Causes and 9 Types of Folliculitis | Treatments | Dermatology


What is folliculitis?

The inflammation of the hair follicles is called folliculitis. It is usually caused by a bacterial or fungal infection. At first, it looks like little red bumps or white pimples around the scalp, little pockets where each hair grows. The infection spreads and becomes crusty sores that do not heal.

Types of folliculitis

  1. Staphylococcus aureus folliculitis: Infection of the hair follicle with the bacteria Staphylococcus aureus is one of the most common causes of folliculitis. Small red or white pimples filled with pus can be seen on the skin. The affected area often resolves (improves) within a few days and can be cared for at home. However, in severe cases, folliculitis must be treated by a medical professional.
  2. Pseudomonas aeruginosa (“hot tub”) folliculitis: Pseudomonas aeruginosa is a bacterium that grows in hot, moving water (hot tubs, hot tubs, waterslides). It infects the hair follicle and appears as a rash caused by staphylococcal strains. Sometimes the rash itches. Hot tub folliculitis usually clears up within a few days, but some patients may need medical treatment.
  3. Malassezia Folliculitis: Malassezia is a family of yeasts that are commonly found on the skin. Sometimes when malaria enters hair follicles, it causes an itchy condition that looks like an outbreak of pimples, usually on the upper chest and back. This form of folliculitis is aggravated (worse) by sweating. The daily use of anti-dandruff shampoo helps to wash the affected areas of the skin.
  4. Beard pseudofolliculitis: Also known as “razor bumps,” beard pseudofolliculitis usually occurs in the chin area. After cutting the beard hair with a razor, the sharp edges return to the skin and irritate. Beard pseudofolliculitis is more common in people with curly hair, especially African American men.
  5. Barba psychosis: Barba psychosis is an acute, scarred form of folliculitis related to shaving. The entire hair follicle is infected, resulting in large red blisters.
  6. Gram-negative folliculitis: Gram-negative folliculitis occurs after long-term use of antibiotics to treat acne. Over time, resistant bacteria grow and multiply, causing an acne flare.
  7. Boils: Boils or furuncles occur when the hair follicle becomes deeply infected. The boil is usually red, pale, and painful. It comes on the head after several days and can leave a scar.
  8. Carbuncles: Carbuncles form when several boils appear in one place. Carbuncles are usually large and a combination of multiple infected hair follicles.
  9. Eosinophilic folliculitis: This condition is more common in immunosuppressed patients (the immune system is not fully functional). There is also a form that is found in babies. Eosinophilic folliculitis is not contagious. It is characterized by itchy rashes on the shoulders, upper arms, neck, and forehead.

Causes of folliculitis

Staph, a type of bacteria, is often blamed. You have staph on your skin all time and it usually doesn’t cause any problems. But if it gets into your body, say through a cut, then it can cause trouble.

These other things can also cause folliculitis:

  • Barriers to skin products like oily moisturizers
  • A fungus
  • Like waxing, shaving, waxing, and tugging
  • Ingrown hairs
  • Other bacteria like those found in a hot tub
  • Some medications, such as corticosteroids, are used to reduce inflammation.

Risk factors

Factors that increase your risk of folliculitis:

  • Suppressed immune system
  • Exposure to a bacterial infection
  • Have other skin conditions, especially those that are very itchy
  • Shaving in the opposite direction of hair growth
  • Use of contaminated hot tubs poorly maintained pools or contaminated lakes
  • Exposure to oils and chemicals.
  • Excessive use of medications applied to the skin.

There are many things you can do to avoid or prevent the spread of folliculitis.

  • Bathe daily with a mild soap. Also, take a shower after exercising and avoid chemicals.
  • Avoid sharing towels, washcloths, or other personal items. If you have this disease, use a clean washcloth and towel every time you shower.
  • Do not scratch the bulbs.
  • Avoid razor bumps. You must shave, change the razor blade every time.
  • Avoid using oils on your skin. The oils can trap bacteria in the pores of the skin and cause folliculitis.
  • After using hot tubs or public spas, shower immediately with soap. If you have your hot tub, follow the manufacturer’s instructions to keep it clean.

Symptoms of folliculitis

This condition affects one or more follicles and can persist for a short period (severe case) or chronic (chronic case).

Some of the common symptoms include:

  • Small red bulbs
  • White pimples on the head
  • Pus-filled sores
  • Krusty sores
  • Redskin
  • Inflamed skin
  • Itching
  • Burning
  • Sensitivity
  • Pain
  • Inflammation
  • Slight fever


Your symptoms and medical history will be asked by a physician. A physical exam will be done. The diagnosis can be made by looking at your skin. The test can help your doctor determine the type and cause of your disease. To find other skin conditions different tests are conducted.

The exams may include:

  • Cleaning the open space to search for cultures-infections
  • Smear: An open area is inserted for viewing under a microscope on a glass slide
  • Analysis of affected hair
  • Biopsy of the affected skin
  • Blood test

Treatment for folliculitis

The treatments for this disease depend on the type and severity of your condition, the self-care measures you’ve already tried, and your preferences. Even if the treatment helps, the infection can come back.

  • Creams or pills to control infection: For mild infections, your doctor may prescribe an antibiotic cream, ointment, or gel. Oral antibiotics are not commonly used for this disease. But for an acute or recurring infection, your doctor may prescribe them.
  • Creams, shampoos, or pills to fight fungal infections: Antifungals for infections caused by fungi instead of bacteria. Antibiotics do not help with this type of treatment.
  • Creams or pills to reduce inflammation: If you have mild eosinophilic folliculitis, your doctor may suggest that you try a steroid cream to reduce itching. If you have HIV / AIDS, you may notice an improvement in your eosinophilic folliculitis symptoms after antiretroviral therapy.

Other interventions

  • Minor surgery: If you have a large boil or carbuncle, your doctor may make a small incision to drain the pus. It can relieve pain, speed recovery, and reduce scarring. If the pus continues to flow, your doctor may cover the area with clean gauze.
  • Laser hair removal: If other treatments fail, laser therapy can eliminate chronic infection by hair removal. This method is expensive and often requires multiple treatments. Eliminates hair follicles permanently, thus reducing the density of the hair in the treated area. Other side effects include pale skin, blemishes, and blisters.

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