What Causes Folliculitis And How to Treat & Prevent It?

Most people think that all blemishes on the skin are acne, and they’re surprised to learn about a whole different category of breakouts called folliculitis. Acne is inflammation and infection of the pores, whereas folliculitis occurs in the hair follicles. Both skin concerns cause red, inflamed bumps on the skin, but the best way to treat them varies depending on what type of acne or folliculitis you’re dealing with. Since most people are already somewhat familiar with acne, this article will focus only on folliculitis.

If your bumps are non-cystic, itchy, and get worse in warm weather, you may be experiencing folliculitis. Understanding the different types, causes, symptoms, and treatment options for folliculitis is important in maintaining clear skin and preventing future flare-ups. Let’s explore these different types of folliculitis.

What is Folliculitis?

Folliculitis refers to inflammation and infection of the hair follicles. It can happen anywhere on the face or body where hair follicles are present. Folliculitis most commonly occurs on the scalp, face, neck, chest, back, butt and legs. It looks like small red bumps with a uniform appearance and small pustules (pus-filled lesions). The bumps sometimes itch or burn, but not always. In contrast, regular acne never itches or burns, so if your breakouts have those sensations then that’s a very good indication that you’re dealing with folliculitis.

Inflammation of hair follicles can be caused by various factors, including bacterial or fungal infections, physical irritation (such as shaving or friction from clothing), blockage of follicles, or underlying skin conditions. Understanding the cause is crucial for effective treatment.

What are the Types of Folliculitis?

Folliculitis can appear in a variety of ways, each with unique characteristics and causes:

  1. Bacterial Folliculitis: This type of folliculitis is caused by bacterial infections, commonly Staphylococcus aureus. It presents as red, swollen, and pus-filled bumps around the hair follicles. Shaving, friction, or a compromised immune function can lead to bacterial folliculitis. Mild cases can often be treated at home.
  2. Fungal Folliculitis: Also known as Malassezia folliculitis, this condition is caused by yeast (Malassezia) overgrowth in the hair follicles. It often appears as itchy, uniform papules or pustules on the chest, back, and shoulders. This type of folliculitis can often be treated at home.
  3. Hot Tub Folliculitis (Pseudomonas Folliculitis): Exposure to contaminated water, typically in hot tubs or pools, can lead to Pseudomonas folliculitis. It appears on the skin as round, itchy bumps that develop within hours of exposure. This type of sudden-onset folliculitis should be evaluated by a doctor.
  4. Pseudofolliculitis Barbae (Razor Bumps): This is commonly seen in individuals with curly hair. Pseudofolliculitis barbae occurs when shaved hairs curl back into the skin and grow inwards, leading to inflammation and pustule formation. Minor to moderate cases can be treated at home, while more severe cases should be treated by a dermatologist.
  5. Gram-Negative Folliculitis: This rare condition happens when individuals are on prolonged antibiotic therapy for acne. This results in pus-filled bumps around the nose and mouth. It is best to see a doctor for this type of folliculitis.
  6. Eosinophilic Folliculitis: This is common among people with HIV/AIDS and compromised immune systems. Eosinophilic folliculitis is characterized by intense itching and recurrent bumps on the face and upper body. See a medical professional if you’re dealing with this.
  7. Boils (Furuncles) and Carbuncles: Staphylococcus bacteria can cause deep infections of hair follicles, resulting in painful, swollen nodules or clusters of boils. Minor boils can be treated at home, but painful, deep boils that don’t go away can require a doctor’s attention.

What Causes Folliculitis

There are several factors that can lead to the development of folliculitis:

