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Folliculitis vs Acne

Written by Andrew Le, MD

UpdatedMarch 7, 2024

Folliculitis and acne can cause similar looking bumps but they are different. In this article, we will explore the differences between these two common skin conditions. From the causes and appearance to the location on the body and treatment options, we will break down everything you need to know about folliculitis and acne.

What Is Folliculitis?

Folliculitis is an inflammation of the hair follicles, often caused by a bacterial infection. It appears as pustules, with redness and itching around the affected follicles. In severe cases, folliculitis can lead to infection and clogged follicles.

Bacteria such as Staphylococcus aureus enter the follicles through small cuts or breaks in the skin. Once inside, these bacteria trigger an inflammatory response from the body, leading to the pustules, redness, and itching that can resemble acne

When the follicles become clogged with excess oil, dead skin cells, or bacteria, the risk of infection rises. Sebaceous glands, responsible for producing oil to lubricate the skin and hair, can sometimes become overactive, contributing to the development of folliculitis.

What Is Acne?

Acne is a common skin condition that causes pimples and breakouts on the face, back, chest, and buttocks. Hormonal changes, particularly during puberty or menstrual cycles, can trigger acne. It is also caused by a buildup of oils, debris, and dead skin cells that clog pores.

For acne, using over-the-counter skin care products with salicylic acid and benzoyl peroxide can help control breakouts. Sometimes prescription medication is necessary.

What Are the Differences Between Folliculitis and Acne?

Folliculitis and acne are distinct skin conditions. While folliculitis affects hair follicles that become infected, acne is when pores get clogged and inflamed.

Folliculitis can be superficial or deep, depending on whether it involves the upper part of the hair follicle and the deeper layers.

On the other hand, acne can be classified as non-inflammatory (such as blackheads and whiteheads) or inflammatory (papules, pustules, nodules).

Folliculitis commonly appears as red, itchy bumps with a central hair, while acne causes red, swollen pimples.


Folliculitis is triggered by bacterial overgrowth around the hair follicles, leading to inflammation. In contrast, acne is caused by excess sebum (oil), bacteria, and skin debris, causing blocked pores and breakouts.

Both skin conditions have some inflammation, where the immune response reacts to the bacteria in the hair follicles or pores, causing redness and discomfort.

Bacteria plays a significant role in folliculitis, whereas acne is more likely to be caused by hormones that stimulate the sebaceous glands to produce excess oil. This excess oil, combined with dead skin cells, can encourage the growth of acne-causing bacteria, leading to pimples and blackheads.


Folliculitis typically causes small, inflamed bumps filled with pus, usually centered around a hair follicle.

Acne causes pimples, whiteheads, blackheads and cysts on the skin surface. Pimples are small, raised bumps, while comedones (blackheads and whiteheads) appear as clogged pores. In severe acne, you can have deeper, painful nodules or cysts under the skin.

Location on the Body

Folliculitis commonly affects areas with hair follicles, including the face (in men), scalp, chest, and buttocks. Scalp folliculitis looks like inflamed bumps on the scalp, while chest and buttocks folliculitis is a sign of a more widespread condition.

In contrast, acne tends to occur on the face, back, shoulders, and chest.

How Are Folliculitis and Acne Diagnosed?

The dermatologist will carefully examine the skin lesions, considering factors such as size, shape, color, and distribution. In folliculitis, typically, there are small red bumps or white-headed pimples around hair follicles, whereas acne often appears as blackheads, whiteheads, or cysts. The dermatologist may ask you about symptoms like itching, pain, or discharge.

What Are the Treatment Options for Folliculitis and Acne?

Folliculitis and acne are treated with a combination of approaches that include topical and oral medications and lifestyle modifications to address underlying triggers.

Topical Medications

Topical medications are the main way of treating folliculitis and acne. Substances like benzoyl peroxide, retinoids, and salicylic acid are effective in reducing inflammation and bacterial overgrowth.

These help unclog pores, reduce excess oil production, and kill acne-causing bacteria. By controlling these key factors, topical medications not only treat existing acne and folliculitis but also prevent future outbreaks, leading to clearer and healthier skin over time.

Oral Medications

Oral medications include antibiotics to address bacterial overgrowth and infection in both folliculitis and acne.

By targeting the underlying bacteria responsible for the skin conditions, antibiotics help prevent further breakouts and promote the healing process. Patients often find relief from the discomfort and appearance of folliculitis and acne with the help of these oral medications.

