I'm A Doctor – Here's When You Should Wash Your Face With Shampoo
As a former acne sufferer, I tried product after product before settling on my current routine of a gentle cleanser, sunscreen, moisturiser, and retinol.
That’s partly because not all spots are created equal, as anyone who’s faced hormonal or fungal acne will know all too well.
In a recent TikTok, Dr Karan Rajan followed up on a video of another app user who had been advised to use an anti-dandruff shampoo on her spots.
After seeing the results, the doctor explained that “you can use antifungal shampoo on your face for acne ― but there’s a catch”.
Which is?
Only fungal acne will respond to antifungal treatments, like dandruff-preventing shampoo.
Dermatologist and associate professor Dr Sarah Massick shared on the Ohio State University’s site that fungal acne, also known as pityrosporum folliculitis, “is routinely mistaken for acne, but it’s actually related to a yeast called Malessezia furfur that’s found naturally on the skin”.
Fungal acne, which can be itchy, has a different cause than other kinds of spots, so treatments used for regular spots won’t work.
In fact, the antibacterial ingredients in many treatments can wipe your skin’s natural bacteria away, leaving nothing for fungal acne bacteria to compete with.
Fungal acne spots “tend to be small, uniform red bumps arising from the hair follicles, often in symmetric rows on the forehead, scattered on cheeks and, occasionally, on the upper back and upper chest,” Dr Massick shared.
You won’t see any pustules or blackheads like you do with other spots.
Fungal acne tends to thrive in the summer months, when hot humid conditions provide a welcoming breeding ground for yeast.
“It can also arise after treatment with medications such as antibiotics and steroids/prednisone, and in conjunction with other systemic diseases like diabetes,” Dr Massick adds.
She recommends trying dandruff shampoo (though she wants us to limit its time on our face), and Dr Rajan agrees.
“The reason shampoo works is because the dandruff on your scalp and fungal acne are both caused by an overgrowth of the skin yeast Malassezia,” he said.
Zinc pyrithione and selenium sulfide, both found in anti-dandruff shampoos, fight that yeast.
When should I avoid it?
Anti-dandruff shampoo can dry out your skin and weaken the protective outer layer of your dermis called the skin barrier.
It won’t improve the “most common types of acne,” like bacterial or hormonal acne, the doctor said.
“Deep, cystic acne might require retinoids,” Dr Rajan shared. This can include treatments like topical adapalene or, in severe cases, Accutane tablets.
“Surface-level blackheads might respond better to salicylic acid,” the doctor added.
“In most cases, the tried-and-tested acne-clearing stuff like benzoyl peroxide, salicylic acid, and retinoids are still GOATs.”
See a specialist if you’re unsure about how best to tackle your skin issues.