  • Shaving Irritation: Shaving causes minor cuts and nicks on the skin, which can lead to folliculitis when bacteria enter the hair follicles. This is common in areas where shaving is frequent, such as the beard area in men or the legs and bikini area for women. Shaving can also lead to ingrown hairs, resulting in folliculitis barbae.
  • Friction from Clothing: Tight clothing, synthetic fabrics, or wearing items that rub against the skin can irritate hair follicles, leading to folliculitis, especially in areas prone to friction like the thighs or buttocks.
  • Taking antibiotics: Sometimes antibiotics are necessary, but they disrupt the skin’s microbiome, which can lead to overgrowth of bacteria or fungi that cause folliculitis.
  • Bacterial or Fungal Infections: Folliculitis can be caused by bacterial infections, such as Staphylococcus aureus, or fungal infections like those caused by yeast. Microorganisms can infect the hair follicles, causing inflammation and pustules.
  • Blockage of Hair Follicles: Hair follicles can become blocked by factors such as sweat, heavy oils on the skin, or certain cosmetic products. The blockage can create an environment where bacteria or fungi grow.s:
  • Excessive Sweating and warm climates: Excessive sweating can create a humid environment for bacterial or fungal growth.
  • Weakened Immune System: Individuals with compromised immune systems due to conditions like diabetes, HIV/AIDS, or those undergoing chemotherapy are more prone to infections.
  • Skin Conditions: People with acne, dermatitis, or other skin conditions that affect hair follicles are more prone to developing follic ulitis.
  • Chronic Skin Irritation: Harsh chemicals, fragrances, oils, or other skin irritants can disrupt the skin's natural barrier and lead to Folliculitis.
  • Exposure to contaminated water: Hot tubs, pools, and stagnant water can harbor the bacteria that cause folliculitis. Infection is more likely to occur when the skin’s protective barrier has been compromised from sunburn, shaving, waxing, or over-exfoliation.

Symptoms of Folliculitis

There are many symptoms associated with Folliculitis that can vary. Common symptoms of folliculitis include:

  1. Red Bumps: One of the biggest signs of folliculitis is the appearance of small red bumps or pimples around hair follicles. These bumps may be itchy and tender to the touch, and are mostly uniform in size
  2. Whiteheads: In some cases, the red bumps may develop visible whiteheads or pustules filled with pus at the center. These pustules can be mildly painful.
  3. Itching and Burning: Folliculitis often causes sensations of itching and burning in the affected areas.
  4. Tenderness: The skin around the affected follicles may feel tender and sensitive, especially when touched or rubbed.
  5. Clusters of Lesions: Folliculitis can occur as isolated lesions or in clusters, particularly in areas where hair follicles are closely packed together, such as the scalp, face, neck, thighs, or buttocks.
  6. Localized Rash: Folliculitis can cause a localized rash that appears inflamed and raised.

Here are some examples of common folliculitis symptoms:

How Common is Folliculitis?

Folliculitis is a very common skin condition, though exact rates of occurrence are unknown. Many people assume what they are experiencing is acne or another skin condition. It can affect people of all ages, including men, women, children, and infants.

Is Folliculitis Contagious?

Folliculitis is not typically considered a contagious condition. It is commonly caused by factors like irritation from shaving, friction, or bacterial/fungal infections that are not easily transmitted from person to person through casual contact. However, there are a few exceptions, such as bacterial and hot tub folliculitis.

Certain types of bacterial folliculitis can potentially be contagious if the bacteria from the affected area comes into direct contact with another person's skin, leading to a new infection.

Hot tub folliculitis is not transmitted from person to person but you can get it through exposure to the contaminated water source.

How is Folliculitis Diagnosed?

Diagnosing folliculitis involves a thorough assessment by a healthcare provider. The process typically begins with a visual examination of the affected skin areas. During this examination, the healthcare provider will look for characteristic signs of folliculitis, such as red bumps, pustules, or inflamed hair follicles. They may also ask about symptoms like itching, tenderness, or any recent activities that could contribute to the condition, such as shaving or exposure to hot tubs.

The healthcare provider may also take a detailed medical history. This involves asking about past skin conditions, recent illnesses, medications being taken, and overall health status. This information helps in identifying potential risk factors and underlying causes of folliculitis.

In cases where the cause of folliculitis is unclear or suspected to be due to a bacterial or fungal infection, microbial testing may be conducted. This can include obtaining a sample of fluid from a pustule or lesion for culture and sensitivity testing in a laboratory. This helps identify the specific bacteria or fungi causing the infection and guides the selection of appropriate treatment, such as antibiotics or antifungal medications.

In very rare cases where the diagnosis remains uncertain or if folliculitis does not respond to treatments, a skin biopsy may be performed. During a skin biopsy, a small sample of the affected skin is taken and examined under a microscope to rule out other skin conditions or infections.

Throughout the process, it's important to communicate openly and honestly with the healthcare provider so that you can get an accurate diagnosis and a customized treatment plan.

How is Folliculitis Treated?

Before and After Almond Clear Treatment , Results may vary from person to person. Images. do not represent guarantee.

