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Folliculitis

Definition

Folliculitis is inflammation of the hair follicle. It can occur anywhere on the skin or scalp. There are many types of folliculitis.

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Causes

Folliculitis has many causes. It may be infectious or noninfectious.

The infectious type is caused by:

  • Bacteria
  • Fungi
  • Viruses
  • Parasites

The non-infectious type may be caused by:

  • Shaving
  • Irritation from clothing
  • Certain medicines
  • Chemical exposure
  • Sun exposure
  • Missing nutrients in the diet

Contact dermatitis, poison ivy, acne, or rosacea may also cause folliculitis.

Risk Factors

Things that raise the risk of folliculitis are:

  • Exposure to bacterial infection
  • Overusing certain medicines, such as:
    • Antibiotics
    • Corticosteroids applied to the skin
  • Having other skin conditions—especially those that itch
  • Exposure to oils and chemicals
  • Having a weak immune system
  • Shaving against the direction of hair growth
  • Using contaminated hot tubs, pools, or lakes

Symptoms

Symptoms of folliculitis may be:

  • Itchy, red rash
  • Crusty sores that do not heal
  • Pus-filled blisters around the hair follicle

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam may be done. Diagnosis can usually be made by looking at the skin. Testing may be done to determine the type and cause.

Tests may include:

  • Swab of an open area—to look for infections
  • Smear—a sample of an open area to be examined under a microscope
  • Biopsy—a sample of skin is taken for testing
  • Blood tests

Treatment

The goal is to treat the irritation and underlying cause. Options may be:

Medications

Folliculitis may be treated with medicines. They may be taken by mouth or applied to the skin.

  • The infectious type may be treated with:
    • Antibiotics—for bacterial infections
    • Antifungal medicines—for fungal infections
    • Antiviral medicines—for viral infections
    • Antiparasitic medicines— for parasitic infections
  • The non-infectious type may be treated with:
    • Corticosteroids
    • Non-steroidal anti-inflammatory drugs (NSAIDs)

Prevention

To reduce the risk of folliculitis:

  • Avoid chemicals, especially at work.
  • Shave in the direction of hair growth.
  • Use proper hygiene and handwashing.
  • Clean pools and hot tubs regularly.
RESOURCES:

American Academy of Dermatology
https://www.aad.org

Centers for Disease Control and Prevention
https://www.cdc.gov

CANADIAN RESOURCES:

Canadian Dermatology Association
https://dermatology.ca

Public Health Agency of Canada
https://www.canada.ca

REFERENCES:

Folliculitis. American Osteopathic College of Dermatology website. Available at: http://www.aocd.org/?page=Folliculitis. Accessed February 17, 2021.

Folliculitis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/folliculitis Accessed February 17, 2021.

Hot tub rash (Pseudomonas dermatitis/folliculitis). Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/healthywater/swimming/swimmers/rwi/rashes.html. Accessed February 17, 2021.

Veraldi S, Desimine C, et al. Can folliculitis be caused by Staphylococcus epidermidis? G Ital Dermatol Venereol. 2019;154(2):212-214.

Last reviewed January 2021 by EBSCO Medical Review Board Mary Beth Seymour, RN  Last Updated: 2/17/2021