- Folliculitis is a very common, benign skin disorder that appears as pinpoint red bumps sometimes with a small dot of pus at the top.
- Folliculitis affects people of all ages, from babies to seniors.
- The numerous smooth little red bumps form around hair follicles and are most common on the face, scalp, chest, back, buttocks, and legs.
- Folliculitis is often seen in otherwise healthy people, it's easily curable in most cases, and frequently clears on its own without treatment, though it may require ongoing maintenance therapy.
- Antibacterial over-the-counter medications containing benzoyl peroxide are often used to treat folliculitis, but resistant cases may need antibiotic pills to clear the skin.
- Good skin hygiene and proper shaving techniques have been shown to prevent folliculitis.
What is folliculitis? What are folliculitis symptoms and signs? What does folliculitis look like?
Folliculitis is an inflammatory condition affecting hair follicles. It appears as a small red tender bump occasionally surmounted with dot of pus surrounding a hair. Older lesions that have lost the pus appear as red bumps surrounding the opening of the follicle. One to hundreds of follicles can be affected anywhere that hair is present. Actually, acne vulgaris, the facial rash that teenagers develop, is a type of folliculitis.
Depending on the cause and severity of folliculitis, it may require no treatment and resolve spontaneously, or it may require treatment with powerful antibiotics or other drugs.
What are common types of folliculitis?
Systemically administered or topically applied steroids (cortisone medications) are a well-known cause of folliculitis.
Cutting oil folliculitis
Machinists exposed to insoluble cutting oils that are used to decrease the friction between machine tools and metal parts can develop a folliculitis on the exposed skin.
Staphylococci are bacteria that commonly inhabit the skin. One species, S. aureus, is a frequent cause of folliculitis. Occasionally, this organism may be insensitive to a number of commonly used antibiotics (such as methicillin-resistant Staphylococcus aureus, or MRSA). In this situation, it is very important that a culture of the organism with sensitivities be performed so the ideal antibiotic is selected.
What is hot tub folliculitis or Jacuzzi folliculitis?
Hot tub folliculitis is caused by the bacteria Pseudomonas aeruginosa. This condition is likely to occur from bathing in poorly maintained hot tubs. It is most common on the back and causes scattered pinpoint, small red to purple bumps all over the torso. These may be very itchy or have no symptoms at all. Typically, there is a history of sitting in a hot tub days prior to the start of the bumps. It is good practice to rinse off the skin in a shower after this sort of bathing.
The hot tub should be tested and possibly treated by trained pool and spa personnel for bacterial overgrowth. Affected patients may be more prone to recurrences in the future and should be cautious about hot tub use. Although this condition often resolves without treatment, it may be useful to rinse the skin with dilute vinegar.
What is razor burn folliculitis?
Razor-burn folliculitis is very common on the male neck and women's legs and is caused by shaving. Repeated passes by the razor produces tiny cuts that allow bacteria to enter the skin and invade the deeper hair follicles. Additionally, excessively close shaving may cause trapping of small hairs beneath the skin surface, causing more inflammation.
Treatment involves stopping shaving with a razor for a few days to a few weeks and using antibacterial washes and topical antibiotics. Additional treatments include laser hair removal, electrolysis, electric razors, or cream depilatories like Neet or Nair. Frequently, shaving less vigorously and leaving a small bit of stubble is advisable.
What is pseudofolliculitis barbae?
Pseudofolliculitis barbae is a very common ingrown hair condition on the beard area (lower face and neck) of men. Typically, there are groups of small red bumps on the beard area that may flare with repeat shaving. Pseudofolliculitis tends to be worse with very curly or kinky hair. It can be quite debilitating especially if one's employment requires a closely shaven appearance. Cutting the hair close to or below the follicular orifice results in hairs that penetrate into the follicular wall as they twist and grow. These trapped hairs cause irritation and inflammation at the hair follicles.
Treatment goals include avoiding overly aggressive shaving, trial of the "bumps-free razor," and antibacterial benzoyl peroxide shaving gels. Other treatment options include professional laser hair removal, electrolysis, electric razors, or a prescription drug called eflornithine (Vaniqa).
What are possible complications of folliculitis?
Complications are infrequent since folliculitis is usually a self-limited skin condition. Rarely, the infected bumps may enlarge, causing an abscess (furuncles or carbuncles) or painful cysts requiring minor surgical drainage. Deeper or more extensive skin infections called cellulitis can be a rare complication.
Another potential complication includes temporary skin discoloration called post-inflammatory hypopigmentation (lighter than the regular skin color) or hyperpigmentation (darker then the regular skin color). This altered skin color may occur after the inflamed red bumps have improved or after a temporary flare.
Permanent scarring is uncommon but may occur from picking, overly aggressive scrubbing, or other deep inflammation.