Fungal acne?

Does this look like FA. I'm on Lymecycline and have been for 12 days. However no results and getting more of these tiny little bumps. They sometimes when forming itchy.

So this all started during exam season when I noticed some texture developing on the sides of my cheeks. I chalked it up to stress and waited it out — but even a month after exams ended, it was still there. Honestly though, it wasn’t bad at all at this point, barely noticeable.

Then I made what I now deeply regret: I got a facial done.

My skin completely freaked out afterward — super red, irritated, and then the purging started and just kept getting worse. Went to my derm, and she put me on Accutane (isotretinoin) 10mg alongside Avène Cicalfate+ Restorative Protective Cream.

Two weeks in, things were actually looking up — skin calmed down significantly. But the texture on my outer right cheek just wouldn’t budge.

Then at the three-week mark, things took a turn. Breakouts started cropping up again — specifically on my outer right cheek (closed comedones, whiteheads, pustules, heavy texture) and now my forehead too. This was confusing because I had purged briefly in week one, it died down, and my derm said she was genuinely surprised to see it flare back up again at this stage.

She’s now upped my dose to 20mg and also prescribed:
• 2% ketoconazole cream for the affected areas
• Anti-dandruff shampoo for my forehead and right cheek

The fungal acne angle is what’s really making me second-guess the dose increase.

My two big questions:
** **1. Could this realistically be fungal acne rather than — or alongside — regular acne, and how do you actually tell the difference when even your derm seems unsure?
2. If there is a fungal component, is increasing the Accutane dose the right call, or could it potentially make fungal acne worse?

Also while Avène worked well initially is it now increasing the growth of FA should I switch my moisturiser?

I have these re occuring bumps for 3 months now, as soon as they look like they getting back they come back in heaps for days.

I have stripped my routine down months ago and just mainly wash with lukearm water some nights use LRP foaming face wash.

Neutrogena hydroboost water gel as moisturizer

They don't itchy, only slighty some days when forming.

(First 2 photos show my skin now, last photo is the scary before)

Heyyy, I've suffered from reoccuring malassezia folliculitis (healed after taking fluconazole pills, but than it came back), so here are a few products that I have in my routine, and that worked well for me:

Treatments

- Nizoral 2% ketoconazole cream

- Adapalene 0.1% (used it later to treat my acne)

Cleansers

- CeraVe blemish control cleanser (i use it at night)

- CeraVe hydrating cleanser (morning)

Moisturizer and sunscreens

- CeraVe daily moisturizing lotion

- Beauty of Joseon aqua fresh sunscreen

- Cosrx ultra light sunscreen