungal - like bumps
Fungal Acne (Essential Collection via Getty Images)

Thrush pimples may also appear red, itchy, or burning. Fungal acne is usually much itchier than hormonal acne, and itchiness is one of the symptoms you might have Candida or other fungi-caused acne.

Diagnosing Candida acne might not be straightforward, as fungal acne may cause bumps very similar to whiteheads. Also, fungal acne may be present along with usual acne (remember, harsh cosmetics used to treat acne may cause thrush pimples as it kills the bacteria and leads to Candida overgrowth).

Can Candida Cause Cystic Acne?


It is unlikely. Candida and other fungi cause inflammation in the hair follicles, but the rash is not that big to cause cysts. Usually, fungal acne bumps are small and of a similar size.

Where Does Candida Cause Acne?


Thrush pimples may be located anywhere on the skin and mucous membranes. As the yeast feeds off of oil on the skin, the most common places of fungal acne bumps are located in the most greasy areas in the body (with the highest density of oil glands):

  • Forehead and frontal hairline
  • Temples
  • Chin
  • Side of the nose
  • Chest
  • Back
  • Shoulders and arms

How Are Thrush Pimples Diagnosed?


Usually, observing the skin and knowing the history (use of antibiotics, weak immune system) is enough to diagnose thrush acne.

In some cases, a skin scrape test is performed, and the scrapes of the skin are looked at under the microscope to see whether yeast spores are present.

Also, if oral or topical antibiotics do not help clear acne, you might have fungal acne. On the contrary, if antifungal treatment helps to get rid of bumps, be sure you have fungal acne.

Is Candida the Only Fungus that Cause Fungal Acne?


No, Candida is one of the fungi that cause thrush pimples. But fungal acne can also be caused by Malassezia (formerly known as Pityrosporum) fungus, which is also a yeast. Malassezia also belongs to the skin’s natural flora and is always present on the skin.

Candida Bumps on the forehead
Candida Bumps (Essential Collection via Getty Images)

Sebum of the skin feeds Malassezia fungi (that is why it causes problems in oily skin more often).  It starts causing skin problems only when it enters the mycelial phase.

As Malassezia is a yeast, it thrives in the same conditions as Candida. Natural flora disbalance and a weak immune system are the main conditions for Malassezia to multiply. There were some reported cases where Malassezia caused pruritic folliculitis during pregnancy. No wonder! Pregnancy weakens the immune system!

Oily and fatty skincare ingredients or natural skin’s oiliness, hot weather, and sweating induce Malassezia’s mycelial phase and skin problems.

But contrary to Candida yeast, Malassezia cannot survive in the presence of sugars and carbohydrates.

Acne Vulgaris versus Fungal Acne


Regular acne and fungal acne might be mistaken as they cause inflammation in the hair follicles, leading to rashes and bumps. However, there are some differences between the two of them.

 Fungal AcneRegular Acne
SymptomsMany small bumps of a similar size might be red or look like whiteheads.Various symptoms and sizes (blackheads, whiteheads, papules, pustules, cysts, nodules)
LocalizationFace (especially forehead, hairline), upper chest and back, or anywhere on the bodyFace, chest, and back (and never somewhere else on the body).
Parts of the skin involvedPilosebaceous unit (composed of the hair follicle, hair shaft, and sebaceous gland)Pilosebaceous unit (composed of the hair follicle, hair shaft, and sebaceous gland)
FeelingsItchyDoes not itch
Common OrganismsCandida albicans, Malessezia furfurCutibacterium acnes
TreatmentAntifungals (antibiotics do not help or worsen)Antibiotics, retinoids, hormonal treatment, acne treatment
CausesAntibiotics, weak immune system, foods high in sugar, estrogen dominance, hot, humid weather, sweating, tight clothing.Hormonal imbalance and shift (adolescence, pregnancy, menopause), comedogenic cosmetics, stress, smoking, and others.
Regular Acne vs. Fungal Acne

How to Treat and Avoid Candida Caused Acne?


As in all diseases, in Candida acne cases, underlying conditions should be treated first and triggering factors avoided:

  • Determine whether you need to continue taking antibiotics (especially if you are on a long course of antibiotics or using antibiotics cream to treat your acne for a prolonged period).
  • Strengthen your immune system, eat well, consume all essential nutrients, and consider supplementing lacking vitamins and minerals.
  • Evaluate if you have usual acne or fungal acne. Stop using harsh bacteria-killing cosmetics if Candida is causing your acne. Harsh cosmetics kill acne-causing bacteria and good bacteria, your natural skin’s flora, and lead to Candida overgrowth.
  • Avoid sweets and high in sugar foods, control your diabetes, try to lose weight – avoid the sugar-filled environment that Candida loves. Instead, eat more vegetables, fruit, and whole grain.
  • Avoid other Candida growth stimulating factors, such as over-moisturizing, overusing sunscreen, and hot and humid weather.
  • Control your sebum secretion because oil helps feed Candida.
  • Avoid oils, fatty acids, esters (e.g., linoleate, isopropyl palmitate), polysorbates, and fatty alcohols (especially Cetearyl alcohol) in skincare as they will feed yeast.
  • Do not stay in your sweaty workout clothing too long; wash it before using it next time because fungi might grow on the clothing. Consider wearing loose clothing for exercising.
  • If you need to wear a face mask, ensure it is breathable, such as a cotton face mask. Unbreathable masks trap moisture and create a perfect – warm and moist – environment for Candida and other fungi to thrive. Change your masks regularly.

