Fungal Acne and Malassezia Warriors LISTEN UP! (Sample Routines)

Fungal acne sufferer here, currently 100% in remission 🙂 Thanks more to your site than any dermatologist! Backstory – Clear skin until two summers ago at the age of 32. Never washed my makeup off, used harsh walnut scrub, never wore sunscreen, and was a junk food vegetarian. Youth! I did have eczema on my hands that would come and go, starting at age 20. Two summers ago, I had several suspicious moles removed and also started noticing melasma around my lips, probably due to hormonal bc. I decided it was time for a skincare routine. I went at it too hard with AHA and vitamin c and destroyed my moisture barrier. I also had started taking biotin supplements, which I am now sure break me out. I also started using the La Roche Posay mineral sunscreen but was not consistent with it because I didn’t like the white cast. I went back to nothing for a while and my skin recovered. But then I had some health issues that resulted in taking medication that possibly started this fungal thing. It’s hard to say. But around this time I decided I needed to be nicer to my body and began eating a much healthier diet (lots of veg, lots of plant fat, not much dairy except full fat yogurt every day, whole grains, adding in some meat occasionally…). I also started exercising. End result: I felt great but my skin was suddenly wrecked. I first suspected it was due to a b12 supplement I was taking. I stopped and things improved slightly. I then thought it was maybe hormonal, since by then I had lost a fair amount of weight and maybe things had shifted (I was not overweight to begin with but was nearly so – I went from the top of my healthy range to the bottom). I used benzoyl peroxide for a while and it seemed to help at first but then my skin stopped being able to tolerate it. After getting seriously rashy, I switched to washing my face with a gentle cleanser from Trader Joe’s and applying a clean and clear BHA spot treatment. This did not really improve things much but didn’t seem to make it worse. Finally, last fall, I decided I was sick of the zits and needed to start trying to get rid of them again. My dermatologist was unhelpful. I tried taking Yasmin bc hoping it would help hormonally but it didn’t make a huge difference. I stopped after maybe 4 months because I didn’t like the emotional side effects. After that, my skin really freaked out again. I had known about AB routines for a while (and by that point was using Biore watery essence and DHC oil cleanser) but it seemed like a big commitment. But at that point I decided I might as well try. And it did definitely help! In February of this year I discovered a lot of my current faves from Cosrx and also started double cleansing. I actually first discovered your blog when googling the evil whitening power essence, which I did like at first. Anyway blah blah, my skin was mostly better by this spring except for a patch of redness/acne looking bumps that would never go away. My derm said it was perioral dermatitis and prescribed 50 mg doxycycline for two months. I took the doxy with a strong probiotic and was fine for two and a half weeks, but then woke up one morning with severe acne/bumps – not just in my face but on my chest, back, and neck as well. I had never had body acne before so I knew something was up. Fortunately (?), that same morning I woke up with oral thrush so I requested Diflucan from my doctor. He actually thought the acne was bacterial folliculitis and wanted to up my dosage of doxy. While I did not stop the lower dosage, I did not feel comfortable bumping it up to 100 mg. I thought about what I had used topically leading up to the zits and all of a sudden remembered reading your post about the galactomyces in the past. I googled around until I found your blog again and knew this was definitely fungal. I actually think my original “perioral dermatitis” was fungal as well. Anyway, after 200 mg of Diflucan (plus washing with nizoral and applying lotrimin ultra), my skin cleared. But then I kept taking the 50 mg of doxy and it came back! At that point I knew it was fungal and dropped the doxy. I saw another derm and was prescribed two more weeks of 100 mg Diflucan, which I tapered to 50 mg the last few days. During that second round of Diflucan, I started using San Marcos brand sulfur soap and cream (kinda gross but I would also smear it all over my back and chest, then chill on the couch with a trash bag over my skin – my husband was very amused). I have actually left it on for up to an hour in large patches, and as a spot treatment overnight, even though I would describe my skin as sensitive. I also switched to the vanicream cleanser and cerave cream, which my skin looooooves. The cerave cream has also totally healed my eczema. Anyway my skin has returned to its former glory and I am very pleased! To summarize, here is what I used for treatment: 3 weeks total of Diflucan, Nizoral shampoo, lotramin ultra, sulfur soap and cream. Oh and zinc soap too. To heal my skin, I switched to very gentle products and cerave cream. Current routine (for sensitive combo skin with oily t-zone, concerns are keeping fungal acne away and brightening) AM – Wash with vanicream cleanser Wash body with free and clear soap Wash hair with free and clear shampoo and conditioner – though I will probably continue to use Nizoral once a week Apply Hada Labo moist lotion If… Read more »

Hi F.C., my phone just ate my lengthy post about my journey and current routine so I will try again tomorrow and go to bed now 🙂

Two questions –

– Do you no longer like the Cosrx BHA? I know you had an old bottle before. I just bought my first bottle in February or March so I assume it’s the higher PH version.

