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What is folliculitis?
Folliculitis is a very common skin rash often found on the scalp, chest, back, arms, legs, buttocks, and cheeks that is caused by a bacterial infection involving the hair follicles. The condition can be barely noticeable without any symptoms or excruciatingly painful depending upon the severity of the condition. At times, the follicles become so infected that they advance to the abscess or carbuncle stage creating a boil like lesion on the skin that can cause it to be difficult to sit or tolerate clothing touching the area.
What causes folliculitis?
There are several common causes.
- Bacterial infection. This often is the case with people who live in hot humid climates with excessive sweating and occlusion leading to infection on the pressure areas of the body. Workers who wear hard hats and helmets and perspire a lot will frequently find themselves bothered by this condition. A special type of folliculitis occurs when you use hot tubs and pools that may harbor various bacteria that can infect the hair follicles causing folliculitis.
- Dry itchy scalp or skin on the body areas when scratched, can create open areas that can become secondarily infected with bacteria causing folliculitis. If your skin is very dry you may not slough off the dead skin cells properly. This build up of dead skin may block the pores causing the little red bumps or pustules. Individuals with a hereditary condition causing goose pimple like changes on the arms, or thighs can be especially prone to this condition.
- Improper shaving techniques. If you shave too closely or in the wrong direction it can cause ingrown hairs and infected follicles. Many individuals think that when these bumps occur after haircuts or shaving that the clippers or shaver is dirty, but it is really due to the fact that the shaving devices or clippers are very short and cause nicks that make it easier for the skin to get infected.
- Hygiene. If the body is not kept clean it can aid the growth of bacteria causing folliculitis. This can be a problem for individuals who participate in sports or workout and experience a delay between the time they finish working out and they are able to get to a shower or bathing facility.
How to treat folliculitis.
Many times, the infected hair follicles will clear up on their own and no treatment is necessary. The regular use of antibacterial body scrubs, bar soap, and shampoos can make this condition less likely. If the bumps or tenderness does not go away within a few days, some over the counter antibacterial washes or topical antibiotic creams may be helpful in clearing it up. Benzyl peroxide washes are particularly good for treating persistent folliculitis. However, if the skin becomes red, swollen, painful or hot to the touch you should seek medical attention as the infection has spread into the surrounding tissues or advanced to the point where you will need oral antibiotics to treat the infection.
4 Steps to eliminate infected hair follicles.
- If your folliculitis is a result of hot tubs, try using an antibacterial wash after getting out of the tub. This will kill the bacteria before it has a chance to cause problems for you. Also, make sure that the hot tub has proper chlorination.
- Use proper shaving techniques. You should always shave in the direction the hair grows and never against the grain of your hair. For ladies, this means shaving your legs downward instead of upward. Replace your razor blade often and do not shave too closely.
- If you are prone to folliculitis, you should shower rather than bathe. If soaking in a hot tub is one of life’s pleasures to you, you should shower first to remove the bacteria from your body and then soak in the tub.
- If the problem persists and continues to be bothersome see your dermatologist. Sometimes the folliculitis will only go away with appropriate internal antibiotic therapy.
Following these steps will help you to eliminate this bothersome problem should you ever experience it.
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As my husband was just diagnosed with folliculitis, I’d like to know if it is contagious. Great article as it was very informative. Thank you!
The type of bacteria present is the key determining factor related to whether folliculitis is contagious or not. If a bacterial culture reveals the presence of MRSA for example then precautions would need to be taken to prevent transmission of this contagious organisms. Some other organisms or normal skin flora would not be as potentially contagious.
My son who is 12 has folliculitis on the scalp for about 4 months. I have tried Zineryt and Dulac. He has had some hair loss. He is using a anti fungal shampoo. The spots come and go. Have you any advice on how to get rid of it altogether.
Sharon.
It would be best to have bacterial and fungal cultures done of the scalp to verify which type of infection is present. Based upon the results obtained and sensitivity studies the best oral medication can be prescribed to cure the infection.
i have had this problem for about 4 months now its not getting no better on antiboicis all the time and so pain full got speacil wash and creams etc doctors dont seem to no what to do please help
If the antibiotics are not helping your condition then with your doctors assistance you might want to consider stopping the antibiotics and having a bacterial culture done to see if a resistant organism is present. You could also have a fungal culture done to make sure that an organism of this type is not masquerading as folliculitis.
