Folliculitis

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Folliculitis

Topic Overview

Illustration of the skin in cross-section

What is folliculitis?

Folliculitis is an infection in the hair follicles. Each hair on your body grows out of a tiny pouch called a follicle. You can have folliculitis on any part of your body that has hair. But it is most common on the face and scalp and areas rubbed by clothing, such as the thighs and groin.

What causes folliculitis?

It usually is caused by bacteria. It also can be caused by yeast or another type of fungus.

You may get folliculitis if you have damaged hair follicles. Shaving or wearing clothes that rub the skin can irritate the follicles, which can lead to folliculitis. They also can become blocked or irritated by sweat, machine oils, or makeup. When the follicles are injured, they are more likely to become infected.

You are more likely to get folliculitis if you:

  • Use a hot tub, whirlpool, or swimming pool that is not properly treated with chlorine.
  • Wear tight clothes.
  • Use antibiotics or steroid creams for long periods.
  • Use or work with substances that can irritate or block the follicles. Examples include makeup, cocoa butter, motor oil, tar, and creosote.
  • Have an infected cut, scrape, or surgical wound. The bacteria or fungi can spread to nearby hair follicles.
  • Have a disease such as diabetes or HIV that lowers your ability to fight infection.

What are the symptoms?

Folliculitis usually looks like red pimples with a hair in the centre of each one. The pimples may have pus in them, and they may itch or burn. When the pimples break open, they may drain pus, blood, or both.

"Hot tub folliculitis" most often appears about 72 hours after you've been in a hot tub or spa. Many small pimples appear on your stomach and sometimes on your arms and legs. You might have a mild fever and have an upset stomach. Most of the time, this kind of folliculitis goes away on its own in 7 to 10 days.

How is folliculitis diagnosed?

Your doctor will check your skin and ask about your health and activities. He or she may do tests to find out what is causing your folliculitis and to make sure you don’t have a different problem, such as impetigo or heat rash. Testing a sample of the fluid in the pimples or a sample of tissue can help your doctor learn what is causing the infection.

How is it treated?

Mild folliculitis usually heals on its own in about 2 weeks. You can take care of yourself at home with:

  • Warm compresses made with white vinegar or Burow's solution. These may ease itching and help healing.
  • Medicated shampoo. It can be used to treat folliculitis on the scalp or beard.

If the infection doesn't go away, you may need an antibiotic or antifungal cream. If your infection is severe, your doctor will prescribe antibiotic or antifungal pills.

Call your doctor if you have folliculitis and:

  • It spreads or keeps coming back.
  • You have a fever over 38°C (101°F).
  • The infected area becomes red, swollen, warm, or more painful.

If the infection doesn't go away or keeps coming back, laser hair removal may be an option. Laser treatment destroys the hair follicles so they can't get infected.

How can you prevent folliculitis?

There are many things you can do to prevent folliculitis or keep it from spreading.

  • Bathe or shower daily with a mild antibacterial soap. Also, bathe or shower after you exercise and after you work around chemicals.
  • Avoid sharing towels, face cloths, or other personal items. If you have folliculitis, use a clean face cloth and towel each time you bathe.
  • Don't scratch the bumps.
  • Avoid shaving the bumps. If you must shave, change the razor blade each time. Try using depilatory creams and lotions, which remove hair without shaving. (These products are not recommended for use more often than once or twice a week.)
  • Avoid using oils on your skin. Oils can trap bacteria in the pores of your skin and can cause folliculitis.
  • After you use public hot tubs or spas, shower right away with antibacterial soap. If you own your own hot tub, follow the manufacturer's instructions for keeping it clean.

Frequently Asked Questions

Learning about folliculitis:

Other Places To Get Help

Organization

Canadian Dermatology Association
1385 Bank Street
Suite 425
Ottawa, ON  K1H 8N4
Phone: 1-800-267-3376
(613) 738-1748
Fax: (613) 738-4695
Email: contact.cda@dermatology.ca
Web Address: www.dermatology.ca
 

The Canadian Dermatology Association promotes research and education for dermatologists, provides information and support for dermatology patients, and offers public education materials on sun awareness and skin care.


References

Other Works Consulted

  • Hall JC (2010). Folliculitis section of Dermatologic bacteriology. In JC Hall, ed., Sauer’s Manual of Skin Diseases, 10th ed., pp. 205–207. Philadelphia: Lippincott Williams and Wilkins.
  • Berger TG (2010). Folliculitis (including sycosis) section of Dermatologic disorders. In SJ McPhee, MA Papadakis, eds., 2010 Current Medical Diagnosis and Treatment, 49th ed., pp. 123–124. New York: McGraw-Hill.
  • Green P (2007). Bacterial skin infections. In J Gray, ed., Therapeutic Choices, 5th ed., pp. 1098–1112. Ottawa: Canadian Pharmacists Association.
  • Habif TP (2010). Folliculitis section of Bacterial infections. In Clinical Dermatology, A Color Guide to Diagnosis and Therapy, 5th ed., pp. 351–355. Edinburgh: Mosby Elsevier.
  • Korman NJ (2004). Pustular eruptions section of Macular, papular, vesiculobullous, and pustular diseases. In L Goldman, D Ausiello, eds., Cecil Textbook of Medicine, 22nd ed., 2473–2475. Philadelphia: Saunders.
  • Lee PK, et al. (2003). Folliculitis section of Pyodermas. In IM Freedburg et al., eds., Fitzpatrick's Dermatology in General Medicine, 6th ed., p. 1860. New York: McGraw-Hill.
  • Pasternack MS, Swartz MN (2010). Folliculitis section of Cellulitis, necrotizing fasciitis, and subcutaneous tissue infections. In GL Mandell et al., eds., Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases, 7th ed., vol. 1, p. 1292. Philadelphia: Churchill Livingstone Elsevier.

Credits

By Healthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Primary Medical Reviewer Anne C. Poinier, MD - Internal Medicine
Specialist Medical Reviewer Alexander H. Murray, MD, FRCPC - Dermatology
Last Revised July 11, 2011

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