– Do you recommend the above sunscreen over the EltaMD one you were previously using? I have yet to replace my sunscreen and am currently relying on the fact that I spend most daylight hours in my office 🙂 Now that it’s summer though I need to pick one up ASAP.

Skin type: oily
Prone to: acne and seborrheic dermatitis
Skin concerns: my ongoing concern is dehydration, caused by an overuse of benzoyl peroxide for many years. My skin is super oily yet dry and tight underneath — these are textbook examples of dehydration, and I believe it is the root cause of my persistent acne. I quit benzoyl peroxide completely 2 years ago and switched to actives which I found much more tolerable (e.g. azelaic acid, adapalene), and were quite effective in keeping my acne mostly under control, but as dehydration continues to be an issue, I want to trial a very gentle routine in which my only active is a PHA, gluconolactone, because it’s unique among the hydroxy acids in that it’s been shown to actually repair the skin’s moisture barrier.

I also suffer from seborrheic dermatitis in areas of facial hair, particularly my chin crease and moustache area, but I’m trialling a special gel-cream called Sebodiane DS with quite good results thus far. I tried a completely “Malassezia-safe” routine for a couple months before trying the Sebodiane DS and didn’t notice any significant improvement in my SD, so I reckon using some products with esters (like glyceryl stearate) doesn’t do any extra harm, in my case.

Current skincare routine:

AM
*Rinse with water only in the shower
*Bioderma Hydrabio Serum — a rare find in that it doesn’t contain any problematic ingredients for Malassezia, and even has xylitol, which some posit might be useful in breaking down the “bio-film” layers Malassezia produces to protect itself. I’m also trialling it because it looks to be useful for dehydrated skin, so it seems like a perfect match for my particular concerns.
*Sebiaclear Active — a simple gel-cream that contains 14% gluconolactone (a PHA as discussed above) and 4% niacinamide. It also contains a few potentially problematic esters at the bottom of the ingredients list, but in practice I have not seen any exacerbation of SD since using this, which supports my view that some esters are fine for me. I avoid palmitate and myristate esters at all costs, but this is because they exacerbate my acne. (on that note, one of the easy ways to distinguish between acne and a Malassezia condition is the depth: acne can cause inflammation deep within the pores, whereas Malassezia conditions are more superficial).
*Sebodiane DS microemulsion — I apply a very small amount only to SD-prone areas of my face.
*Sebiaclear SPF 50 — a great moisturising, but lightweight and matte sunscreen, which works well when layered on top of the Sebiaclear Active mentioned above.

PM
*Simple Gel Wash — very basic sulphate-free cleanser. During this trial period to focus on dehydration I might temporarily sub it with the Superdrug Simply Pure Calming Cleanser, which is a cream cleanser based on mineral oil and fatty alcohols (Malassezia-safe, in other words, although I think for cleansers this is less of a concern).
*Hada Labo Premium Lotion — with 3% urea and 5 types of hyaluronic acid, this is one of the products that I hope will really help with my dehydration issue. It’s too sticky to use in the morning, so I prefer to use it only at night.
*Bioderma Hydrabio Serum
*Sebiaclear Active
*Sebamed Clear Face Gel — this is my “Old Faithful”, but I’m looking for something silicone-rich and more moisturising as a possible substitute. I might try out EltaMD PM, because, again, I don’t think the esters it contains are a concern for me. It also has linoleic acid, which is a free fatty acid to avoid in theory, but I also suspect this *might* be more beneficial than harmful, the more I research it.

I’m fairly fortunate in that if my SD ever worsens, I can just shave and apply a ciclopirox olamine cream and it resolves within a few days. This is why I’m taking a riskier approach with esters.

So my current routine without all the longwinded exposition (sorryz!!)

