Folliculitis Causes and Treatment
a hair follicle is damaged, a type of skin abscess can form, allowing
folliculitis causes such as bacteria (usually Staphylococcus
aureus) and fungus to
enter the skin. Hair follicles are damaged by anything that
irritate or damage the skin such as shaving, a skin scrape or clothing
that rubs against the skin. The condition is referred to by several
names based on the cause and area of the body affected. This
includes Pseudofolliculitis barbae (bacterial folliculitis
that occurs after shaving or when the beard hair curls into the skin),
Tinea barbae (caused by a fungus). Barber's
itch, hot tub folliculitis or hot tub dermatitis. In cases where there
was exposure to water, it occurs under the bathing suit, such as on the
chest and rear/buttocks several hours to five days after being exposed
to the bacteria. Folliculitis symptoms include the
appearance of a white follicle or pimple located at the base of one or
more strands of hair. It can occur anywhere on your skin and
can be painful. The infection may be just on the skin surface
or in more chronic cases, penetrate into deeper skin layers.
Cases caused by water such as hot tub folliculitis will
with no treatment. Other forms that are only on the surface of the skin
can be treated with topicals applied to the skin and antibacterial
soaps. Infection that penetrates deeper into the skin will require oral
anti-biotics. Individuals that frequently contract
folliculitis may require frequent use of anti-bacterial soaps and
shampoos to control the condition."
Ever been to the hairdresser or barber and they use a razor on the back
of your neck making you itch uncontrollably for days afterwards? Join
the club. The itch may be folliculitis and is the result of many
things, including friction from your clothes, shaving or the blocking
of a follicle. Folliculitis typically gets infected by staph bacteria
or Pseudomonas (bacteria) as well.
Folliculitis is commonly
seen on the scalp, resulting in pus filled abscesses.
Source: Principles of Pediatric Dermatology
Superficial Folliculitis Causes
As mentioned, there are several types of superficial
folliculitis causes (also called Bockhart impetigo).
Superficial refers to the conditions which do not penetrate
deeply into the skin. These include::
folliculitis: this is the most common type of bacterial folliculitis. In
children it occurs on the scalp, and in adults the condition can occur
in any hairy area. When in the beard it
is called Barber's itch. Symptoms include itch and puss
filled abscesses that cause skin bumps.
It usually occurs around the bearded area
of a man’s face, and the upper lip. If you have
this condition it's not a good idea to
shave, as this only makes thing a lot worse.
- Hot tub
folliculitis (pseudomonas folliculitis): Folliculitis can
be caused by exposure to bacteria in a
heated pool such as a whirlpool or hot tub. This type of folliculitis
is referred to as either hot tub dermatitis or hot tub folliculitis. It
is caused by bacteria that colonize in hot tubs and whirlpools that are
not properly chlorinated. This type results in rash filled with skin
bumps. The rash will itch, with the worst rashes appearing
under areas which were covered by a bathing suit
- Tinea barbae:
Tinea barbae is a close
cousin of barber’s itch, but is caused by a fungus. It is
most often seen in beards, with the skin area that surrounds the beard
becoming red. The skin abscesses are also filled with puss.
other symptoms can include fever. The lymph nodes
may swell as well.
barbae: This is a condition where the beard hairs curl
into the skin causing irritation. It can result in scaring on
the man's face and also the neck. Pseudofolliculitis barbae
usually affects men with darker skin. What happens is, if curly beard
hairs are shaved off too short, they may curl back into the skin,
causing inflammation. There may or may not be a
skin infection with the irritation.
folliculitis: This is one of the folliculitis causes in
teens and men that is triggered by a fungus. Symptoms
primarily appear on the chest and back. It can also
appear on the face, upper arms, shoulders and neck.
folliculitis: When a cold sore is cut during shaving, a
blister can form which is triggered by the herpes simplex virus. The
virus can spread to hair follicles.
Deeper Folliculitis Causes
In deeper folliculitis causes, the folliculitis penetrates deeply into
the hair follicles (called perifolliculitis). Deep
folliculitis can result in crusted lesions, and scars (cicatricial
- Gram negative
folliculitis: Anti-biotic can affect the
bacteria in the nose, resulting in more bacteria being allowed to
colonize than normal. Bacteria can spread to the face, resulting in
- Skin Boils:
When a folliculitis infection
penetrates deeply into the skin, boils can form in the shape of a pink
or red bump. As puss accumulates under the bump, it can get larger and
break. Several boils in a group are referred to as a
carbuncle (appear on the thighs, back, shoulders, neck). A
carbuncle can result in a scar. in addition to prescription
medications, healing can be supported with a natural remedy such as Boil-RX.
folliculitis: This is one of the
folliculitis causes, particularly in people with HIV. Symptoms include
patches of skin sores/puss filled abscesses and itch. it may change
the skin to a darker color.
