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Everything You Need To Know About Folliculitis

Folliculitis is a skin disorder involving the inflammation of hair follicles. It is typically due to an infection of the hair follicle and results in irritated pimple-like spots or pustules.

Folliculitis affects the hair-bearing areas of the body, often the arms, head, and face. The condition presents small discolored bumps that may have a white, pus-filled tip.

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 may appear similar to an acne outbreak, but it is important to differentiate them.

Other symptoms include:

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.

Common types include:

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 prevalent among 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 causes of viral folliculitis. Symptoms are typically self-limiting.

Demodex folliculitis: Demodex folliculitis often affects follicles on the face. It occurs when small mites that live on the skin's surface enter the follicle.

Doctors typically diagnose folliculitis through a physical examination and medical history assessment.

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:

Medication

Various medications are available for folliculitis. They can treat either bacterial or fungal infections, depending on the condition's cause. A doctor may also recommend anti-inflammatory drugs.

Forms of medication include:

topical antibiotic creams

oral antibiotics

topical antifungal creams

antifungal shampoos

oral antifungals

steroid creams

oral corticosteroids

Light therapy

In severe cases, doctors may recommend light therapy or photodynamic therapy to treat folliculitis. This type of treatment can help improve symptoms of deep folliculitis.

Lancing

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.

Home remedies

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.

Hidradenitis Suppurativa Vs. Folliculitis: How To Tell The Difference

Folliculitis and hidradenitis suppurativa (HS) are two skin conditions characterized by red, acne-like rashes. HS is chronic and typically more severe.

Folliculitis is a red or discolored, bumpy, pimple-like rash caused by many different types of infection.

Hidradenitis suppurativa (HS) is a rash that may also resemble acne, but often takes the form of deeper nodules or boils. It's a chronic condition thought to be tied to genetics and immune system issues, though scientists don't know for sure.

Here's what else to know about the difference between these two conditions.

There are many key differences between the conditions, including:

Severity: Folliculitis is typically pretty mild and disappears within 1–2 weeks on its own or with topical treatment. HS is a recurring condition that typically requires more extensive medical intervention, including in some cases, surgery.

Incidence rate: Folliculitis is more common, and therefore, you're more likely to get it. HS only affects about 1% of people, while getting folliculitis at some point in life is very common (though exact figures remain unknown).

Cause: Folliculitis is typically caused by the Staphylococcus (staph) bacteria or certain types of fungi. The cause of HS is unknown, but it's thought to be related to your family history and immune system.

Contagion: Bacterial folliculitis can be passed through skin-to-skin contact or through items like towels, razors, or clothing. It's especially passed via wet or moist items since that's where staph thrives. One type of folliculitis, Pseudomonas folliculitis, also called "hot tub folliculitis," is caused by a germ commonly found in poorly maintained hot tubs or pools.

Rash type: Though both rashes may be characterized by red, pimple-like bumps, outbreaks from HS tend to be deeper and more painful. HS lesions also tend to be larger and may take the form of cysts or boils. Deep, inflamed channels may also form in between HS lesions.

Rash location: HS affects the sweat glands and hair follicles and typically occurs on areas where the skin rubs together, like the armpits, groin, anus, inner thighs, under the breasts, or between the buttocks. Folliculitis impacts the hair follicles and is often found on the neck, breasts, buttocks, groin, face, back, arms, or scalp. For example, when folliculitis occurs as the result of being in a pool or hot tub, the rash will typically be more extreme where your swimsuit had contact with your skin.

While folliculitis typically resolves on its own within 1–2 weeks, HS tends to be more challenging to treat.

Applying topical antibiotics or diluted white vinegar can help ease symptoms and side effects associated with folliculitis. If the rash is very severe and doesn't resolve with topical treatment, other treatments may be recommended, including:

While there's not yet a cure for HS, there are various methods to help manage it, including:

antibiotics

biologics

steroids

pain medication

hormone therapy

retinoids

acne washes

topical medication

zinc

In some cases, surgery may be necessary to remove painful lesions. Surgeries may include:

deroofing

electrosurgical peeling

total or partial excision

It's always a good idea to visit a doctor if you have a rash that:

is painful or interferes with your daily life

doesn't improve within about 2 weeks

disappears then reemerges

A dermatologist can examine the inflamed areas and may be able to diagnose your condition based on its appearance alone. You will also be asked questions about your lifestyle, medical and family history, and other symptoms you may have experienced.