AM
*Rinse with water in the shower
*Bioderma Hydrabio Serum
*Sebiaclear Active
*Sebodiane DS microemulsion (only to SD-prone areas of the face.)
*Sebiaclear SPF 50

PM
*Simple Gel Wash
*Hada Labo Premium Lotion
*Bioderma Hydrabio Serum
*Sebiaclear Active
*Sebamed Clear Face Gel

Pure unrefined honey you all! Read about it. For past week I have washed my face with it each morning (actually let it sit on skin few minutes while it penetrates). Rinse off thoroughly. I have oily skin and hoping it begins to balance my skin moisture as I’ve read. ? so far it doesn’t break me out and brightens/evens my complexion. And the awesome thing- 1 ingredient! Also I really like the gentle BHA from Silk that FC suggested.

I can’t thank you enough for all your work, you helped soo many people and that’s awesome!! 🙂
Wanted to write down my (new) routine – I do it 100% Malassezia safe since 3 days, before I thought I don’t have it or didn’t want to have it, especially because I wanted to use up ALL my product I bought for a lot of money, mostly Paula’s choice, which worked for me nearly for 2 years very well, but it got worse every day since 2 month…
So I overcame myself and put all my (lovely) old products away and bought new ones (how much money I spend all together…it’s a shame..). But now I love my new routine and the products, because I can feel that they are good for my skin – my skin feels more hydrated the whole day, and the pimples calm down…but too early to say that i’m finally healed 😀
My new routine is (products available in Germany or online from Germany):
Morning:
Wash with CD waterlily face foam
Toner with a cotton pad from a drugstore here in Germany with a little amount of BHA in it (Rival de loop rosa Gesichtswasser)
Aloe vera Spray from Sanct Bernhard
Benton Snail Bee Essence (I’m using this for 2 years now, the only thing that could stay)
Sebamed Face Gel or The Ordinary Niacinamide+Zinc
Dermedic Urea Gel Cream (the one that the angel-face-testimonial #3 from your blogpost uses :D)
Squalane from The Ordinary
Avene Sunsimed Sunscreen 50+ (ppd 39)
Make-up: Maybelline SuperStay 24h Foundation and Concealer (the concealer has one bad ester unfortunately..)
Little bit powder from essence for the t-zone

Evening:
the same as in the morning, except the Make-up and the first I do after washing my face is putting a mask on with Green tea (boiled water and a teabag;)) mixed with MSM and honey. I hope the MSM works like sulfur, so far I like it. Let this on for half an hour or longer, then gently wash it away in the shower (there are little harsh grains on my face, don’t want to rub it).

I’m waiting for the 2 actives from skinactives to arrive – willow bark extract and azeloyl – want to put these individually in my Aloe vera Spray as a toner. Also I ordered the Hada Labo Plumping Gel Cream with Urea and the Hada Labo Lotion Toner with Urea – when all the products have arrived, my routine will be complete 😉
The things I like MOST are SQUALANE and UREA! So glad you introduced me to these wonderful skincare ingredients ;D I really feel that I do what’s best for my skin now 🙂

Hope that helps some people!

Hugs, Anna :*

You should make a kickstarter campaign to start your own skincare line! Liah Yoo is doing her Krave Beauty line one product at a time. Maybe you could do that too

Hello
I recently have diagnosed myself with fungal acne – thank you so SO much for this article. Mine began due to stress and I just couldn’t comprehend why the same spots were going and coming, plus why my forehead was sandpapery!
I used to be a model and in this industry the obsession with physical appearance is so painfully overwhelming that I’ve been incredibly depressed over the state of my face. I’ve talked myself down so far that I don’t even remember who or how I used to be. Now I realise its time to get myself back to who I used to be again.

Could I ask a few questions please
1. Is the clinique anti-redness foundation okay to use? It’s my HG product and it would kill me to lose it

Active: Octinoxate 5.90%, Titanium Dioxide 3.70%, Zinc Oxide 2.90%.
Inactive: Water / Aqua / Eau, Methyl Trimethicone, Phenyl Trimethicone, Dimethicone, Triethylhexanoin, Butylene Glycol, Trimethylsiloxysilicate, PEG-10 Dimethicone, Lauryl PEG-9 Polydimethylsiloxyethyl Dimethicone, Aluminum Hydroxide, C12-15 Alkyl Benzoate, Lactobacillus Ferment, Citrus Grandis (Grapefruit) Peel Extract, Magnolia Grandiflora Bark Extract, Poria Cocos Sclerotium Extract, Astrocaryum Murumuru Seed Butter, Glycerin, Caffeine, Sodium Myristoyl Sarcosinate, Caprylyl Methicone, Methicone, Polyglyceryl-6 Polyricinoleate, Disteardimonium Hectorite, Acetyl Glucosamine, Isopropyl Titanium Triisostearate, Dimethicone Crosspolymer-3, Lecithin, Tocopheryl Acetate, Laureth-7, Dimethicone / PEG-10 / 15 Crosspolymer, Sodium Chloride, Dipropylene Glycol, Disodium EDTA, Polyaminopropyl Biguanide, Phenoxyethanol. May Contain: Mica, Titanium Dioxide (CI 77891), Iron Oxides (CI 77491, CI 77492, CI 77499).

