How to Treat and Prevent Folliculitis

Folliculitis Symptoms

Your symptoms will vary based on the exact type of folliculitis you have and how bad it is. You may have:

• Groups of small bumps like pimples, some with whiteheads on them
• Blisters that break open, ooze, and become crusty
• Large areas of swollen skin that may leak pus

These areas of your skin may be itchy, tender, and painful as well.

Types of Folliculitis

There are two main types of folliculitis. Superficial folliculitis is when only part of the hair follicle is damaged, while deep folliculitis is when the whole follicle is damaged.

Within these two categories, there are several subtypes:

Bacterial folliculitis

The most common form of folliculitis, it causes itchy, white bumps filled with pus. You can get it if you cut yourself and bacteria (usually staph) gets in.

Hot tub folliculitis (pseudomonas folliculitis)

You get this from swimming in a pool or sitting in a hot tub where pH or chlorine levels aren’t balanced. You’ll see a rash of round, itchy bumps a day or so after being in the water.

Pityrosporum folliculitis

This type happens along with a yeast infection. It causes itchy, pus-filled pimples that show up on your upper body, mostly on your back and chest, but you can also have them on your neck, shoulders, arms, and face.

Folliculitis decalvans

This is a rare type of scalp folliculitis. If bacteria inflame your hair follicles for a long time, your immune system may attack them, leading to hair loss. Doctors aren’t sure what causes this type. 

Malassezia folliculitis

Malassezia is a type of yeast naturally found on your skin. If too much grows, it can get into a hair follicle and make your skin itchy. You’re more likely to have this type if your skin is oily, you have dandruff, or you sweat a lot. 

Eosinophilic folliculitis

This type typically affects babies or people with conditions that affect their immune systems. It causes itchy, pus-filled bumps, most often on the shoulders, upper arms, neck, and forehead.

Razor bumps (pseudofolliculitis barbae)

This type is caused by ingrown hairs linked to shaving or a bikini wax. You’ll have dark bumps, or keloids, on your face or neck after shaving or in your groin area after a wax. It's more common in men of African and Asian descent. 

Other types include:

• Sycosis barbae: This is when the whole hair follicle gets infected after shaving. It causes large, pus-filled bumps and can sometimes lead to scarring.
• Gram-negative folliculitis: This type is caused by the use of long-term antibiotics to treat acne. It happens if the bacteria become resistant to the antibiotics and make the acne worse.
• Boils and carbuncles: A boil (a bump that can be tender or painful) happens when a hair follicle is seriously infected. A carbuncle is a cluster of several boils.

Folliculitis Locations

This condition can show up on any part of your body with hair follicles, even if it’s hard to see. Some common areas include:

Folliculitis on your butt

Anything from wearing tight clothes to waxing can cause folliculitis to show up on your backside. Sometimes it may show up as a single, red pimple. Or it could appear as a widespread rash.

Scalp folliculitis 

While this is rare, the hair follicles on your head can become inflamed. This type of folliculitis can cause round or oval-shaped bald spots. Your scalp may also itch, feel tight, or be painful.

Folliculitis on your legs

Small bumps, sometimes full of pus, can show up on your legs, especially your thighs. They may itch or hurt. 

Folliculitis on your face

If you shave, “razor bumps” can show up on your cheeks, chin, and neck. When they get infected, these small spots can get bigger and fill with pus. Folliculitis can also show up on other parts of your face, like your forehead. That’s often because a hair follicle has become blocked up with bacteria.

Folliculitis Causes and Risk Factors

Staph bacteria is most often to blame. You have staph on your skin all the time, and it normally doesn’t cause any issues. But if it gets inside your body, say through a cut, it can cause problems.

These other things can also cause folliculitis:

• Blockages from skin products, such as moisturizers with oils
• A fungus
• Hair removal, such as shaving, waxing, and plucking
• Ingrown hairs
• Other bacteria, such as the kind you might find in a hot tub
• Some drugs, such as corticosteroids that are used to ease inflammation

In general, you’re more likely to get the condition if you have damaged follicles. This can happen from things such as shaving, skin injuries, sticky bandages, and tight clothes. 

You also might be more likely to have folliculitis if you:

• Have acne, especially if you use a steroid cream or long-term antibiotic for it
• Are a man who has curly hair and shaves
• Wear tight clothes, rubber gloves, or boots that don’t let sweat or heat out
• Spend time in a pool or hot tub that’s not cleaned regularly
• Have an illness that affects your immune system, like diabetes, leukemia, or HIV or AIDS

When to See a Doctor

Most of the time, folliculitis goes away with a little self-care at home. But let your doctor know If you have:

• Firm, painful bumps
• Pus drainage
• Bumps that are spreading 
• Fever
• Chills
• Fatigue (feeling tired)
• A rash that clears up, then comes back
• A rash that gets worse 

Folliculitis Diagnosis

Your doctor can usually tell if you have it by looking at your skin closely and asking questions about your medical history. They may ask about things like:

• Whether you've been in a hot tub
• How often you shave
• What medications you use
• How much you tend to sweat

You don’t usually need tests unless treatments don’t work. In that case, your doctor may:

• Use a swab to take a culture from one of your sores so a lab can determine what's causing the infection
• Scrape your skin and send the sample to a lab to be checked for yeast
• In rare cases, do a biopsy to rule out more serious issues

