The most common factors that contribute to the development of folliculitis include:
- Irritation from shaving
- Friction from tight clothing
- A pre-existing skin condition, such as eczema, acne, or another dermatitis (inflammation of the skin)
- Injuries to the skin, such as abrasions
- Extended contact from plastic bandages or adhesive tape
Other risk factors for folliculitis include:
- Suppressed immune system due to HIV, organ transplantation, or cancer
- An underlying skin condition, such as eczema, acne, or another dermatitis
- Frequent shaving
- Pressure (prolonged sitting on the buttocks)
- Beard area in men
- Underarms, groin, or legs in women
Mild and moderate cases of folliculitis are often tender or itchy. More severe cases of folliculitis, which may be deeper and may affect the entire hair follicle, may be painful.
Mild and moderate cases of folliculitis usually clear quickly with treatment and leave no scars. However, more severe cases of folliculitis may lead to complications, such as cellulitis (an infection of the deeper skin tissue), scarring, or permanent hair loss.
- Shave in the same direction of hair growth.
- Avoid shaving irritated skin.
- Use an electric razor or a new disposable razor each time you shave.
- Consider other methods of hair removal, such as depilatories.
- Avoid tight, constrictive clothing, especially during exercise.
- Wash athletic wear after each use.
- Use an antibacterial soap.
- Apply hot, moist compresses to the involved area.
- Launder towels, washcloths, and bed linens frequently, and do not share such items with others.
- Wear loose-fitting clothing.
Be sure to tell your doctor about any recent exposure to hot tubs, spas, or swimming pools, as a less common form of folliculitis may be caused by contamination from these water sources.
If you are currently being treated for a skin infection that has not improved after 2–3 days of antibiotics, return to your doctor.
Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is a strain of "staph" bacteria resistant to antibiotics in the penicillin family, which have been the cornerstone of antibiotic therapy for staph and skin infections for decades. CA-MRSA previously infected only small segments of the population, such as health care workers and persons using injection drugs. However, CA-MRSA is now becoming a more common cause of skin infections in the general population. While CA-MRSA bacteria are resistant to penicillin and penicillin-related antibiotics, most staph infections with CA-MRSA can be easily treated by health care practitioners using local skin care and commonly available non-penicillin-family antibiotics. Rarely, CA-MRSA can cause serious skin and soft tissue (deeper) infections. Staph infections typically start as small red bumps or pus-filled bumps, which can rapidly turn into deep, painful sores. If you see a red bump or pus-filled bump on the skin that is worsening or showing any signs of infection (ie, the area becomes increasingly painful, red, or swollen), see your doctor right away. Many people believe incorrectly that these bumps are the result of a spider bite when they arrive at the doctor's office. Your doctor may need to test (culture) infected skin for MRSA before starting antibiotics. If you have a skin problem that resembles a CA-MRSA infection or a culture that is positive for MRSA, your doctor may need to provide local skin care and prescribe oral antibiotics. To prevent spread of infection to others, infected wounds, hands, and other exposed body areas should be kept clean and wounds should be covered during therapy.
- Penetrating the pus-filled lesion with a needle, scalpel, or lancet.
- Rubbing a sterile cotton-tipped applicator across the skin to collect the pus.
- Sending the specimen away to a laboratory.
Depending on bacterial culture results, your physician may recommend the following treatments:
- Prescription-strength antibacterial wash, such as chlorhexidine gluconate
- Topical antibiotic lotion or gel, such as erythromycin or clindamycin
- Oral antibiotic pills, such as cephalexin, erythromycin, or doxycycline
- A combination of two different oral antibiotics, including trimethoprim-sulfamethoxazole, clindamycin, amoxicillin, linezolid, or a tetracycline
- A topical medication, mupirocin ointment, to apply to the nostrils
- If your doctor prescribes antibiotics, be sure to take the full course of treatment to avoid allowing the bacteria to develop resistance to the antibiotic prescribed.