2. Could someone please recommend me a fungal safe:
highlighter
bronzer
powder
concealer
???

3. Is the holland and barred 99% aloe vera gel suitable for fungal acne?

I am a massive makeup junkie, I in fact specialise in it primarily for horror and sfx purposes so I really need to find replacements asap so if anyone could help out I would be eternally grateful

Thanks so much, I am in such a low place and this site has honestly aided me no end. Never stop <3

This is actually the first time I’m commenting here, I’m more of a lurker, but why not maybe help some people! Thank you for all the work btw, it’s been immensely helpful!

Skin type: normal, recovering from dehydration (too much bha, not enough tlc), t-zone a lil oily around that time of the month
Skin concerns: redness, mild texture issues, some fungal sensitivities

I figured out that i had fungal sensitivities when i always broke out after trying out oil cleansers or moisturisers with fatty acids. One moisturizer gave me red bumps all over my face that really overstayed their welcome. Quitting any oil/fatty acid brought my face back to normal, then quitting all esters & polysorbates is bringing it to levels i never imagined possible. Anyway, apart from that I don’t have any acne except the occasional hormonal pimple on my chin. I do have stupid pale face redness though 🙁

My routine:
AM:
– rinse with water
– Benton snail bee skin (it’s like a toner? it’s similar to the essence and not problematic for fungal sufferers + has niacinamide & azelaic acid. I also use the essence and this just gives me that extra hydration that i often need)
– skin aqua uv like your sister – definitely HG!

PM:
– if i wear make up, Clinique Redness Relief Cleanser. It’s problematic. But also expensive, so I wanna finish this up and then maybe get albolene. I follow up with micellar water to get everything off.
– if i’m barefaced I just use micellar water (currently l’oreal, but wanna try bioderma) and I do rinse this off, because i’m paranoid of surfactants lingering lol. I haven’t found a waterbased cleanser that isn’t drying and problematic. I can’t get the vanicream in europe! And this works so far, so well :p
– benton snail bee skin
– benton snail bee essence (seems a bit overkill, but, the essence is more calming and really helps with my redness issues)
– sebamed clear face gel
– vaseline in winter sometimes

twice a week I use The Ordinary Niacinamide + Zinc serum. I think it’s also unproblematic for fungal victims! It seems a bit cautious, but my skin was super dehydrated from using a harsh cleanser and overusing bha, I quit all actives cold turkey and I’m really hesitant of overdoing it again. I used to use Paula’s BHA but it didn’t do much, just irritated my skin, but i thought i didn’t use it enough and overexfoliated and that led to the whole dehydration thing. I’m actually thinking of getting AHA instead of BHA sometime in the future because I don’t have acne issues, just some texture/dullness “issues”.

I’m currently trying out the hada labo premium (seems to work good) and also got the benton aloe propolis gel lined up!

So, for me cutting out “bad ingredients” and focusing on hydration instead of treatment has worked best. Of course, ymmv! I’ve never had ‘proper’ acne and just got triggered by fatty acids and oils. My face is at a good base level now, got the basics down and all next improvement is just bonus! Thank you FC, it’s largely down to you!

My winning combo,

AM
– 2.5% benzoyl peroxide (any brand) short contact therapy 5-10 minutes prior to shower
– Simple Kind to Skin Wash Gel / Shampoo with Clear & Free
– Mad Hippie Vitamin C Serum
– Hada Labo Gokujun Hyaluronic Lotion Moist
– Hada Labo Gokujun Premium Hyaluronic Solution
– Elta MD Clear SPF 46

PM

– 2.5% benzoyl peroxide (any brand) short contact therapy 5-10 minutes prior to washing
– Simple Kind to Skin Wash Gel
– Hada Labo Gokujun Hyaluronic Lotion Moist
– Hada Labo Gokujun Premium Hyaluronic Solution
– Differin Gel
– Mix 50/50 – Corsx Snail 96 and The Ordinary Niacinamide/Zinc
– Corsx Master Pads (if required)

Thanks again!

