Folliculitis is a common skin condition commonly triggered by bacterial or fungal infections. The resulting rash of raised bumps can be itchy and painful, but it is treatable with topical medications. There are several types of folliculitis, the difference is determined by the cause of the infection or inflammation.
Basic skin hygiene practices can help lower your risk of developing folliculitis, but if the condition does appear, it’s helpful to know how to recognize it and how best to respond.
Folliculitis can occur on your skin wherever hair grows, including your scalp. It’s most likely to occur on your thighs, buttocks, neck, and armpits — places where friction is common. It usually appears as small bumps.
It may look like acne or a rash and can be isolated to one hair follicle or affect many. It can be acute (occurring for a short time) or chronic (ongoing).
Folliculitis is relatively common. People who have obesity are more likely to experience it.
Folliculitis is usually minor and goes away on its own without treatment. If you have skin irritation that’s accompanied by a fever, a spreading rash, or pus-filled and smelly bumps, seek medical help.
To treat acute folliculitis that’s severe or slow to heal, your doctor may recommend over-the-counter or prescription medications. For example, they may recommend:
- oral or topical antibiotics or antifungal medications to treat the cause of your infection
- NSAIDs or antihistamines to relieve pain or itching
Chronic folliculitis can be more difficult to treat. Antibiotics and other medications may not clear up chronic cases. If other treatment options fail, your doctor may recommend laser hair removal.
During treatment, you should refrain from removing hair by plucking, waxing, or shaving. Allowing your hair to grow may help your follicles to heal. For chronic folliculitis, your doctor may advise you to grow your hair for up to 3 months.
Folliculitis is usually caused by Staphylococcus bacteria (Staph) or types of fungi. While you can contract Staph bacteria through bodily contact with someone who has it, folliculitis caused by fungi is not passed through physical contact.
You can also contract folliculitis caused by Staph bacteria through contact with items, such as razors, towels, or clothing used by someone who has bacterial folliculitis.
You can pick up bacteria or fungi at pools or spas that are not well-sanitized.
Folliculitis causes small or crusty bumps to form on your skin. Some of the bumps may be pustules — raised areas that contain pus — and may resemble pimples. They can be red, white, or yellow in color. They may be accompanied by:
Folliculitis can appear at first glance like an acne breakout, according to the American Academy of Dermatology. The condition features small areas of raised, red, or white bumps. The fluid-filled bumps can crust over and become painful and itchy. In some cases, folliculitis appears as a large, single bump.
Anyone at any age can develop folliculitis, but common risk factors include:
- wearing tight clothing that traps sweat
- touching, rubbing, or scratching your skin frequently
- shaving anywhere on the body
- soaking in a hot tub
- having a weakened immune system that increases your vulnerability to infection
Hot tub folliculitis (pseudomonas folliculitis)
As its name suggests, hot tub folliculitis forms after spending too much time in a hot tub containing the bacteria Pseudomonas aeruginosa, according to the
Regular swimming pools and water slides can also bring on the infection. The rash commonly appears as scattered red bumps. Areas of the skin covered by swimwear such as the buttocks are most prone to develop the rash, but it may also affect the skin directly exposed to the contaminated water. Other symptoms include itching and burning.
Hot tub folliculitis often resolves on its own. Topical treatments that may be helpful include silver sulfadiazine cream twice a day or white vinegar applied to the rash for 20 minutes 2 to 4 times per day. In severe cases, oral antibiotics may be prescribed.
Pityrosporum folliculitis forms when the yeast Pitysporum moves into hair follicles and spreads. An acne-looking rash erupts on the surface of the skin. Pityrosporum normally lives on the skin and causes no rash or other skin condition. It’s only when there is an overgrowth that pityrosporum folliculitis forms. Triggers include:
- wearing tight, moisture-trapping clothes
- hot and/or humid weather
- oily skin
- use of oily or greasy products, such as certain sunscreens
Bacterial folliculitis is the most common form of this condition. It usually develops when the bacteria Staphylococcus aureus — which exists on the skin always — enter the skin and infect the hair follicles. A cut or scrape can provide an entry point. Mild cases may be treated by a topical antibiotic, while more serious cases may require an oral antibiotic, too.
To diagnose folliculitis, your doctor will examine the inflamed or irritated areas of your skin. They will also ask:
- how long you’ve had bumps on your skin
- what other symptoms you’ve been experiencing
- whether you have a history of folliculitis
Your doctor may be able to diagnose folliculitis based on appearance alone. To identify the cause, they may remove or take a small sample of one of the bumps for testing.
Most cases of folliculitis go away without treatment. It rarely causes more severe problems. In a small number of cases, it can cause:
- boils to form under your skin
- permanent scarring or dark patches to develop on your skin
- damage to your hair follicle, resulting in permanent hair loss
If you’ve had folliculitis in the past, you’re more likely to have it again in the future.
To help prevent folliculitis:
- Shave only in the direction that hair grows, or use an electric razor.
- Avoid tight-fitting clothing, especially rough fabrics such as denim.
- Use lotions that don’t clog your pores to keep your skin moisturized.
- Avoid sharing personal care products, such as razors and towels.
- Shower after heavy sweating.
To help prevent complications and lessen the severity of folliculitis when you have it:
- Avoid friction caused by shaving or rubbing the infected area.
- Use a warm compress to calm irritation and reduce pain.
- Wash your towels and washcloths every day until your symptoms have subsided.
Ask your doctor for more tips on preventing folliculitis. If you experience it regularly, they may refer you to a dermatologist to help you learn how to avoid and manage the condition.