ConditionSkin, hair & nails
Folliculitis
Folliculitis is inflammation of hair follicles, causing small, red, often itchy bumps or white-headed pimples around hairs. It is very common and usually caused by bacteria (mainly Staphylococcus aureus), but also by yeast, shaving, friction, tight clothing or a poorly maintained hot tub. Mild folliculitis usually clears in 7 to 10 days with warm compresses and good hygiene. Deeper or recurring infections can turn into boils and may need antibiotics or antifungal treatment.
Also called: Inflamed hair follicles, razor bumps (pseudofolliculitis barbae), hot tub rash, barber's itch, sycosis barbae
At a glance
- What it is
- Inflamed or infected hair follicles producing red bumps or pustules.
- Common causes
- Staph bacteria, shaving, friction, sweating, hot tubs (Pseudomonas), yeast (Malassezia), steroid use.
- Where
- Anywhere with hair: beard, scalp, chest, back, buttocks, legs, groin.
- Course
- Mild cases clear in 7 to 10 days; deep or recurrent cases need treatment.
- Treatment
- Warm compresses, antibacterial washes, topical or oral antibiotics, antifungals for yeast folliculitis.
When to get help
See a doctor within a day or two
- Spreading redness, warmth and swelling around the bumps, especially with fever (possible cellulitis)
- Painful, large, deep lumps that fill with pus (boils or carbuncles), especially if recurring
- Folliculitis in someone with diabetes or a weakened immune system that is spreading
Book a routine appointment
- Bumps that keep coming back, or last more than 2 weeks despite home care
- Painful bumps in the armpits or groin that scar and recur (possible hidradenitis suppurativa)
- Patches of hair loss with scarring on the scalp
- Itchy bumps on the back and chest that do not respond to acne treatment (possible yeast folliculitis)
Usually safe to manage at home
- A few small, mildly itchy red bumps or pimples after shaving, sweating, waxing or a hot tub, with no fever
What folliculitis looks like
- clusters of small red bumps or white-headed pimples centered on hair follicles
- itching, burning or tenderness
- crusted sores where pustules have broken
- in deeper forms, larger, painful, swollen bumps
It is often mistaken for acne. A key difference: folliculitis has no blackheads or whiteheads (comedones) and is centered on hairs.
Types of folliculitis
| Type | Cause | Clues |
|---|---|---|
| Bacterial (staph) folliculitis | Staphylococcus aureus | Itchy white pustules, often on beard, buttocks or thighs |
| Hot tub folliculitis | Pseudomonas aeruginosa in poorly chlorinated water | Itchy red bumps 1 to 2 days after a hot tub or pool, worse under swimwear |
| Pseudofolliculitis barbae (razor bumps) | Shaved, curly hairs growing back into the skin | Beard area and neck, common in Black men; not an infection |
| Malassezia (pityrosporum) folliculitis | Yeast overgrowth | Uniform itchy bumps on upper back, chest and shoulders; worse with sweat and heat |
| Gram-negative folliculitis | Bacteria after long-term acne antibiotics | Pustules around the nose and mouth |
| Eosinophilic folliculitis | Immune condition, often with HIV | Very itchy bumps on the face and upper body |
| Steroid folliculitis | Steroid creams or tablets | Uniform small bumps on chest and back |
| Boils and carbuncles | Deep staph infection | Large, painful, pus-filled lumps; see boils |
Causes and risk factors
- shaving, waxing and plucking
- tight clothing, friction and heavy sweating
- hot tubs, pools and whirlpools with inadequate chlorine
- oily skin products and heavy moisturizers that block follicles
- long-term antibiotic or steroid use
- diabetes and a weakened immune system
- carrying staph bacteria in the nose
- occupational exposure to oils and tar
Diagnosis
Folliculitis is usually diagnosed by its appearance. A doctor may swab a pustule for bacterial culture (including MRSA), take skin scrapings for yeast, or perform a biopsy for unusual or persistent cases.
Treatment
Home care for mild folliculitis
- warm compresses for 10 to 15 minutes, 3 to 4 times a day, to ease discomfort and help drainage
- antibacterial wash with benzoyl peroxide or chlorhexidine
- avoid shaving the area for a few weeks, or use an electric razor or clippers
- loose, breathable clothing, and showering soon after sweating
- do not squeeze or pick the bumps
- wash towels and razors, and do not share them
Medical treatment
- bacterial folliculitis: topical antibiotics such as mupirocin or clindamycin; oral antibiotics for widespread or deep infection
- recurrent staph: decolonization with nasal mupirocin and antiseptic body washes
- hot tub folliculitis: usually clears within 1 to 2 weeks without treatment; avoid the contaminated tub
- Malassezia folliculitis: antifungal shampoos (ketoconazole, selenium sulfide) used as body wash, or oral antifungals
- razor bumps: stop close shaving, use clippers, laser hair removal, and topical retinoids or mild steroid creams
- boils: incision and drainage by a doctor for large ones
Complications
- recurrent infection
- cellulitis or boils
- dark spots (post-inflammatory hyperpigmentation), especially in darker skin
- scarring and permanent hair loss in deep or chronic scalp folliculitis
Prevention
- shave with the grain, using a sharp blade and shaving gel, or switch to clippers
- shower after exercise and change out of sweaty clothes
- use hot tubs only if they are well maintained; shower afterward
- avoid heavy, oily skin products in areas prone to folliculitis
Frequently asked questions
What causes folliculitis?
Folliculitis is most often caused by staph bacteria infecting hair follicles. Other causes include shaving, friction, sweat, hot tubs contaminated with Pseudomonas, yeast, steroid use and ingrown hairs from shaving curly hair.
How do you get rid of folliculitis?
Mild folliculitis usually clears with warm compresses, antibacterial washes, loose clothing and avoiding shaving. Persistent or widespread cases may need topical or oral antibiotics, or antifungal treatment for yeast folliculitis.
Is folliculitis contagious?
Bacterial folliculitis can spread through shared razors, towels and hot tubs, and through skin contact with draining sores. Razor bumps, yeast folliculitis and steroid folliculitis are not contagious.
What is the difference between folliculitis and acne?
Both cause bumps and pustules, but acne has blackheads and whiteheads (comedones) and occurs mainly on the face, chest and back. Folliculitis is centered on hair follicles, often itches, appears anywhere with hair, and has no comedones.
Sources
This guide was written from current patient and clinical guidance, including:
- American Academy of Dermatology: Folliculitis, overview and treatment
- CDC: Hot Tub Rash (Pseudomonas Dermatitis/Folliculitis)
- MedlinePlus: Folliculitis
- NHS: Folliculitis
- Infectious Diseases Society of America: Practice Guidelines for Skin and Soft Tissue Infections (2014)