Treating folliculitis involves a range of approaches tailored to the specific type and severity of the condition. The choice of treatment depends on factors such as the underlying cause and the extent of the skin condition. Here are some treatment options commonly used for folliculitis:

  1. Topical Medications:
  • AHAs (Mandelic Acid, Salicylic Acid, etc)
      • Mandelic Acid: This AHA is much more gentle than other popular AHAs. It has antibacterial properties that help exfoliate the skin and clean out the buildup of dead skin cells around hair follicles.
      • Salicylic Acid: This powerful exfoliant has anti-inflammatory properties, which can help unclog pores and calm inflammation caused by folliculitis.
      • Antibiotics: Topical antibiotics like mupirocin or clindamycin are effective against bacterial folliculitis. These medications can be applied directly to the affected area to help clear the infection.
  • Benzoyl Peroxide: For folliculitis, benzoyl peroxide works great at combatting bacteria commonly found. By reducing the number of bacteria on the skin and inside pores, it can clear and prevent future infections.
  • Antifungals: For fungal folliculitis (caused by yeast), antifungal creams such as ketoconazole may be prescribed to get rid of the fungal infection.
  • Corticosteroids: Topical corticosteroid creams can help reduce inflammation and calm itching.
  1. Oral Medications:
  • Antibiotics: Oral antibiotics like cephalexin or doxycycline may be prescribed to target bacterial infections more effectively.
  • Antifungals: Oral antifungal medications are used for treating systemic fungal folliculitis that does not respond well to topical treatments.
  1. Lifestyle Changes:
  • Avoiding Irritants: Irritants that can make folliculitis worse, such as harsh soaps, tight or sweaty clothing, or excessive sweating should be avoided.
  • Proper Hygiene: Practice good hygiene by keeping the affected area clean and dry. Avoid sharing personal items like towels or razors to prevent spreading the infection.
  • Avoiding Warmth and Humidity: Try to minimize exposure to warm and humid environments because they can make folliculitis worse. ex: steam rooms, hot tubs, and excessively hot showers.
  • Shaving and Razors: Use clean and sharp razors when shaving. Avoid shaving too closely and consider using an electric razor to reduce irritation.
  • Wear Loose Fitting Clothes and Natural, Breathable Fibers: Go for loose-fitting clothing made from breathable fabrics like cotton or linen. This helps reduce friction and allows better airflow around affected areas.
  1. Other Treatments:
  • Laser Hair Removal: In cases of folliculitis due to ingrown hairs, laser hair removal can reduce hair growth and prevent future flare-ups.
  • Surgical Drainage: If folliculitis leads to large abscesses or boils, your healthcare provider may drain the fluid to facilitate healing.
  1. During the healing process, you may notice scars forming. Here are some Folliculitis scar treatment options to reduce the scars:
  • Topical Scar Creams: Silicone-based scar creams or gels can be applied to reduce the appearance of scars over time.
  • Laser Therapy: Laser treatments such as fractional laser resurfacing or intense pulsed light (IPL) can help improve the texture and tone of scarred skin.
  • Microdermabrasion: This technique gently exfoliates the skin to reduce the appearance of scars and promote smoother skin texture.

Can Folliculitis Be Prevented?

Preventing folliculitis involves adopting good hygiene practices and minimizing factors that can lead to hair follicle irritation or infection. The following tips can help reduce the risk of developing this skin condition:

  • Practice Proper Hygiene: Wash skin regularly with a gentle, anti-microbial cleanser such as Almond Clear’s Face and Body Wash to keep the area clean and free from dirt, sweat, and excess oils.
  • Use AHAs: Consider using an Alpha Hydroxy Acid like mandelic acid. AHAs help unclog pores, reduce inflammation, reduce scarring, promote skin cell turnover and prevents folliculitis.
  • Shaving precautions: Take care when shaving to avoid nicks and cuts that can lead to folliculitis. Use a clean razor and shaving cream, and shave in the direction of hair growth. Some men find that using an electric razor helps to prevent folliculitis.
  • Maintain Skin Health: Healthy skin has a natural acid mantle barrier that helps to keep out irritants. Folliculitis is much more likely to occur if the skin’s protective barrier is compromised. To avoid this, wear sunscreen, use moisturizer, and avoid over-exfoliating the skin.
  • Practice Safe Hair Removal: Consider other options for hair removal (examples: waxing, tweezing, laser hair removal) Consider alternatives to frequent shaving if it is causing irritation.
  • Manage Health Conditions: Control underlying health conditions like diabetes or immune system disorders that can increase susceptibility to infected skin
  • Maintain a Healthy Lifestyle: Exercise regularly and manage stress levels.

