What Is Folliculitis? Infected Hair Follicles Explained

Folliculitis is a common skin condition that occurs when hair follicles become inflamed, usually due to a bacterial or fungal infection. It appears as small red bumps or white-headed pimples around hair follicles and can affect any area of the body where hair grows. While mild cases often clear up on their own, understanding the different types and when to seek treatment can help prevent complications.

What Causes Folliculitis?

Hair follicles can become infected through various causes. The most common culprit is Staphylococcus aureus (staph bacteria), but other organisms can also trigger the condition. Common causes include:

• Bacteria, particularly Staphylococcus aureus

• Fungi, such as Malassezia yeast

• Friction from tight clothing or backpacks

• Shaving or waxing

• Excessive sweating

• Poorly maintained hot tubs or pools

Types of Folliculitis

Bacterial Folliculitis

This is the most common type, causing itchy, pus-filled bumps when hair follicles become infected with staph bacteria. It can occur anywhere on the body where hair grows.

Hot Tub Folliculitis (Pseudomonas Folliculitis)

Caused by Pseudomonas aeruginosa bacteria found in poorly chlorinated hot tubs and heated pools. Round, itchy bumps typically appear 1 to 2 days after exposure and often clear up within one to two weeks without treatment.

Fungal Folliculitis (Pityrosporum Folliculitis)

This type results from yeast infections, typically Malassezia species. It presents as itchy, pus-filled bumps, most commonly on the back and chest. Unlike bacterial folliculitis, it requires antifungal treatment rather than antibiotics.

Folliculitis vs Acne: How to Tell the Difference

Folliculitis is often mistaken for acne, but there are key differences:

• Location: Folliculitis can appear anywhere hair grows, including the scalp, arms, legs, and buttocks. Acne typically occurs on the face, chest, and back.

• Itchiness: Folliculitis is often itchy, while acne generally isn't.

• Appearance: Folliculitis bumps center around a hair follicle, while acne includes blackheads and whiteheads (comedones).

• Cause: Acne involves blocked oil glands and Propionibacterium acnes bacteria, while folliculitis stems from infected hair follicles.

Treatment Options

Mild folliculitis often heals on its own within a few days with basic care. For persistent or severe cases:

• Bacterial folliculitis: Topical antibiotics like mupirocin or clindamycin, or benzoyl peroxide wash

• Fungal folliculitis: Antifungal medications (antibiotics won't help)

• Severe cases: Oral antibiotics or antifungals may be necessary

Prevention Tips

You can reduce your risk of folliculitis by:

• Wearing loose, breathable clothing to minimize friction

• Using clean towels and washcloths

• Washing skin with warm water before shaving

• Showering after sweating heavily

• Avoiding shared hot tubs and pools with questionable maintenance

When to See a Dermatologist

Seek medical attention if your symptoms don't improve after a few days, if the condition worsens, or if you develop fever, spreading rash, or increasingly tender bumps. Left untreated, severe folliculitis can lead to permanent scarring, skin discoloration, or deeper infections like boils and carbuncles. If you experience recurring folliculitis, a dermatologist can help identify triggers and develop a prevention plan.

Frequently Asked Questions

Can folliculitis spread from person to person?

While folliculitis itself isn't contagious, the bacteria or fungi causing it can spread through direct contact or shared items like towels and razors. Avoid sharing personal items and practice good hygiene to prevent transmission.

How long does folliculitis take to heal?

Mild folliculitis typically clears up within a few days to a week with basic self-care. Hot tub folliculitis often resolves within one to two weeks without treatment. More severe cases may require medication and take longer to heal.

Should I stop shaving if I have folliculitis?

Temporarily avoiding shaving can help the affected area heal. If you must shave, use a clean razor, wash with warm water first, and consider using an electric razor to reduce irritation.