The most common symptoms may include itching, a red rash and either
pimples or pustules near hair follicles on your groin, neck or even
genital area. On the head, white pustules appear at the base of each
hair. Depending on how much you scratch and how bad your
infection happens to be, the pimples may even crust over. Folliculitis
may affect 10%-20% of people at some point in their lives.
It may start out as multiple tiny red or even pink bumps at the base of
your hair follicles. You might think it looks a bit like chicken skin
in coloration and have a pebbly feel. Some of the bumps may have a red
halo around them, which indicates inflammation. You may find it
anywhere on your body, and that will include your cheeks, legs, arms,
buttocks, back and chest. It does not affect the soles of your feet,
your eyes, mouth, or palms.
If you scratch the tops off the bumps, you may see a hair trapped
inside, which is turning back into the skin and causing the
inflammation and itching. You may also have acne whiteheads at the same
time. It doesn’t really matter how old you are, as just about anyone
can get folliculitis.
There are however, some groups that are more susceptible to
folliculitis, including, diabetics, people with compromised immune
systems, people taking immune-suppressing drugs, those with cancer,
chronic illnesses and those undergoing chemotherapy.
Usually, the doctor only needs to see how your skin looks. However,
there are a number of other conditions that also “look” like
folliculitis. To differentiate the condition from other possible causes
the Doctor may recommend tests such as a skin biopsy or skin
culture. Some of the other conditions that may mimic folliculitis are:
atopic dermatitis, whiteheads, acne, keratosis pilaris, impetigo, fire
ant bites, insect bites, heat rash, contact dermatitis and dry skin.
Folliculitis, a skin boil
(Furuncle) and Carbuncle are differentiated by the symptoms and type of
Source: John L. Bezzant, M.D.
To determine which of the folliculitis causes is affecting you,
your doctor may want to conduct microscopic skin and fungal tests with
potassium hydroxide, to figure out if your folliculitis is caused by a
fungus or yeast. As for skin biopsies, they are normally only done if
your folliculitis is not “typical” and is all over your body. The skin
biopsy will help rule out other possible conditions.
Folliculitis Causes and Treatment
Most mild forms of this condition will heal on their own with no
treatment. To aide healing, there are numerous folliculitis treatments,
depending on what the
caused the condition. Some of those treatments are listed below:
- Hot, moist compresses. Apply an antibiotic cream
(mupirocin, Bactroban) or take
oral antibiotics (dicolxacillin). Use anti fungal medications if
- Over the counter antibacterial washes: benzoyl peroxide
Clearisil), chlorhexidine (Hibiclens), phisoderm twice a day.
supportive remedies such as Boil-Rx
can help to relieve the puss and inflammation.
- Combine topical products with antibacterial washes.
- Soaking in warm tub of diluted white vinegar (4 parts
water, 1 part
- Soaking in warm tub with dilute Clorox bleach (full tub
with ¼ cup
- For bacterial folliculitis, use antibacterial skin washes
topical and/or oral medications
- For moderate folliculitis causes and conditions, use
topical antibiotic twice a
(clindamycin or metronidazole lotion). Take course (5-30 days) of oral
antibiotic such as levofloxacin, ciprofloxacin, tetracycline,
cephalexin, minocycline or doxycyline. When infection clears, revert to
mild antibacterial washes and topical antibiotics.
- For dry skin folliculitis, treat dryness first by using
cleansers and moisturizers like Lubriderm or Cetaphil. Other options
include lactic-acid lotions (Lac-Hydrin, AmLactin), alpha hydroxyl acid
lotions (glycolic body lotions), urea cream (Carmol 10,20,40, Urix 40)
and/or salicylic acid (Salex lotion).
- For yeast or fungal based folliculitis, anti fungal
twice a day. The more resistant fungal folliculitis may need
a topical anti fungal cream, such as lotrimin or lamisil and the
addition of an anti fungal pill, like difulcan.
- For folliculitis in the beard or face, a doctor may
recommend that a patient not shave until the condition has healed.
- For severe folliculitis causes and acne, the doctor may
Accutane. This is off-label usage and not routine. Take care with the
- Homeopathic products such as Skin
Dr. can provide added support when the
skin is healing from minor skin irritations and rashes.
In cases of hot tub dermatitis or hot tub folliculitis, treatment imay
not be needed as long as the condition goes away in about a week.
If not visit a Doctor to determine which of the folliculitis causes
triggered your skin condition.
References for Folliculitis Causes: