Folliculitis is a common rash caused by superficial inflammation and infection of the hair follicles. Follicles are the tiny cavities in the layer of skin that surround the root of a hair. Certain types are called hot tub rash, 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 or painful. The bumps are frequently observed in areas of repeated shaving, although they can occur almost anywhere on the skin. They are most commonly found on the neck, thighs, buttocks, or armpits. Groups of several follicular lesions or extension of a lone follicular lesion into deeper portions of the skin may develop into an abscess (deep pimple) with pain and tenderness, and possible purulent discharge from the area. Severe folliculitis may rarely cause hair loss or scarring.
Causes of Folliculitis
Folliculitis may be caused by bacteria, fungus, or irritation. A common cause of bacterial folliculitis is the normal skin bacteria Staphylococcus aureus when it enters the hair follicle through shaving, friction, or a cut. Folliculitis can also occur from excessive sweating from exercise, working outside, or using a hot tub.
Pseudomonas is another causative bacteria from inadequately chlorinated hot tubs, whirlpools, and swimming pools.
Fungal folliculitis is sometimes seen when antibiotics have been used, steroids have been taken, or if someone is immunocompromised from chemotherapy or HIV/AIDS.
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, soapy 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 of 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. Topical antibiotics (most commonly to treat Staphylococcal infection) may be required in some cases; oral antibiotics may be necessary in more severe or repeat infections.
- Clean the affected skin twice daily with an antibacterial soap. Use a clean washcloth and towel each time and do not share your towels or washcloths. Use hot, soapy water to wash your towels and washcloths.
- Warm compresses, with a clean, warm, moist washcloth, applied three to six times daily for 10 minutes at a time. White vinegar may be added to water to moisten the washcloth and help dry out the pimples.
- Avoid shaving in areas of folliculitis.
- Avoid scratching the affected 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 sulfide 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 Student Health Center Medical Clinic. Schedule online or call 812-855-7688.