Folliculitis is a common skin condition that’s often caused by an infected or inflamed hair follicle. It can look similar to acne and be uncomfortable or itchy. Folliculitis often has a psychosocial impact because of its appearance. There are many different types of folliculitis — each one unique based on the cause, the infectious organism and its impact on the skin. Folliculitis can happen as a result of daily activities like shaving, getting in a hot tub, and excess sweating from exercise or outdoor work.
You can have folliculitis anywhere on the body that has hair. Common places include your:
Face.
Arms.
Upper back.
Lower legs.
You have hair almost everywhere on your body. Some hairs are so fine that you may not notice they are there, while others are very prominent. Your hair has a larger purpose than appearance — it acts like an insulator, keeping you warm. It’s part of your body’s protection system. The spot where an individual hair enters your skin is called a follicle. The follicle holds the thin hair in place and is home to oil glands.
Unfortunately, follicles can gather bacteria and other materials from the outside world that could cause inflammation or infection. When something is inflamed, it’s swollen. A swollen hair follicle will bulge up and make a bump on the skin. If you have an infected hair follicle, you may experience:
Redness.
Irritation.
Itching.
Bumps on the skin.
What are the symptoms of folliculitis?
In most cases, the main symptom of folliculitis is red bumps that look like pimples on your skin. These could also look like they’re white-filled bumps or they could be filled with pus (pustules). Folliculitis can feel itchy and uncomfortable. Many people feel the need to scratch when they have folliculitis. It’s best to try and not scratch at the spots because you don’t want to open them up (this could possibly cause a worse infection of the hair follicle).
What causes folliculitis?
In general, folliculitis is caused when a hair follicle is inflamed (swollen) and infected. This causes the follicle to swell under the skin, creating uncomfortable bumps on the surface of your skin. For many of the specific types of folliculitis, the cause isn’t always known. However, there are certain factors that can increase your risk of developing folliculitis. A few risks can include:
If you shave often.
If you have been using an oral antibiotic for a long period of time.
If you do activities that make you sweat a lot and don’t fully clean off afterwards.
If you spend time in a hot tub or sauna that isn’t properly cleaned.
Treatment options for folliculitis depend on the type of folliculitis you have and it’s severity. Certain types may need more aggressive types of care, while others may go away with little to no treatment. If your folliculitis is mild, it can sometimes be treated at home. There are several ways you can care for your irritated skin, including:
Using antibacterial cleansers to clean the skin. This will limit the amount of bacteria on your skin.
Applying warm towels to your irritated skin to sooth the discomfort.
Using anti-itch creams.
In less severe types of folliculitis, like Pseudomonas folliculitis (hot tub rash), your symptoms will typically fade within a few days without treatment. If they don’t, reach out to your healthcare provider. When you have a more severe case of folliculitis, oral antibiotics may be needed to treat the condition. Deeper infections, like boils and carbuncles, may have to be drained by your healthcare provider. This will remove the build-up of pus and allow the area to heal. Because Pseudofolliculitis barbae and Sycosis barbae heavily affect the beard area, you can manage these conditions by changing your shaving habits. These changes can include:
Softening the hair with hot water before shaving.
Shaving with the grain of the hair, not against it.
Using a shaving gel or cream.
Shaving every other day, rather than daily.
Using an electric razor or hair removal product instead of a traditional razor blade.
Avoiding pulling the skin while shaving.
How is folliculitis diagnosed?
Folliculitis is usually diagnosed during a physical exam with your healthcare provider. This can be done during an appointment and in most cases, you do not need to see a skincare specialist. Your primary care physician is usually able to diagnose folliculitis and provide a treatment plan. In certain, severe or persistent cases, an appointment with a dermatologist is recommended.
Your healthcare provider will go over your medical history and ask you about your habits. Some questions might include:
Have you been sweating more than normal lately or doing activities that cause you to sweat a lot?
Have you been in a hot tub or sauna?
Do you shave every day?
Are you currently taking any medications, including acne treatments?
The answers to these questions often confirm a diagnosis of folliculitis and help your provider determine which type it might be.
In some more severe cases, your provider may refer you to a dermatologist for additional tests to make sure your folliculitis isn’t another medical condition. One test that can be done is a biopsy. This is a test where a small sample of your skin is removed and then taken to a lab where it’s studied.
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