As of the past 6 months I have had folliculitis about 4 times now, once on my chin and 3 times on the back of my scalp. They have all left bald spots on my skin the size of a dime to a quarter (scar tissue?). They start out pimple-size and the swelling spans to about 2-3 inches in diameter on me and it is extremely painful! During my first episode I was taking many pain killers/anti-inflammatories and eating several cloves of raw garlic per day as an antibiotic – see I have no medical insurance and just cannot handle any medical bills right now… After a few days of pain and sleepless nights it seemed to do the trick and began pussing/bleeding for a couple days until it finally went away and left it’s bald spot. I have gone through this with all 3 abscesses and currently I am dealing with my 4th one. It has been extremely painful for 2 days now, I plan to start the garlic/painkiller process tonight (perhaps I should have sooner). I am guessing that I am causing the folliculitis by picking and scratching at my psoriasis, which I have had almost all my life and have never been able to manage with any prescription or remedy… Maybe I am causing the bacteria infection by picking at my scalp? I guess I don’t really have a specific question here I just wanted to share my story and thank you for posting this… But perhaps you can shed some light as to why I am just all-of-a-sudden starting to get folliculitis? I have never had it before 6 months ago… nothing has really changed in my life either (I am 28 years old)… I am stumped. But it seems as though this nuisance is here to stay with me as I seem to get this now about every month or so!
Everything you describe so far seems classical for a methicillin resistant staph aureus (MRSA) infection. You will need to find a way to have a bacterial culture done to see which organism is responsible for the folliculitis and provide guidance for the appropriate medical therapy. There should be a way to get this done in most communities at a reasonable price even if you do not have insurance. Without the correct treatment this type of problem can go on and on for months and sometimes years.
I was told I have yeast (fungus) on my scalp and hair follicles I was given a shampoo called ketoconazole that I use weekly, the area where the yeast is still itch and I’m having alot of hair lost. should I have a bacterial and fungal cultures done to find out what kind of fungus infection is present or a skin biopsy of the scalp for the best treatment plan
It would be useful to either have a microscopic examination to check for a fungus and if it is positive, that could indicate that you need to take an oral anti-fungal medication for up to 4 or 6 weeks. If the scraping is negative, a culture could be done for fungal and bacterial organisms to check further into possible causes of the infected hair follicles. Ketoconazole shampoo is most often used to treat seborrheic dermatitis which is felt to be related to a type of yeast organism which is different from a fungus and not usually associated with hair loss.
I’VE BEEN SUFFERING WITH FOLLICULITIS EVER SINCE I WAS 18 im 29 NOW AND IT’S GOTTEN WORST BECAUSE ITS SPREAD ALL OVER MY SCALP, IT OOZES ITS PAINFUL AND THE DOCTOR JUST KEEPS GIVING ME DOXYCYCLINE FOR ALL THESE YEARS I’VE EVEN DONE SURGERY ON THE ONES THAT STARTED TO KELOID I DON’T KNOW WHAT ELSE TO DO.
If you have chronic oozing from your scalp it suggests that an ongoing bacterial infection is present. If it has not been done, then you might have your physician do a bacterial culture with sensitivity studies to see which organism is growing and which antibiotic treatment should work best. While doxycycline is helpful at times, it is possible that the bacteria on your scalp have become resistant to it so that it doesn’t do any good.
I just read your article.
I was told I have folliculitis in my genital area, although it’s not bad it IS a pain in the butt. It’s been going on for the past couple years. It’s very annoying because as a girl you definitely want to be able to shave in that area. Every time I do any type of hair removal I always get those annoying red or ones that look like whiteheads. Sometimes they come right away, sometimes they come up within the next few days. I’ve been told just to use polysporin and for the most part it works but I was wondering if there’s anything else that will help me. I’m getting fed up because they sometimes come at the most random time and it stresses me out big time! I’ve been to the doctors lots of times because of this and they tell me it’s very common in girls. I’ve been tested and it’s definitely NOT an STD. Help?
Getting folliculitis to clear up can require oral antibiotics in addition to topical so you might check into getting one prescribed. Also, you might want to consider laser hair removal to clear the hair from the area and eliminate the source of the folliculitis.
Thank you for the informative article. I recently developed folliculitis on the inner thigh (crural) region. At first I thought I was developing a case of jock itch, but it is definitely red, pimple like individual inflammatory sites. I seem to sweat alot in the groin region and have used GoldBond to try and keep the area dry. Is there any sort of special wash or treatment to apply to the skin to kill fungus and bacteria daily? I would like to just prevent this from happening again or mitigate the symptoms before they progress to severe. It makes me feel uncomfortable and really makes my anxiety worse. Grateful for sharing your medical knowledge of this skin disease. Sincerely, AJ W
Antibacterial soaps or body washes as well as topical antibiotics are good to help prevent flare ups of folliculitis. If the problem keeps recurring and does not clear with topical treatment alone, a culture might be necessary as well as oral antibiotics to eliminate the problem