If the lesions are leaking fluid, the doctor may collect a sample and perform lab tests to help identify the cause.

Since HS may become more severe without treatment, it's a good idea to visit a doctor as soon as possible.

Folliculitis and hidradenitis suppurativa (HS) are two skin conditions characterized by red, acne-like rashes. Folliculitis is caused by a bacterial or fungal infection, while HS is a chronic condition with a hereditary link.

HS outbreaks reemerge over time and tend to be characterized by larger, more severe lesions. Though HS currently has no cure, there are ways to help manage the condition.

Folliculitis is less severe and can resolve on its own within a couple of weeks.

If your rash is painful or persistent, visit a doctor for a diagnosis and treatment as soon as possible.

What To Do (and What Not To Do) During A Boil Water Advisory

A boil water advisory is a public health measure that suggests the possibility of bacterial contamination in the water system, making the water unsafe to drink tap water without boiling it first, according to the Atlanta-based Centers for Disease Control and Prevention.

But what exactly should you do under a boil water advisory? Only use or consume bottled water or water that has been boiled.

Here are seven tips to keep in mind from public health experts:

Read more from the CDC and DeKalb Health Department (PDF)

1. Only drink tap water after you've boiled it.

When boiling water, fill your pot with water and heat it until you see bubbles reach the top.

Once you notice a rolling boil, let it continue boiling for 1-3 minutes before you turn off the heat and let the water cool.

Store the water by pouring it into a clean container with a cover.

2. Don't use ice from ice machines or commercial soft-drink dispensers. Don't use drinks from soft-drink dispensers either. The DeKalb Health Department says to avoid these during the boil-water advisory:

Carbonated fountain drink machines.

Beverage "gun" dispensers.

Machines that produce ice.

Mechanical dish washing machines.

Self-serve bulk water dispensers

3. Can you drink water from a water filter or use ice from an ice tray?

You should still boil tap water even if you're using a water filter. According to the CDC, most water filters don't remove bacterium or viruses.

And no, do not use the ice in your ice tray. You should throw out all ice made with tap water, including ice in trays, dispensers or ice makers.

Instead, the CDC recommends you make new ice with boiled or bottled water.

4. Cooking food under a boil water advisory

When preparing to cook, wash any food prep surfaces with boiled water.

You can cook to your heart's content, but be sure to also wash your ingredients with boiled water that has cooled (or use bottled water).

CDC experts recommend using boiled water when preparing beverages like coffee, tea and lemonade.

When you're ready to wash your dishes, you're OK to use your dishwasher as long as your appliance reaches a final rinse temperature of at least 150 degrees (or if your appliance has a sanitizing cycle), according to the CDC.

You can also use hot water mixed with a teaspoon of unscented household liquid bleach for each gallon of hot water to hand-wash your dishes.

Just soak the rinsed dishes in the mixed water for at least one minute and let them air dry.

5. Is it safe to take a shower or brush your teeth?

Of course, but be careful not to swallow any water when doing so and, when brushing your teeth, do not use untreated tap water. Instead, use boiled or bottled water.

If you have a baby or young child, consider giving them a sponge bath.

6. How to feed your baby safely under a boil water advisory

While CDC experts recommend breastfeeding, if that isn't an option, use ready-to-use baby formula.

Use bottled water or boiled water (or, if you can do neither, disinfect the water using the disinfecting steps above) to prepare powdered or concentrated baby formula.

Be sure to both wash and sterilize the nipples and bottles before feeding.

7. Is the water safe for your pet?

CDC experts recommend abiding by the same guidelines for pets as you would for yourself and your family. Give your adopted fur babies boiled water that has been cooled.

More about boil water advisory safety at CDC.Gov.

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