Learn more about this common skin condition, including causes, symptoms & treatment options
What is folliculitis?
Folliculitis is a common skin condition where hair follicles (the opening on the surface of the skin through which hair grows) become inflamed. It’s commonly caused by a bacterial, fungal or viral infection or blockages within the hair follicle, such as ingrown hairs.
It can happen anywhere that hair grows on your body such as your legs, chest, underarms, pubic area and beard area (if you have a beard) but not anywhere without hair follicles such as your lips, palms of your hands and soles of your feet.
Below we share the most common signs and symptoms of folliculitis along with information on how best to treat it and when you may need to see a GP.
What are the signs & symptoms of folliculitis?
Folliculitis can be classed as superficial (usually a milder form where only part of the hair follicle is affected), or deep (often a more severe form where the whole hair follicle is affected).
Common signs and symptoms of folliculitis include:
• Clusters of small red bumps around the hair follicles which may look like pimples and may have a white head filled with pus
• Sores that are filled with pus (pustules)
• Blisters that are filled with pus that can break open and crust over
• Itchy or burning skin
• Tender or painful skin
What are the main causes of folliculitis?
Folliculitis is commonly caused by staphylococcus aureus (staph) bacteria getting into and infecting the hair follicle. Staph bacteria live on the skin all the time and are usually harmless, but can cause the itchy, pus-filled bumps present in folliculitis when they enter the body. Sometimes bacteria can get in via cuts and wounds, but in folliculitis this often happens after removing hair by shaving, waxing or through other methods.
In other cases, folliculitis can be caused by different types of bacteria or fungal and viral infections. It may also be caused by non-infected inflammation or blockages in the hair follicle.
Here are some of the most common types of folliculitis and their causes:
• Folliculitis barbae–folliculitis in the beard area, usually caused by staph bacteria or other facial bacteria entering the hair follicles after shaving, but occasionally happens in unshaven beards
• Sycosis barbae – long-term (chronic) folliculitis in the beard area, often affecting the upper lip, where skin is painful and crusted with a burning and itching feeling whilst shaving. This can lead to scarring
• Pseudomonas folliculitis (also known as hot tub rash) –a rash of round, itchy bumps caused by pseudomonas bacteria which is found in hot tubs or heated pools where there’s not enough chlorine to keep it clean
• Pityrosporum folliculitis –a rash of itchy, pus-filled bumps, usually on the back and chest, caused by a yeast infection
• Eosinophilic folliculitis – recurring patches of pimples and bumps along with an intense itching feeling, usually on the face and upper body, which mainly affects people with HIV/AIDS though it’s not known why
• Gram-negative folliculitis – pus-filled bumps that usually appear around the nose and mouth which can be caused by long-term use of oral antibiotics, such as those taken for acne
• Boils and carbuncles –boils are large, sometimes painful, red bumps that happen when a hair follicle is deeply infected with staph bacteria and carbuncles are a cluster of several boils
• Pseudofolliculitis (also known as shaving rash or razor bumps) – dark bumps that occur in areas where you shave which are caused by ingrown hairs rather than an infection of the hair follicle
Is folliculitis an STI (sexually transmitted infection)?
Folliculitis is not classed as an STI but in some cases can be contagious. Folliculitis caused by the herpes simplex virus can be contagious but is extremely rare. Herpes simplex is the virus that causes cold sores that can spread through skin-to-skin contact and contact with bodily fluids including through oral contact or oral sex, or in the genital area (genital herpes) where it’s spread through sexual contact.
Is folliculitis the same as acne?
Folliculitis is not the same as acne, but it can look similar to the spots and pustules that occur in acne, as well as the symptoms of other skin conditions including:
• Papulopustular rosacea – a type of rosacea that causes whiteheads and red swollen bumps to appear on the cheeks, chin and forehead
• Keratosis pilaris – a harmless condition where patches of small bumps appear on your arms, thighs or bottom
• Scabies – an intense itching or a rash and raised spots caused when tiny mites burrow into the skin and lay eggs
• Hidradenitis suppurativa – a painful, long-term skin condition causing abscesses and scarring near hair follicles where there are sweat glands
How can you treat folliculitis?
Folliculitis often clears up within 7-10 days by following a few simple measures for good hygiene and self-care tips, including:
• Regularly cleaning the affected area with soap and water
• Placing a warm compress over the affected area for up to 15 minutes, several times a day
• Avoiding scratching the area as this could spread the infection or lead to scarring
• Avoiding shaving, waxing or plucking the area until it has fully healed
• Avoiding popping any of the bumps, pustules or blisters which could cause the infection to spread
When you’re ready to go back to removing hair, it can be helpful to use plenty of shaving cream or gel or try using an electric razor instead of waxing or shaving with a blade.
When do I need to see a GP for folliculitis?
You should see a GP for folliculitis if you experience any of the following:
• You have folliculitis and you’re diabetic or have a weakened immune system
• You get abscesses or larger boils around hair follicles
• You frequently get folliculitis
A GP can talk to you about your symptoms and suggest suitable treatment options for you. Depending on the type and severity, treatments may include topical antibiotic creams or antiseptics, oral antibiotics or topical or oral antifungal agents.
In some cases, you may be referred to a skin specialist to further assess symptoms and suitable treatment options for you.
