Folliculitis is a common rash-like superficial infection of the hair follicles. Follicles are the tiny cavities in the dermis layer of skin that surround the root of a hair. Some types are called hot tub folliculitis, razor bumps or barber’s itch.
Folliculitis manifests as multiple small, red raised bumps or little white head pimples around hair follicles. These bumps or pimples are less than 5 mm in diameter. Folliculitis may be itchy and is frequently observed in areas of repeated shaving. It can occur almost anywhere on the skin, but it is most commonly found on the neck, thighs, buttocks, or armpits. Coalescence of several follicular lesions or extension of a lone follicular lesion into deeper portions of the skin may develop into an abscess with pain and tenderness, and possible purulent discharge from the area. Severe folliculitis may cause hair loss or scarring.
Causes of Folliculitis
Folliculitis may be caused by bacteria, fungus or irritants. A common case of bacterial folliculitis is the normal skin bacteria Staphylococcus aureus when it enters the superficial portion of the hair follicle through shaving, friction, or a cut.
Pseudomonas is another causative bacteria in the setting of inadequately chlorinated hot tubs, whirlpools, and swimming pools.
Fungal folliculitis is sometimes seen in the setting of broad-spectrum antibiotic administration, glucocorticoid therapy, and/or immunocompromised individuals
To reduce likelihood of folliculitis, try these steps to protect yourself:
Avoid tight-fitting clothes that trap sweat and bacteria.
Wash clothes worn next to the skin in very hot water.
Avoid public hot tubs or spas and shower with antibacterial soap after using one.
Avoid shaving or shave with care: shave in the direction of hair growth with plenty shaving gel or cream. Use a sharp blade, rinse the razor with warm water after each stroke and do not share razors, towels or wash cloths.
Treatment of Folliculitis
Mild to moderate cases of folliculitis usually resolve spontaneously. Most cases of hot tub folliculitis are self-limited, requiring no specific treatment.
- Warm compresses applied three to six times daily for 10 minutes. Burow’s solution or white vinegar may be used instead of plain tap water.
- Avoid shaving in areas of folliculitis.
- Avoid scratching the infected area.
- Topical antibiotics (most commonly to treat Staphylococcal infection) may be required in some cases; oral antibiotics are necessary in only certain circumstances.
If the infection is on your scalp or beard, try a shampoo that contains selenium or propylene glycol, such as Selsun Blue.
If the rash is persistent despite treatment, worsens, spreads or presents in an unusual manner, schedule an appointment at the IU Health Center Medical Clinic, through www.healthcenter.indiana.edu click on Schedule Your Appointment or call (812) 855-7688.