Folliculitis is a skin disorder involving the inflammation of hair follicles. It is typically due to an infection and results in irritated pimple-like spots or pustules. Antibiotic or antifungal creams and other therapies can help.
In most cases, folliculitis is a harmless condition. However, it can progress to a more serious disease in people with compromised immune systems.
- Staphylococcus aureus is the most common infectious cause of folliculitis.
- In most cases, folliculitis will disappear independently.
- The most common cause of folliculitis is damage to the hair follicle.
- Improper shaving techniques, tight clothing, skin rubbing, and some medications can all cause follicle damage.
This article details the causes, symptoms, and complications of folliculitis. We also cover what people can do to treat or prevent the condition.
Folliculitis is generally the result of an infection in a damaged hair follicle.
Infection by Staphylococcus aureus bacteria, yeast, fungus, and viruses can all cause folliculitis.
Other causes include:
- skin irritation
- occlusion, or blockage, of the follicle
- topical steroids
- skin disorders, such as acne or dermatitis
- some medications
- irritant chemicals
- immunosuppressive medications
The following may increase a person’s risk of developing the condition.
- history of diabetes
- long-term antibiotic use
- frequent shaving
- using an unclean hot tub or swimming pool
- weakened immune system from conditions, such as HIV or cancer
- being overweight or having obesity
Folliculitis is inflammation of a hair follicle. Follicles are small tube-like cavities in the epidermis in which individual hairs grow. They are present on all parts of the skin except the lips, palms of the hands, and soles of the feet.
In the initial stages, folliculitis may look like a rash, a patch of small bumps, or yellow- or white-tipped pimples. Folliculitis patches may appear red or pink on light skin tones. On darker skin tones, it may appear darker than the surrounding skin and may contain red, or purple hues.
Learn more about how rashes can appear on dark skin tones here.
Over time, this can spread to nearby hair follicles and progress to crusty sores. It
Other symptoms include:
- itching or tender bumps
- pus-filled sores
- crusty sores
- inflamed skin
The condition can affect one or many follicles and may last a short time or persist long term.
Although folliculitis is not life threatening, some complications may arise. These include:
- furunculosis — boils under the skin
- scars or dark patches
- permanent hair loss due to follicle damage
- recurrent follicle infections
- infections that spread to other areas
- cellulitis — infection of the skin
There are several forms of folliculitis, depending on the depth of infection. Some types may only cause superficial symptoms, while others can progress to a deeper follicle infection.
- Bacterial folliculitis. This is a common type of folliculitis that features pus-filled pimples that itch. This usually results from a staph or pseudomonas aeruginosa infection or long-term topical antibiotic use.
- Pseudofolliculitis barbae. Also known as barber’s itch, this type of folliculitis results from ingrown hairs. It is most common in people with tightly-curled hair and those who shave close to the skin. Studies have found that in professions with prescriptive clean shaving policies, such as the military, the condition
is highly prevalentamong African American males and less so in Asian, Hispanic, and non-Hispanic white males.
- Pseudomonas folliculitis. People often refer to this as hot tub folliculitis. It results from a type of bacteria — pseudomonas — found in pools and hot tubs with incorrect chlorine levels and pH balance.
- Pityrosporum folliculitis. A yeast infection of the skin, which leads to chronic lesions that are red and itchy. It most commonly affects the face and upper body and is particularly prevalent in young adults and adult males.
- Eosinophilic folliculitis. People with HIV, late-stage AIDS, or cancer are most likely to experience this form of folliculitis. Symptoms are intense and recurrent itching and can cause dark patches of skin known as hyperpigmentation. Doctors do not know the cause of eosinophilic folliculitis.
- Viral folliculitis: The herpes simplex virus and molluscum contagiosum are
common causesof viral folliculitis. Symptoms are typically self-limiting.
- Demodex folliculitis:
Demodex folliculitisoften affects follicles on the face. It occurs when small mites that live on the skin’s surface enter the follicle.
The doctor may examine the skin, note symptoms, and review the person’s medical and family history. They may also ask questions related to recent nonmedical activity, such as hot tub usage or recent changes to new clothing.
They may take a swab of the infected skin to test for which bacteria or fungus is the cause of the folliculitis.
In rare cases, a doctor may order a skin biopsy to exclude the possibility of other causes.
The treatment for folliculitis varies depending on the type and severity of the condition.
Mild cases often only require home remedies. However, severe or recurrent cases may need medication or other therapies.
Available treatments include:
Forms of medication include:
- topical antibiotic creams
- oral antibiotics
- topical antifungal creams
- antifungal shampoos
- oral antifungals
- steroid creams
- oral corticosteroids
Sometimes a doctor will drain a boil or carbuncle by making a small incision in the lesion to drain the pus. The aim is to reduce pain and encourage a faster recovery time.
Laser hair removal
Laser therapy may help reduce folliculitis that results from frequent shaving. It destroys the hair follicles, meaning bacteria, fungi, or viruses can no longer infect them.
Several treatments are usually necessary to see results.
Several home remedies are effective at treating folliculitis and its symptoms. They include:
- Warm compresses: Placing a warm compress on the affected area can reduce itching and draw out pus. A person can make a compress by soaking a cloth in warm water and wringing out the excess.
- Over-the-counter products: Several topical creams, gels, and washes are available for folliculitis without a prescription. These may help reduce general inflammation.
- Good hygiene: Gently washing the affected area twice daily with a mild soap will help reduce the infection. A washcloth is not advisable as it can cause further irritation to the skin.
- Soothing bath: Soaking in a tub of warm water may help reduce the itching and pain associated with folliculitis.
To prevent folliculitis, avoid or reduce exposure to the causes of the condition. These include:
- tight clothing
- irritating clothing
- harsh chemicals or irritating personal care products
- improper shaving techniques
- blunt or unclean shaving tools
- improperly treated hot tubs and pools
- spending too long in sweaty clothing
A person should also treat underlying medical conditions and speak with a doctor if they are taking medications that increase the risk of folliculitis.
Folliculitis will typically resolve on its own. However, if symptoms do not resolve independently after a few days, it may be beneficial for a person to contact a medical professional.
A doctor will be able to confirm a folliculitis diagnosis and advise on suitable treatment courses. Persistent folliculitis may signify an immunodeficiency disorder or other underlying condition.
Folliculitis is a common skin condition that is often the result of a bacterial, viral, or fungal infection. It is typically not a cause for concern and will remedy independently. However, folliculitis can result in painful skin inflammation, sores, and pimple-like bumps.
It is often the result of improper shaving technique, poor hygiene, and wearing tight clothing. Avoiding these practices can help prevent folliculitis. However, if symptoms persist or worsen, medical assistance may be necessary.