Folliculitis is a rash-like appearing superficial infection of the hair follicles with purulent material in the epidermis.
It manifests as multiple small, raised, sometimes pruritic, erythematous lesions that are less than 5 mm in diameter. Pustules (or small white heads) may be present at the centers of the lesions. Hair follicles are often seen in the center of the bumps. Folliculitis is frequently observed in areas of repeated shaving. It can occur almost anywhere on the skin, but it is most commonly found on the neck, thighs, buttocks, or armpits. Coalescence of several follicular lesions or extension of a lone follicular lesion into deeper portions of the dermis may give rise to abscess formations, typically with pain and tenderness, and possible purulent discharge from the area.
Causes of Folliculitis
- Usual causes include normal skin floral carriage of Staphylococcus aureus that gets into the superficial portion of the hair follicle through shaving, friction, etc.
- Pseudomonas is a causative pathogen in the setting of inadequately chlorinated hot tubs, whirlpools, and swimming pools
- Fungal folliculitis is sometimes seen in the setting of broad-spectrum antibiotic administration, glucocorticoid therapy, and/or immunocompromised individuals
To reduce likelihood of folliculitis, take these steps to protect yourself:
- Wash your hands frequently.
- Use antibacterial soap and a clean washcloth and towel every time you shower or bathe.
- Avoid sharing towels, wash cloths, razors or other personal care items.
- Change clothes and shower with antibacterial soap after participating in sports or exercising.
- Avoid tight-fitting clothes that trap sweat and bacteria. Wash clothes worn next to the skin in very hot water.
- Avoid overuse of skin oils or make up, which can trap bacteria in your pores.
- Avoid public hot tubs or spas and shower with antibacterial soap after using one.
- Shave in the direction of hair growth with shaving gel or cream. Frequently cleanse razor w/antiseptic cleansing agent and change razor blade after each shaving.
- May use antiseptic cleansing agent designed for bodily use to shaved areas.
Treatment of Folliculitis
Lesions associated w/mild to moderate cases of folliculitis usually resolve spontaneously. There are some self-care measures that can help to expedite relief from the condition. Most cases of hot tub folliculitis are self-limited, requiring no specific therapy apart from avoiding exposure to the source of contaminated water.
- Warm compresses are recommended and should be applied three to six times daily for 10 minutes. Burow’s solution or white vinegar may be used instead of plain tap water.
- Shaving should be avoided in involved areas. If you do shave, use a new blade every time.
- Avoid scratching the infected area.
- Topical antibiotics (most commonly to treat Staphylococcal infection) may be required in some cases; oral antibiotics are necessary in only certain circumstances.
- If the infection is on your scalp or beard, try a shampoo that contains selenium or propylene glycol, such as Selsun Blue.
- If rash is persistent despite treatment, worsens, or presents in an unusual manner, schedule an appointment at the IU Health Center Medical Clinic (http://healthcenter.indiana.edu/about/contact.shtml or call (812) 855-7688). You should also see a medical provider if folliculitis spreads or recurs, or you have other concerns regarding skin rash.