Self-Care for Folliculitis

Mild folliculitis might go away without any medical treatment. To help yourself heal and ease symptoms, you can:

• Clean the infected area. Wash twice a day with warm water and antibacterial soap. Be sure to use a fresh cloth and towel each time.
• Use salt. Put warm saltwater – 1 teaspoon table salt mixed with 2 cups of water – on a washcloth and place it on your skin. You can also try this with a solution of water and white vinegar.
• Try gels, creams, and washes. Use over-the-counter antibiotics that you rub on your skin. If you’re itchy, you can try oatmeal lotion or hydrocortisone cream. It also helps to avoid shaving, scratching, and wearing tight or rough clothes on the infected area. To help your skin heal, you can:
  • Change your habits. Stop doing whatever may have inflamed your hair follicles. For instance, you may need to stop plucking, using a hot tub, or wearing your favorite leggings for a while.
  • Apply warm compresses. Try moist heat on the area three to four times a day, for 15 to 20 minutes each time. This will speed up the healing process.
  • Try not to scratch. Although the area may be itchy, scratching could open up the follicle and either cause or worsen an infection.
  • Don’t squeeze, pop, or cut open bumps. This can spread infection. 

Folliculitis Treatment

If these self-care treatments don’t work, your doctor may give you medications or recommend other treatments. These include:

Antibiotics

Your doctor can prescribe infection-fighting lotions or gels if your folliculitis is caused by bacteria. If you have a serious infection, or if it keeps coming back, they can give you antibiotic pills to fight infection. 

Antifungals

If you have fungal folliculitis, your doctor may prescribe antifungal shampoos, creams, or pills 

Steroids

For eosinophilic folliculitis, your doctor may recommend a steroid cream to help with itching.

Draining the infected follicle

In severe cases, your doctor may make a small cut in an infected follicle to help it drain and heal.

Laser hair removal

If you have razor bumps that haven't responded to treatment, one option is to replace shaving with laser hair removal treatments. You'll probably need several treatments over a period of time. 

How long does it take folliculitis to go away?

How long it takes your skin to clear up will depend on the type of folliculitis you have and the steps you and/or your doctor take to treat it. If it’s a simple case, your skin should start to improve in 7-10 days. 

But sometimes, folliculitis can be more stubborn. It could take longer to clear up if you’re not sure what’s causing it. It might not respond right away to a certain type of medicine, or it might go away and come back. In some cases, it may take a few months before your skin is back to normal.

Folliculitis Complications

Most of the time, folliculitis clears up without any issues. But sometimes, longer-term problems can crop up. You might have scarring once your skin clears up. Or you could notice that the skin in the affected area is lighter or darker than your usual skin tone. Depending on the cause of your folliculitis, you could also lose hair that doesn’t grow back.

Folliculitis that’s due to an infection sometimes clears up, then returns. It can also spread to other areas. Folliculitis that’s caused by staph can start to grow inside your body. Over time, it can spread to your organs and blood. While this is uncommon, it can be deadly if not treated right away.

If your doctor needs to treat your folliculitis with antibiotics, you could also have side effects from the drug.

Folliculitis Prevention

To lower your chances of getting folliculitis, your best bet is to stop shaving for at least 3 months. But for a lot of people, that won’t do. You might want to try an electric razor or other hair removal methods, such as depilatories. If those don’t work for you, then follow these steps for shaving:

• Wash your skin with warm water and a gentle cleanser.
• Apply plenty of gel or shaving cream, not soap, and let it sit 5-10 minutes to soften your hair.
• Use a new blade each time you shave so you know it’s clean and sharp; single blades are ideal.
• Shave in the direction your hairs grow.
• Rinse with warm water and use moisturizing lotion.
• Shave only every other day. 

Another way to avoid folliculitis is to limit your use of oils and other greasy skin products. These can cause blockages and trap bacteria. Other things you can do:

• Dip into hot tubs only if you know for sure they are clean and well-maintained.
• Use clean towels, razors, and other personal care items, and avoid sharing them with anyone else.
• Wash your hands often.
• Avoid getting too close to others who have folliculitis. They may pass on their germs without realizing it.
• Talk to your doctor about trying anti-dandruff shampoo. If your folliculitis is caused by yeast, using the shampoo on itchy parts of your skin may make a difference.
• Avoid clothes that irritate your skin or trap heat and sweat, such as Lycra, rubber gloves, and high boots. Instead, choose loose clothing made with fabrics (like cotton) that let your skin breathe. This will cut back on sweat and friction.
• Remove and rinse off your swimsuit as soon as you get out of a hot tub or pool.
• Do laundry often. Wash towels, sheets, and sweaty clothing in hot, soapy water to kill germs.

Takeaways

Folliculitis is a common and usually minor skin problem. Most of the time, it clears up with self-care at home. See your doctor if it doesn't clear up within a couple of weeks, or if your symptoms are serious.. 

Folliculitis FAQs

What triggers folliculitis?

Bacteria and fungi are common triggers for folliculitis. So are heavy or oily skin products and hair removal techniques like shaving and waxing.

What kills folliculitis bacteria?

Washing with warm water and antibacterial soap is often enough to clean and help heal the area. You can also try a saltwater solution, or vinegar mixed with water. Over-the-counter antibiotic creams often work as well. If none of these things does the trick, your doctor can prescribe an antibiotic you apply to your skin.