How to Treat Folliculitis: Causes, Symptoms, and Solutions

Folliculitis is the inflammation (and potentially an infection) of a hair follicle, which is the shaft through which a hair grows. It’s really common—probably everyone will experience it at some point in their life.

It can affect everyone—men, women, children, and at any time of life.

OK, so that’s the simple overview. But when you look at what causes folliculitis and the resulting treatments, then it all gets a bit more complex.

First up, there are multiple types. These are generally classified by the underlying cause, but also where on the body it is.

But before we talk about folliculitis treatment, let’s get an overview of the general background and symptoms it presents with.

What Does Folliculitis Look Like?

As with anywhere that inflammation strikes, swelling is evident. Because it affects the hair follicles, typical presentation comes with:

• Red spots on the skin around one or more hairs.
• Physical bumps that can be seen and felt.
• Irritation and itching.
• In severe cases, the rash can also be hot and painful

Most people have hair virtually everywhere on the body, even if some is so fine that it’s barely noticeable. This means that folliculitis can, potentially, occur anywhere. However, some areas are more prone.  They include the face, armpits, bikini line, and legs—all areas where we often shave or epilate.

And yes, you’ve got it, shaving is one of the key reasons behind a certain type of folliculitis, known as Pseudofolliculitis barbae, or razor rash.

The Different Types of Folliculitis Treatment

Treatment depends on the underlying cause and severity. After shaving, one of the most common causes is bacteria build-up within the follicle. This leads to infection and the associated redness, raised bumps, and perhaps pus-filled pimples. Mild cases can be self-treated with warm compresses and anti-bacterial soap/saltwater to encourage the follicles to open and the infection to drain. There are also plenty of OTC creams that aid healing and reduce itching and irritation.

OK, so now we’ve opened the can of worms that is the different types of folliculitis, we need to address each one individually to discuss the relevant treatment.

• Staphylococcus aureus folliculitis: The most common and the one we’ve just referred to. If the above home treatment doesn’t work or the problem worsens, then your general physician can prescribe antibiotics. Stubborn cases might warrant specialist dermatological care.
• Pseudofolliculitis barbae: Shaving bumps tend to be more prevalent in those with strong, curly hair growth. The cut edge of the hair can turn inwards and back into the skin, causing redness, itching, bumps, and irritation. Severe cases, known as Sycoses barbae, have the potential to scar. Initial treatment of a mild shaving rash involves stopping shaving, warm compresses, and anti-bacterial soap. See a dermatologist if this doesn’t help. 
• Hot tub folliculitis: Clinically known as Pseudomonas aeruginosa, this is from bacteria that thrives in warm waters, such as a hot tub. It presents as a mild, irritating rash around 1-2 days after exposure and can arise anywhere on the body. It usually reduces over the next few days, but do seek medical attention if it persists.
• Gram-negative folliculitis: Prolonged use of strong antibiotics to treat acne can sometimes cause resistance. This means the very bacteria they target can multiply, potentially worsening the symptoms. It requires dermatological treatment.
• Malassezia folliculitis: A type of yeast infection generally seen on the chest and back. It causes an acne-type rash that often gets worse with excessive sweating. While using an anti-dandruff shampoo to wash the area might help, it’s best to seek healthcare advice if it doesn’t go away after a few days.
• Eosinophilic folliculitis: A rarer type that generally occurs in babies or those who are immune suppressed. It can be very itchy and is usually on the upper half of the body, including the face or forehead. Again, it’s wise to seek medical treatment, although it often self-resolves. However, once you’ve had it, it has the potential to reoccur.

Whether or not you need to see a dermatologist for infected hair follicles will depend on where it is, the cause, and the severity. Whatever the underlying reason, if you have a rash that won’t go away and/or is worsening, it’s absolutely best to get a professional opinion sooner rather than later.

Not only will this get any necessary treatment started as soon as possible, but you’ll also be given the best advice on how to reduce the risk of further folliculitis issues in the future.

Need more help? Visit Services | Bayou City Dermatology and call today to book a consultation.