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Folliculitis

Definition

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

Folliculitis has many causes. It may be infectious or noninfectious.
Infectious folliculitis is caused by:
  • Bacteria
  • Fungi
  • Viruses
  • Parasites
Non-infectious folliculitis may be caused by:
  • Shaving
  • Irritation from clothing
  • Certain medications
  • Chemical exposure
  • Sun exposure
  • Missing nutrients in your diet
Contact dermatitis (poison ivy), acne, or rosacea may also cause folliculitis.

Risk Factors

Factors that may increase your chances of folliculitis include:
  • A suppressed immune system
  • Exposure to bacterial infection
  • Having other skin conditions, especially those that cause a lot of itching
  • Shaving against the direction of hair growth
  • Use of contaminated hot tubs, poorly maintained swimming pools, or contaminated lakes
  • Exposure to oils and chemicals
  • Overuse of topical medications

Symptoms

Folliculitis may cause:
  • Itchy, red rash
  • Appearance of crusty sores that don’t heal
  • Pus-filled blisters around the hair follicle

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. Diagnosis may be made by looking at your skin. Testing will help your doctor determine the type and cause of the folliculitis. Other tests may be done to rule out specific skin or health conditions.
Tests may include:
  • Culture—a swab of an open area to look for infections
  • Smear—a sample an open area is smeared onto a glass slide to be looked at under a microscope
  • Analysis of affected hair
  • Biopsy of affected skin
  • Blood tests

Treatment

In most cases, folliculitis is treated with medication. The type of medication depends on the cause of the folliculitis. Talk with your doctor about the best treatment option for you.

Medications

Infectious folliculitis may be treated with:
Infectious folliculitis may be treated with:
  • Topical or oral antibiotics for bacterial infections
  • Topical or oral antifungal medications for fungal infections
  • Oral antiviral medications for viral infections
  • Topical or oral antiparasitic medications for parasitic infections
Non-infectious folliculitis may be treated with:
  • Topical corticosteroids
  • Non-steroidal anti-inflammatory drugs (NSAIDs)

Prevention

To help reduce your chance of getting folliculitis:
  • Be aware of, and avoid exposure to chemicals, especially at work
  • Avoid shaving against direction of hair growth
  • Use proper hygiene and handwashing techniques
  • Clean and maintain pools and hot tubs on a regular basis

RESOURCES

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

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

CANADIAN RESOURCES

Canadian Dermatology Association http://www.dermatology.ca

Public Health Agency of Canada http://www.phac-aspc.gc.ca

References

Folliculitis. American Osteopathic College of Dermatology website. Available at: http://www.aocd.org/?page=Folliculitis. Accessed July 9, 2013.

Folliculitis. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated October 4, 2010. Accessed July 9, 2013.

Hot tub rash (Pseudomonas dermatitis/folliculitis). Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/healthywater/swimming/rwi/illnesses/hot-tub-rash.html. Updated February 15, 2013. Accessed July 9, 2013.

Luelmo-Aguilar J, Satandreu MS. Folliculitis: recognition and management. Am J Clin Dermatol. 2004;5(5):301-310.

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