But if you have already developed fungal acne, antifungal creams, washes, or oral antifungal medications.

A woman with a fungal rash on the chest
Fungal Rash (Shutterstock)

Remember! Before starting your treatment, always consult with a doctor for an accurate diagnosis and prescription medications if needed.

The most effective treatment is oral antifungal tablets, as the yeast is found deep in the follicles. Fluconazole is one of the oral medications prescribed for fungal acne. It is often prescribed along with a topical antifungal cream or in cases when topical medications have been ineffective.

Itraconazole is another oral antifungal medication used to treat severe cases of fungal acne but is less frequently used than fluconazole.

You can also try antifungal creams, such as Nizoral, containing ketoconazole, washes containing tea tree oil or benzoyl peroxide, and shampoos (Nizoral). Usually, you can buy antifungal shampoos and washes (and creams in some places) over the counter. Oral medication and topical creams most often require a prescription.

Ketoconazole, found in Nizoral creams and shampoos, effectively reduces Candida-caused acne while being gentle on the skin. It is one of the most effective and most often used medications to treat fungal acne.

Clotrimazole topical cream is another choice to try. It is found in Mycelex and other creams.

Benzoyl peroxide fights acne bacteria and Candida (and other yeast infections). It is found in face and body washes and spot-treating gels. The side effect of benzoyl peroxide is that it dehydrates the skin. It is best to use a benzoyl peroxide wash and rinse it after 10 minutes or benzoyl peroxide gel over a moisturizer.

Tea tree oil is a natural antimicrobial agent, fighting bacteria and fungi. It is widely used in antibacterial and antifungal washes and cosmetics for acne-prone skin.

Salicylic acid can also be used to reduce thrush pimples. It has a strong anti-inflammatory, anti-bacterial, and anti-fungal effect. As fungi like pH 5.5 to 7.5, a more acidic environment kills these beasts. Whether you get a professional salicylic acid peel in the doctor’s or beautician’s office or use skincare containing salicylic acid (washes, creams, or masks), it might help reduce fungal acne.

Azelaic acid, despite being a byproduct of Malassezia, also creates an acidic environment and reduces the number of fatty acids on the skin: no fatty acids, no food for Candida and Malassezia yeasts. Azelaic acid is found in the Skinoren cream.

Sulfur is another possible ingredient to look for if you have Candida acne. Once used to treat various skin conditions, such as acne vulgaris, rosacea, seborrheic dermatitis, dandruff, and others, it is still in use nowadays. Sulfur is one of the safest ingredients. It has an antibacterial and antifungal effect and fights acne bacteria, and fungi on the skin. Moreover, sulfur is known to kill Demodex mites, causing rosacea. Look for washes, masks, and other skincare products containing sulfur.

Zinc pyrithione is an antifungal ingredient but is less effective than ketoconazole. It is found in Head and Shoulders shampoo.

Probiotics help restore a healthy balance between ‘good’ bacteria and fungi. Always take probiotics during and after the course of antibiotics or if you suspect fungal acne. Also, you might try skincare with probiotics.

Turmeric (Curcumin) works as an antimicrobial and antifungal agent. You can look for skincare with turmeric (there are plenty of cosmetic products containing turmeric) or take it as a supplement.

Moisturizer is always helpful, no matter the skin type or condition. Every live cell on Earth needs water, and so does your skin. Hydration can even regulate oil secretion (dehydrated skin will produce more sebum which will feed fungi).

Stay hydrated! Drinking water helps to keep your body’s detoxification, reduce toxins and flush out excess estrogen.

Sunscreen will protect you from harmful UV rays and possible dark spots. The skin in Candida-caused inflammation sites is more susceptible to sun and hyperpigmentation. Also, sunscreen will protect you from photoaging and premature wrinkles. Only make sure your sunscreen does not clog your pores.

Takeaway of the Annoying Question if Candida Cause Acne


As you have read the article, you now know the answer to the question, “Can Candida cause acne”? Yes, Candida and other fungi, such as Malassezia, CAN cause acne.

The main factors that lead to Candida overgrowth are:

  • Consumption of antibiotics
  • Harsh bacteria reducing cosmetics
  • Weak immune system
  • High in sugar diet
  • Estrogen dominance
  • Oily skin
  • Tight clothing and face masks
  • Hot, humid weather, sweating
  • Over-moisturizing, overusing sunscreen

The treatment options include oral or topical antifungal medications and skincare containing antifungal ingredients such as tea tree oil, salicylic or azelaic acid, sulfur, and benzoyl peroxide.

Probiotics, moisturizers, and sunscreens are a must for fungal acne.

Remember that fungal acne is a disease that CAN be treated.

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