Folliculitis is inflammation or infection occurring at the hair follicle. The follicle is where the hair begins, just below the skin. Folliculitis can occur on the skin wherever hair grows on the body, including the scalp. It usually appears as small bumps; it may look like acne or a rash. Folliculitis is most common on the thighs, buttocks, neck, and armpits—places where friction is common. Infection could be isolated to one hair follicle or many.
Folliculitis can be acute or chronic. Acute cases occur for a short time and chronic cases are ongoing.
Folliculitis is relatively common. People who are obese have a higher incidence.
Common symptoms of folliculitis include:
- small crusty bumps on the skin (can be red, white, or yellow)
- bumps with pus
- soreness or swelling
Folliculitis is usually caused by staph bacteria or by fungus. Infection can be caused by body contact with an infected person, or by contact with a personal item (towels, soap, or clothing, for example) used by an infected person.
The bacteria or fungus may be present in unclean pools or spas.
Tight clothing that irritates the skin, skin injuries (such as those caused by shaving), a weakened immune system, and not showering after excessive sweating may contribute to folliculitis.
To diagnose folliculitis, your doctor will first do an examination of the inflamed or irritated skin. Be sure to tell your doctor how long you’ve had the bumps, what symptoms you are experiencing, and whether you have a history of folliculitis.
Your doctor may be able to diagnose folliculitis on appearance alone. To identify the cause of folliculitis, he or she might remove one of the bumps for testing.
Folliculitis is usually minor and goes away on its own without treatment. If you have skin irritation accompanied by fever, a spreading rash, or pus-filled, smelly bumps, seek medical help.
Acute folliculitis that is severe or slow to heal can be treated with oral or topical antibiotics or antifungal medications. Steroids are sometimes used to control inflammation. For pain or itching, your doctor might suggest NSAIDs or antihistamines.
Chronic folliculitis can be more difficult to treat than acute folliculitis. Antibiotics don’t usually clear up chronic cases.
During treatment, you should refrain from removing hair by plucking, waxing, or shaving. Allowing the hair to grow will help with the treatment. For chronic folliculitis, it’s best to allow hair to grow for up to three months.
Folliculitis rarely causes more severe problems, but it could cause scarring. People who have had folliculitis in the past are more likely to have it again in the future. In rare cases, folliculitis could damage the hair follicle, resulting in permanent hair loss.
Some lifestyle practices may prevent folliculitis from reoccurring and lessen its severity:
- When you have folliculitis, avoid friction caused by shaving or rubbing the infected area.
- Shave only in the direction that hair is growing, or use an electric razor.
- Avoid tight-fitting clothing, especially rough fabrics like denim.
- Use lotions to keep skin moisturized (but look for lotions that do not clog pores).
- Apply cortisone cream to the infected areas to reduce itching.
- Use a warm compress to calm irritation and reduce pain
- Wash your towels and washcloths every day until all symptoms have subsided.