Folliculitis Treatment Overview

When to see a healthcare provider

Sometimes, you may need to see a healthcare provider for folliculitis.

See a provider if:

• You have been using at-home treatments and changing how you shave for about 2–4 weeks and there isn’t any improvement.
• You keep seeing new lesions or bumps.
• You noticed the folliculitis after being in a hot tub. Certain types of folliculitis that are from being in a hot tub need to be treated with oral antibiotics.
• Your folliculitis becomes painful.

Getting diagnosed

Your doctor can diagnose folliculitis by examining the rash. You may be asked about your shaving habits, certain medications you may be taking and whether you have been in a hot tub.

If your folliculitis is not getting better, your doctor may decide to take a bacterial, fungal, or viral culture to determine the cause of the folliculitis. To do the test, your doctor will use a needle to open one of the pus bumps (pustules) and then swipe the inside of the pustule with a cotton swab.

What to expect from your visit

• Your doctor will examine your skin and ask what you’ve tried to treat your folliculitis.
• They may recommend an OTC medication or give you a prescription cream or pill. If there isn’t any improvement after using topical antibiotics, or if your folliculitis is severe, your doctor may prescribe oral antibiotics. It could be a 2–4 week course.
• If your folliculitis doesn’t seem to be getting better, your doctor may then take bacterial, viral, and fungal cultures of it to find out the cause.
• If a fungus is causing your folliculitis, your doctor may recommend a prescription topical or oral antifungal.
• If your folliculitis still doesn't get better, your doctor may take a skin biopsy to make sure that the rash is not another condition that looks like folliculitis.
• Sometimes folliculitis is not from a bacteria, fungus, or virus. It may be diagnosed as chronic folliculitis. Your doctor may recommend taking isotretinoin (Accutane) to manage it. Accutane is a vitamin A derivative that helps stabilize the hair follicle and decrease oil production. It should never be taken if you are trying to get pregnant or not using birth control.

Prescription folliculitis medications

• Clindamycin lotion or gel, a topical antibacterial
• Bactroban ointment (Mupirocin), a topical antibacterial
• Cephalexin (Keflex), an oral antibiotic
• Doxycycline, an oral antibiotic
• Sulfamethoxazole/Trimethoprim, an oral antibiotic
• Ciprofloxacin, an oral antibiotic used to treat hot tub folliculitis
• Ketoconazole wash or cream, an antifungal used to treat fungal folliculitis
• Fluconazole, an oral antifungal used to treat fungal folliculitis
• Isotretinoin (Accutane)—do not take if trying to get pregnant or not using birth control.

Types of folliculitis providers

• A primary care provider can treat mild to moderate symptoms.
• A dermatologist can diagnose and treat folliculitis and evaluate you for other conditions that may mimic folliculitis.

How to treat folliculitis at home

Folliculitis, an inflammation of the hair follicles, can often be treated at home with acne cleansers and OTC medicated creams, and by changing how you shave. It may take 2–4 weeks to get better.

OTC medicated acne cleansers can help treat folliculitis. They usually have antibacterial ingredients to help get rid of bacteria in the follicle. The antibacterials can also help open up clogged hair follicles.

• Look for acne washes that contain benzoyl peroxide, salicylic acid, or sodium hypochlorite.
• Use higher-strength benzoyl peroxide wash (10%) on the back, chest, and arms, and a lower strength (4%) on the face. Apply daily in the shower and leave on for several minutes before rinsing them off.

OTC medications

• Benzoyl peroxide wash (PanOxyl, CeraVe Acne Foaming Cream Cleanser) helps get rid of bacteria.
• Salicylic acid (Neutrogena Oil-free Acne Wash) helps unclog hair follicles.
• Sodium hypochlorite (CLn BodyWash) removes bacteria from the skin and hair follicle and reduces inflammation.

How to treat folliculitis at home

• If you have folliculitis in areas that you shave, start shaving in the direction of the hairs.
• Frequently change your razor.
• If you can, shave less often.
• Use electric clippers for a beard instead of a razor blade.
• Don’t keep on sweaty or wet clothing. Take them off as soon as you are done.
• After getting sweaty, shower or wash up.