My super simple routine:
-CosRX Good Morning Gel Cleanser (has Saccharomyces Ferment- probably negligible)
-Meishoku Ceracolla Perfect Gel (stellar ingredient list, has multiple ceramides, cholesterol, and phytophingosine but my skin doesn’t seem to mind them plus I like ceramides)
-CosRX BHA Liquid (as a spot treatment; I want to replace this with an AHA)
-Biore Micellar Water as a makeup remover (but I don’t often wear makeup because I’ve been trying really hard to take care of my skin)

Dropped the Ceracolla lotion (toner) because it has hydrogenated castor oil, which makes my face feel warm, itchy, and I think it may have caused micro-congestion. I’ll probably get the Hada Labo Premium as a replacement. I have used Hada Labo SHA Moist and Light before without problems but I want to try something with urea. 😀

Looking forward to try Biologique Recherche Lotion P50 (No-Phenol) for my AHA needs. Have you heard of this?
They say it’s like Jesus in a bottle lol. It’s pretty expensive though, especially since I live in the PH. This is why all of my skincare products are Asian.

But tbh my skincare routine is futile if I’m not careful with my diet. I got ill in the past and took a long course of antibiotics which I suspect ruined my gut flora. Started drinking Raw Goat’s Milk Kefir yesterday because I think imported probiotic pills will get destroyed in the Philippine heat. I avoid processed dairy and white sugar like the plague, it makes my face feel itchy. 🙁

Another fungal acne sufferer whose skin is FINALLY turning around since discovering FC’s blog, so – only fair to give back 🙂 I live in sunny Singapore where it’s hot + humid + tropical year round, so tbh I can’t tell if I’m more oily/normal skin. Definitely oily in the t-zone.

Played around with green beauty for the longest time, wanting to take the ‘natural’ approach to healing my acne haha but screw that cos green beauty only messed up my skin more. Giving up oils/balms in favor for silicones and petroleum has been the best thing I’ve ever done for my acne. I’m also highly clog-prone and have to be mindful of certain ingredients because even if they’re safe for fungal acne, they clog me up anyway e.g. any type of seaweed-derived ingredient hates my skin – Ian, if you read this, laminara in Bioderma Hydrabio serum is seaweed derived!

AM:
Vanicream cleanser
Hada labo HA lotion (will test the premium lotion at some point, but nervous about algae-derived sacrum)
Benton snail bee essence
Benton aloe propolis soothing gel + 1-2 drops of COSRX propolis ampoule
Cotz natural tint sunscreen (this product is full of dimethicone y’all)

PM:
Oil cleanse with Roccoco Pore Cleansing Oil (not fungal acne safe cuz sunflower oil, but don’t want to waste it and it DOES get plugs out like a dream)
Quickly follow with Vanicream to remove any traces of oil
Hada labo HA lotion
COSRX snail mucin + 1-2 drops of COSRX propolis ampoule (I find the COSRX snail more hydrating and sticky than the Benton snail so I use the former at night)
Benton aloe propolis soothing gel
Thin layer of Vaseline

And the actives I rotate right now are 10 min sulfur masks, Stratia mandelic (I like this a lot) and COSRX BHA (which I was on the fence about but now think I should drop it after hearing FC’s explanation). Excited to introduce Stridex this week since it should arrive anytime now!

Am also waiting to hear back from FC if this particular propolis is safe, which I want to try after the COSRX one:

Propolis extract, Portulaca Oleracea Extract, Hippophae Rhamnoides Fruit Extract, Panthenol, Rosa Centifolia Flower Water, Niacinamide, 1, 2-Hexanediol, Ethyl Ascorbyl Ether, Hamamelis Virginiana (Witch Hazel) Bark/ Twig Extract, Centella Asiatica Extract, Carbomer, Arginine, Spirodela Polyrrhiza Extract, Hydroxyethylcellulose, Dipotassium Glycyrrhizate, Adenosine, Sodium Hyaluronate.
It’s this product, in case anyone’s interested: https://www.glowrecipe.com/products/vita-propolis-ampoule

FC PLS TEACH US NEWBS HOW TO MAKE THAT DIY UREA CREAM PLS PLS PLS!