First steps to consider
- Can often be treated at home with acne cleansers and OTC medicated cream
When you may need a provider
- Folliculitis is not starting to improve after 2 weeks
- It is spreading (you have new bumps every few days), or some spots are very painful
- Folliculitis developed after being in a hot tub.
Call 911 or go to the ER if you have any of the following symptoms:
- Fever and rash
- Spreading redness around any of the folliculitis lesions
- Severe pain
- Body aches or chill
What it is
Folliculitis is inflammation of the hair follicle. You can develop folliculitis almost anywhere on the body that has hair. It looks like small pink bumps or can be filled with pus. Each one surrounds an individual hair. It can be itchy or painful.
Folliculitis is usually caused by the bacteria Staphylococcus aureus (known as Staph). But it can also be caused by other bacteria. Or a virus, fungus, parasite, and even certain medications.
It can go away on its own if mild, or you may need medications.
Most common symptoms
Be sure to let your doctor know if you have significant pain, fever, fatigue, or other systemic symptoms. —Dr. Mollie MacCormack
Folliculitis can be itchy, but may also be painful. It looks like small or medium-sized, red bumps or pustules with a hair in the center. They can be anywhere on your body where hair grows, and can range from just a few in a cluster to many.
Sometimes folliculitis looks like acne, but follicultis tends to arise suddenly, with larger and more bumps.
How do you get rid of folliculitis?
How you treat it depends on the type of folliculitis you have and how serious it is. Your doctor may be able to diagnose it by looking at your skin and taking a medical history. They may do a swab of the folliculitis to test for a bacterial, viral, or fungal infection.
Different types of folliculitis
When it is a bacterial infection, it is usually treated with antibiotics.
Mild folliculitis, including hot tub folliculitis, often gets better on its own. You can use warm compresses (soak a hand towel in warm water) on the affected area several times a day to ease the itch, pain, and to speed healing.
If you have been taking antibiotics, applying topical steroids, wearing tight or constricting clothing or gear, have a history of cold sores or recently been in a hot tub, tell your doctor. This information will help them make the correct diagnosis and choose the most appropriate treatment. —Dr. MacCormack
Your doctor will decide which medication is best depending on how severe the infection is.
- Antibiotics applied to the skin (topical). These are used to treat bacterial infections. They include benzoyl peroxide and clindamycin. If the infection is from the Staph bacteria, an antibiotic cream called Mupirocin is usually prescribed.
- Oral antibiotic (doxycycline or tetracycline). You may need to take a pill or you may need medicine intravenously (IV).
- Antifungal or antiviral medication. This may be used for fungal and viral infections.
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- Compromised immune system: Certain illnesses or chemotherapy can make it harder to fight off infections.
- Bacterial colonization: Some people tend to have the staph bacteria living on their skin, in places like the nose and under the fingernails. This increases the chance of getting folliculitis.
- Shaving: Razors and shaving against the direction of hair growth can allow bacteria from the skin to get into hair follicles.
- Hot tub use: Folliculitis can also be caused by pseudomonas bacteria. The bacteria lives in hot, wet environments, like poorly sanitized hot tubs. This is known as hot tub folliculitis.
- Long-term antibiotic use, such as when treating acne.
- TIght clothing or equipment can clog hair follicles
- Excessive sweating
Hot tub folliculitis is caused by Pseudomonas Aeruginosa bacteria. It often appears a few hours to a few days after exposure to a contaminated tub. Unfortunately, showering after exposure does not decrease your risk of developing disease. The rash can be impressive—bright red bumps and pustules especially involving areas covered by swimsuits. But it usually gets better without treatment in 5 to 10 days. —Dr. MacCormack
Mild cases of folliculitis may go away on their own. Keep an eye on the bumps to make sure they don't get worse—redder or more painful.
If it gets worse or doesn’t get better, contact your doctor or a dermatologist.
If the rash becomes hot and red, has blisters, spreads quickly, becomes very painful, or you have a fever, see a doctor immediately or head to urgent care or the ER. You may have a more serious skin infection.
How long does folliculitis last?
Folliculitis can take several weeks to get better.
If you are diagnosed with folliculitis, finish all medications that your doctor prescribes. If the folliculitis does not go away, comes back, or you have other symptoms like pain or a fever, see your doctor again.
- Shave with a new, sharp blade, with shaving cream. Always shave in the direction (as opposed to against) of hair growth. Never share your razor.
- Wash hands regularly and avoid picking at your skin and hair.
- Avoid tight, constricting clothing
If your doctor thinks you have Staph colonization, they may recommend one of these treatments. Talk to your doctor first as these are not right for everyone.
- Special antibacterial soaps like chlorhexidine wash.
- Bathe in highly diluted bleach—as directed by your doctor—to help kill bacteria on the skin.
- Antibiotic ointment in the inside of your nostrils, under the supervision of a doctor.
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