Ingredients to Avoid

Avoid ingredients that can lead to fungal growth. For a more specific list of ingredients to avoid and suitable alternatives, check out Simple Skincare Science.
Ingredients to avoid:

  • Oils High in Oleic Acid: Olive oil , almond oil , or argan oil
  • Esters: Isopropyl myristate or Isopropyl palmitate
  • Certain Fatty Alcohols: Cetyl alcohol or stearyl alcohol
  • Fungal-Feeding Ingredients : Coconut oil, cocoa butter , or wheat germ oil
  • Other Potentially Irritating Ingredients: Lanolin, Squalene, or Ethylhexyl palmitate

When to See Your Doctor

If your folliculitis comes on suddenly then it’s best to see a doctor right away so that they can test for more aggressive types of staph infections. For more chronic, long-term folliculitis, see a doctor if your at-home treatments aren’t working. Also, if you notice worsening redness, swelling, or tenderness or if the condition spreads to larger areas of your body, it's time to see your doctor. Persistent pain or the development of itchy, pus-filled bumps could also require medical attention.

Additionally, if you experience systemic symptoms like fever, chills, or have underlying health conditions that weaken your immune system, seek medical attention right away.

How Mandelic Acid Products Help

Before and After Almond Clear Treatment , Results may vary from person to person. Images. do not represent guarantee.

Mandelic acid is a type of alpha hydroxy acid (AHA) derived from bitter almonds that offers several benefits and properities for treating folliculitis. First and most importantly, it has antibacterial and antifungal properties that can clear active bumps and prevent future flare-ups. Mandelic acid also works by gently removing dead skin cells and oil from the skin's surface, which unclogs pores and follicles. Mandelic acid is a gentle AHA that’s safe for daily use.

Regular use of mandelic acid can also improve skin texture and tone by promoting cell turnover and collagen production. It minimizes hyperpigmentation and scarring associated with folliculitis and helps reduce inflammation.

Almond Clear is a skincare line powered by Mandelic Acid. The products are designed with ingredients to clear acne and folliculitis and are free from ingredients that feed fungal acne. This simple, 3-step skincare routine can be highly effective.

  1. CLEANSE: Almond Clear Face and Body Wash: A gentle wash with 2% mandelic acid that is safe for daily use. It has exfoliating properties that unclog pores, remove dead skin cells and help combat bacteria and fungi that worsen folliculitis.
  2. TREAT: Almond Clear Level 1 and Level 2 Exfoliating Serum: These gentle but powerful serums exfoliate and clean the skin. We recommend the Level 1 with 10% mandelic acid for the face and the Level 2 with 15% mandelic acid for the body. The mandelic acid unclogs pores, removes scars and combats folliculitis.
  3. MOISTURIZE: 2-in-1 Hydrating Gel or Soothing Daily Moisutizer : Always follow up with a non-comedogenic moisturizer. The 2-in-1 Hydrating Gel has a low percentage of mandelic acid and is great for oily skin. Our Soothing Daily Moisturizer has a cream base and is great for dry skin. Excessively dry skin can worsen folliclulitis so after exfoliating it is important to keep your skin moisturized and to protect your skin barrier. By using a proper moisturizing routine, you can ensure that your skin is properly hydrated.

Following a consistent skincare routine that includes mandelic acid products can help manage and clear folliculitis.

Key Takeaways

  • What is Folliculitis? : Folliculitis is inflammation and infection of hair follicles. It is typically characterized by red, inflamed bumps that can itch or burn. It’s different and unique from acne and can be triggered by bacterial or fungal infections, shaving, or contaminated water.
  • Prevention and Treatment Strategies:
    • Practice Proper Hygiene: Use gentle and antifungal cleansers to remove dirt and impurities from the skin.
    • Wear Loose Fitting Clothes and Natural, Breathable Fibers: Go for loose-fitting breathable clothing made from fabrics like cotton or linen. This helps reduce friction and allows better airflow around affected areas.
    • Avoiding Warmth and Humidity: Try to minimize exposure to warm and humid environments because they can make folliculitis worse. ex: steam rooms, hot tubs, and excessively hot showers.
    • Use AHAs: Incorporate Alpha Hydroxy Acids like mandelic acid to unclog pores and reduce inflammation. This will also encourage cell turnover to reveal new skin.
    • Shaving Precautions: Use clean razors and shave in the direction of hair growth to prevent irritation.

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