Lifestyle Changes

Incorporating lifestyle changes may help prevent folliculitis and acne. Establishing a consistent skincare routine, avoiding irritants, and maintaining a balanced diet may help reduce breakouts.

A tailored skincare regimen helps maintain skin health. This includes cleansing, moisturizing, and protecting your skin from UV damage. By opting for non-comedogenic products and gentle cleansers, you may prevent pore blockages and potential breakouts.

Diet may also improve skin conditions, such as reducing sugar and processed foods while increasing intake of fruits, vegetables, and water.

Incorporating stress-reduction techniques and getting enough sleep also contribute to enhancing skin resilience and reducing inflammation.

How Can Folliculitis and Acne Be Prevented?

You may be able to prevent folliculitis and reduce acne by adopting measures such as good skin care, avoiding skin irritants, and eating a healthy diet. Choosing skin care products and establishing a cleansing routine tailored to your skin can help reduce inflammation and infections.

  • Incorporating gentle cleansing techniques, such as using a mild, non-comedogenic cleanser, can help maintain a balanced skin barrier and reduce the likelihood of clogged pores.
  • Exfoliating regularly but gently can help prevent dead skin cell buildup, which can contribute to acne and folliculitis. Remember to moisturize with non-comedogenic and hydrating products to keep your skin nourished.

Proper Hygiene

Maintaining a good skin care routine can help minimize bacteria. Effective cleansing routines remove dirt, debris, and excess oil that can clog pores and contribute to skin issues.

Choosing gentle cleansers can help maintain the skin barrier's integrity and pH balance.

Incorporating products with ingredients like salicylic acid or benzoyl peroxide can help control acne by targeting bacteria and regulating oil production.

Ensuring proper hydration and UV protection can support healthy skin function and reduce inflammation.

Avoiding Irritants

Avoiding skin irritants may help avoid folliculitis and acne, preserving the natural turnover of skin cells and reducing inflammation triggers. Sensitivities to substances like sebaceous filaments can exacerbate folliculitis.

When skin is exposed to harsh chemicals or allergens, it can disrupt the delicate balance of sebum production, leading to clogged pores and increased bacterial growth. This can cause comedones and acne lesions. By choosing skincare products with non-comedogenic ingredients and avoiding known irritants like alcohol, fragrances, and sulfates, you can maintain a healthier skin barrier and reduce the risk of developing folliculitis and acne.

Maintaining a Healthy Diet

Maintaining a healthy diet may help your skin. Incorporating foods high in omega-3 fatty acids, such as fatty fish, chia seeds, and walnuts, can help reduce inflammation and decrease sebum production.

Consuming probiotic-rich foods like yogurt and kefir can promote a healthy balance of skin bacteria, reducing the chances of bacterial overgrowth that can lead to folliculitis.

Frequently Asked Questions

What is the difference between folliculitis and acne?

Folliculitis and acne are both common skin conditions that can cause inflammation and bumps on the skin. However, they have different causes and treatments. Folliculitis is caused by an infection of the hair follicles, while acne is caused by clogged pores and overproduction of oil.

How can I tell if I have folliculitis or acne?

Folliculitis often appears as small red bumps or white-headed pimples around hair follicles, while acne includes blackheads, whiteheads, and larger, deeper pimples on the face, chest, and back. A doctor can also make a proper diagnosis by examining the affected area.

Can folliculitis turn into acne?

While they are different conditions, folliculitis can sometimes lead to acne-like bumps if left untreated or if the infection spreads to surrounding follicles. It is important to properly treat folliculitis to prevent it from worsening or causing other skin issues.

What causes folliculitis and acne?

Folliculitis is usually caused by bacteria, fungi, or viruses entering the skin through a damaged hair follicle. Acne is primarily caused by excess oil production, which can be influenced by hormones, genetics, and lifestyle factors.

How are folliculitis and acne treated?

Folliculitis can be treated with topical or oral antibiotics, antifungal medications, or antivirals, depending on the cause. Acne can be managed with over-the-counter or prescription topical creams, oral medications, and lifestyle changes. It is best to consult a dermatologist for personalized treatment.

Can I prevent folliculitis and acne?

While it may not always be possible to prevent these conditions, there are steps you can take to reduce your risk. These include keeping your skin clean, avoiding tight clothing and irritating products, and maintaining a healthy diet and lifestyle. It is also important to seek treatment for any underlying conditions that may contribute to these skin issues.