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Everything You Need to Know About Killing Acne Germs

By Dr. Jaggi Rao, MD, FRCPC, Double board-certified dermatologist

Many acne care products advertise that they kill germs on contact (they usually don’t) or that they get rid of all the germs on your skin after just a few uses (they never do). Typically, these claims are carefully worded to make them sound much more exciting than they are, but you’ll be able to see straight through them after reading this article and learning all there is to know about acne germs and how you can really get rid of them.

acne bacteria
Not all acne bacteria are bad.

Summary:

  • Germs may sound like a bad thing, but they are really a very natural part of our existence.
  • True acne is typically caused by Propionibacterium acnes, AKA, P. acnes.
  • A yeast called Malassezia may be responsible for fungal acne, a different type of acne.
  • Regular acne and fungal acne require different treatments because they’re caused by different types of germs.
  • If you aren’t sure what kind of acne you have, it’s best to speak to a dermatologist.

Are Acne Germs Actually a Good Thing?

The first thing we want to point out in this discussion of acne germs is that acne germs are completely natural and normal, and don’t always automatically cause acne. Acne is a multifactorial condition, meaning it is caused by several factors coming together rather than just one or two separate, distinct causes. Everyone alive has acne germs on their skin, and those germs can even help you in some ways.

Acne germs need food just like any other living organism, and their food of choice is sebum. Sebum is the oil-like substance our skin produces in order to protect itself from irritation, and in small amounts, it’s a very important aspect of healthy skin. However, sebum is often overproduced due to hormonal fluctuations, which can result in oily-looking skin and clogged pores. Luckily, acne germs are there to help consume some of this excess sebum. In the right balance, acne germs can help prevent the unfortunate side effects of sebum overproduction.

The Bacterial Acne Germ: Propionibacterium Acnes

Next, it’s important to discuss what we mean when we say “acne germs.” Most skincare companies say “acne germs” when they’re advertising their product, but “germ” is an incredibly broad term. This makes their claims intentionally vague. We’d like to clear things up. Acne is generally caused by two types of germs: bacteria and fungi. Acne vulgaris, AKA “normal” acne, is caused by bacteria, so we’ll start there.

The microorganism most clearly identified with acne is a species of bacteria known as Propionibacterium acnes. Most inflamed blemishes (pimples, papules, nodules, and cysts) are infected with Propionibacterium acnes. The bacteria themselves, however, don’t cause the inflammation and irritation we associated with acne. Redness, swelling, itching, and pain are actually caused by the immune system’s reaction to these bacteria. The germs are capable of releasing “decoy” chemicals known as chemotaxins that can redirect inflammation away from bacteria and to healthy skin.

Propionibacterium acnes is only one of about 2,000 different species of bacteria that ordinarily live on the skin. It’s only a problem when it gets trapped in pores. Before there is an infection, there is hyperkeratinization. That means, the skin cells lining the walls of a pore grow too rapidly, and trap skin oils and bacteria inside. If there is no hyperkeratinization, there is no infection. In most cases, the best way to fight acne caused by P. acnes is to reduce hyperkeratinization and ease the severity of the immune system’s reaction to any infection that does occur. It’s a different matter entirely, however, when the microorganism growing unchecked in a pore is a yeast of the genus Malassezia.

The Fungal Acne Germ: Malassezia Yeast

Malassezia is a group of yeasts that can grow on the skin. Usually, microorganisms in this group don’t cause skin problems unless they grow in large numbers deep inside pores, and they usually don’t penetrate pores at all. If these yeasts do grow inside a pore, however, they cause a condition known as fungal acne. Fungal acne is typically itchy and the “pimples” it creates are usually very uniform. Unlike acne vulgaris, which involves all kinds of acne of different shapes and sizes, fungal acne tends to produce lesions that are very similar in size and shape.

Malassezia can grow anywhere on the body, but they are more common on the forehead and chest than they are on the sides of the face. They usually don’t grow on the cheeks at all. Acne, as you probably know, is more common on the cheeks of the face than it is on the forehead and chest. And yeast may be the reason.

Korean researchers have found that yeast and acne bacteria usually don’t coexist in the same pore. Malassezia seems to displace P. acnes so that pimples do not form. Killing all the microorganisms on your face may kill some of the microbes that keep acne bacteria from taking over a pore.

How to Kill Acne Germs

The trouble with referring to all acne-causing microorganisms as one group of “acne germs” is that treatments designed to kill P. acnes will likely not work on Malassezia, and vice versa. This has led to endless frustration as people try to use products to cure their acne that are simply not capable of doing so. The Korean researchers mentioned above believe that treatment-resistant acne may be resistant because it is not really acne at all. Sometimes skin blemishes that don’t respond to acne treatment may actually be fungal acne.

If your acne is a variety of shapes and sizes and is not itchy, then there’s a good chance it is caused by P. acnes. In moderate to severe cases of acne, some dermatologists will prescribe antibiotic treatment to get rid of acne. Clindamycin, tetracycline, and minocycline are just a few of the antibiotic medications commonly prescribed. If taken for the correct amount of time, antibiotic treatment can help get serious acne under control enough that other, more permanent acne solutions can do their job and prevent and treat acne. However, if it turns out that your acne is fungal rather than bacterial, antibiotics won’t be able to help. In fact, by killing the natural competitors of yeast infections, antibiotics leave more food and oxygen for the yeasts to grow and may even make skin problems worse.

If your acne is uniform and itchy and you’re fairly confident that it’s caused by Malassezia, it’s best to seek out an anti-fungal treatment like ketoconazole. Ketoconazole is available in both prescription and over-the-counter strengths and it is one of the best ways to kill Malassezia specifically.

If you aren’t sure what kind of acne you have or if you want to cover your bases and just kill both types of acne germs, we recommend tea tree oil. Studies have found that tea tree oil can effectively kill P. acnes bacteria plus it can also kill Malassezia yeast, so regardless of what kind of acne you have, tea tree oil could definitely help.

When to See a Dermatologist

The harder you try to treat an infection you don’t have, the more likely you are just to accumulate side effects. If you have not been able to get your acne under control, don’t keep using products that don’t work. Talk to your dermatologist and figure out if fungal acne could be the problem. Try to eradicate the right microbes from your face by treating yeast infections when yeasts are the problem.

Frequently Asked Questions About Yeast Infections That Appear To Be Acne

Q. Are there any people who are at special risk for yeast infections of the skin that are often misdiagnosed as acne?
A. Diabetics and people receiving radiation or chemotherapy often get yeast infections. Treatments for Cushing disease, Hodgkin disease, or HIV, infliximab therapy for Crohn’s disease, and immune suppressants taken after receiving an organ transplant all increase the likelihood of yeast infections. Coating the skin with cosmetics, insect repellants,  or sunscreen also gives yeast a favorable environment for growth.

Q. Can you have both acne and yeast infections?
A. Yes, these can coexist, but you will likely have them in different locations of your body.

Q. Are there any acne medications that make yeast infections worse?
A. Yes. Tetracycline for acne will actually make yeast infections worse.

Q. Are there any home remedies for yeast infections of the skin?
A. Microdermabrasion and exfoliation with beta-hydroxy acid (salicylic acid) will open up pores that are clogged with yeast. If you use a microdermabrasion cloth, it is especially important to sterilize it between uses so you do not reinfect your skin.

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Sridevi Reply

Can we remove Malassezia yeast from skin using natural products?

January 30, 2014 at 12:53 pm Reply
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Abirami Reply

does malassezia cause acne and pimples on the face ?

June 28, 2014 at 6:51 am Reply

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