Folliculitis treatment and prevention

If you have red, itchy, painful bumps on your skin, you may have folliculitis. Learn what folliculitis is, how to treat it, and ways to prevent it.

What is folliculitis?

Folliculitis is an inflammation of the hair follicles, the tiny pockets in your skin from which hair grows. When these follicles become inflamed or infected, it can lead to small, red, and sometimes pus-filled bumps on the skin. Folliculitis can happen anywhere you have hair, but it's most common on the face, scalp, arms, and legs.

Folliculitis causes and symptoms

Folliculitis is most often caused by bacterial infection. Other infectious causes of folliculitis include fungi, viruses, and parasites. Folliculitis can also result from noninfectious causes, for example, when hair follicles are irritated or damaged by things like shaving or rubbing against right clothing. Types of folliculitis include:

• Bacterial folliculitis:Staphylococcus aureus bacteria are the most common cause of bacterial folliculitis. So-called "hot tub" folliculitis is usually caused by Pseudomonas aeruginosa bacteria and may occur in people who use hot tubs with poorly maintained water.
• Fungal folliculitis: Also called pityrosporum folliculitis, this condition is often seen during the teenage years due to more active oil glands. It appears across the shoulders, back, and neck.
• Viral folliculitis: Often caused by the herpes simplex virus, this type of folliculitis is usually painful and occurs in groups or clusters on the skin.
• Eosinophilic folliculitis: Primarily seen in individuals with weakened immune systems, such as those with HIV/AIDS. It involves an accumulation of a type of white blood cell (eosinophils) around the hair follicles, leading to irritation and inflammation.
• Demodex folliculitis: This condition is caused by tiny Demodex mites, which live in the hair follicles and oil glands on our skin. When there are too many of these mites, they can cause irritation and redness, leading to folliculitis. This is most common in people with rosacea.
• Noninfectious folliculitis: Also called pseudofolliculitis, this can be caused by irritation from shaving or wearing tight clothing.

Symptoms of folliculitis can vary based on the cause, but often share common features. Common symptoms include:

• clusters of small red bumps or white-headed pimples around hair follicles
• itching or burning skin
• painful, swollen bumps
• pus-filled blisters that break open and crust over.

Folliculitis is often mistaken for keratosis pilaris (KP), a common skin condition characterized by small, rough bumps often found on the upper arms, thighs, cheeks, or buttocks. Unlike folliculitis, KP is caused by a buildup of keratin that blocks hair follicles. KP can be managed with exfoliation and moisturizing.

Treating folliculitis

Treatment for folliculitis depends on the severity and cause. For mild cases, keeping the affected area clean and avoiding irritants might be enough. Warm compresses can help soothe itching and promote healing. Most folliculitis resolves on its own within seven to 10 days.

If your folliculitis does not improve on its own, see your doctor. For persistent cases, a doctor might prescribe medications that are applied to the skin or taken by mouth. For folliculitis caused bacterial infection, a doctor might prescribe a topical antibiotic or antibiotic pills. If the cause is a fungus, an antifungal cream or shampoo may be recommended. Viral folliculitis can be treated with antiviral medications, and Demodex folliculitis can be treated with antiparasitic medications.

In severe cases, a minor procedure to drain large boils might be necessary. Eosinophilic folliculitis usually requires treatment of the underlying, immune-suppressing condition.

Preventing folliculitis

Folliculitis can often be prevented by adopting simple habits that make your skin less susceptible to infection and irritation. Preventive measures include:

• Practice good hygiene. Keep your skin clean and dry. Clean your skin gently with a mild soap and water, particularly after sweating from exercise or spending time outdoors.
• Avoid tight clothing. Wear loose, breathable clothes to reduce irritation.
• Shave carefully. Use a clean, sharp razor and shave in the direction of hair growth. Consider using shaving cream or gel to reduce friction.
• Limit exposure to hot tubs. If you do use a hot tub, make sure it's clean and well maintained.
• Avoid sharing personal items. To reduce the risk of infection, don't share towels, razors, or clothing.