Your doctor is likely to diagnose folliculitis by looking at your skin and reviewing your medical history. He or she may use a technique for microscopic examination of the skin (dermoscopy).
If initial treatments don't clear up your infection, your doctor may use a swab to take a sample of your infected skin or hair. This is sent to a laboratory to help determine what's causing the infection. Rarely, a skin biopsy may be done to rule out other conditions.
Treatments for folliculitis depend on the type and severity of your condition, what self-care measures you've already tried and your preferences. Options include medications and interventions such as laser hair removal. Even if treatment helps, the infection may come back.
- Creams or pills to control infection. For mild infections, your doctor may prescribe an antibiotic cream, lotion or gel. Oral antibiotics aren't routinely used for folliculitis. But for a severe or recurrent infection, your doctor may prescribe them.
- Creams, shampoos or pills to fight fungal infections. Antifungals are for infections caused by yeast rather than bacteria. Antibiotics aren't helpful in treating this type.
- Creams or pills to reduce inflammation. If you have mild eosinophilic folliculitis, your doctor may suggest you try a steroid cream to ease the itching. If you have HIV/AIDS, you may see improvement in your eosinophilic folliculitis symptoms after antiretroviral therapy.
- Minor surgery. If you have a large boil or carbuncle, your doctor may make a small incision in it to drain the pus. This may relieve pain, speed recovery and lessen scarring. Your doctor may then cover the area with sterile gauze in case pus continues to drain.
- Laser hair removal. If other treatments fail, long-term hair removal with laser therapy may clear up the infection. This method is expensive and often requires several treatments. It permanently removes hair follicles, thus reducing the density of the hair in the treated area. Other possible side effects include discolored skin, scarring and blistering.
Modo de vida y remedios caseros
Mild cases of folliculitis often improve with home care. The following approaches may help relieve discomfort, speed healing and prevent an infection from spreading:
- Apply a warm, moist washcloth or compress. Do this several times a day to relieve discomfort and help the area drain, if needed. Moisten the compress with a saltwater solution (1 teaspoon of table salt in 2 cups of water).
- Apply over-the-counter antibiotics. Try various nonprescription infection-fighting gels, creams and washes.
- Apply soothing lotions. Try relieving itchy skin with a soothing lotion or an over-the-counter hydrocortisone cream.
- Clean the affected skin. Gently wash the infected skin twice a day with antibacterial soap. Use a clean washcloth and towel each time and don't share your towels or washcloths. Use hot, soapy water to wash these items. And wash clothing that has touched the affected area.
- Protect the skin. If possible, stop shaving, as most cases of barber's itch clear up a few weeks after you stop shaving.
Preparación para la consulta
You're likely to start by seeing your primary care doctor. He or she may refer you to a doctor who specializes in skin disorders (dermatologist).
To get the most from your appointment, it's a good idea to be well-prepared. Here's some information to help you get ready.
What you can do
- List any symptoms you're experiencing, including those that seem unrelated to your skin condition.
- List key personal information, including any major stresses or recent life changes.
- List all medications, vitamins and supplements you're taking.
- List questions to ask your doctor.
For folliculitis, some basic questions to ask your doctor include:
- What's the most likely cause of my symptoms?
- What are other possible causes for my symptoms?
- Do I need any tests?
- What's the best treatment for my condition?
- I have these other health conditions. How can I best manage them together?
- What types of side effects can I expect from treatment?
- Is there a generic alternative to the medicine you're prescribing me?
- Do you have any relevant brochures or other printed material that I can take home with me? What websites do you recommend?
- What will determine whether I should plan for a follow-up visit?
Don't hesitate to ask any other questions that occur to you during your appointment.
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:
- How long have you had this skin infection?
- Do you have a history of dermatitis?
- Does your work or a hobby expose your hands to heat and moisture, such as from wearing rubber gloves?
- Were you in a hot tub or a heated swimming pool a day or two before you noticed your skin rash?
- Have your symptoms been continuous or occasional?
- Does your skin itch? Is it painful to the touch?
- Does anything seem to improve your symptoms?
- Does anything make your symptoms worse?
What you can do in the meantime
Sometimes folliculitis goes away without medical treatment. Self-care measures, such as warm compresses and anti-itch creams, can help relieve your signs and symptoms.
Oct. 11, 2017
- Folliculitis. American Osteopathic College of Dermatology. http://www.aocd.org/skin/dermatologic_diseases/folliculitis.html. Accessed July 12, 2017.
- Folliculitis. Merck Manual Professional Version. http://www.merckmanuals.com/professional/sec11/ch129/ch129e.html. Accessed July 12, 2017.
- Hot tub rash (pseudomonas dermatitis/folliculitis). Centers for Disease Control and Prevention. http://www.cdc.gov/healthywater/swimming/rwi/illnesses/hot-tub-rash.html. Accessed July 17, 2017.
- Pseudofolliculitis barbae. Merck Manual Professional Version. http://www.merckmanuals.com/professional/sec11/ch134/ch134d.html?qt=pseudofolliculitis barbae&alt=sh. Accessed July 17, 2017.
- Rajendran P, et al. HIV-associated eosinophilic folliculitis. http://www.uptodate.com/ content/search. Accessed July 17, 2017.
- Ferri FF. Folliculitis. In: Ferri's Clinical Advisor 2018. Philadelphia, Pa.: Elsevier; 2018. https://www.clinicalkey.com. Accessed Aug. 10, 2017.
- Goldsmith LA, et al., eds. Bacterial colonizations and infections of skin and soft tissues: Introduction. Fitzpatrick's Dermatology in General Medicine. 8th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://accessmedicine.mhmedical.com. Accessed July 17, 2017.
- Alexis A, et al. Folliculitis keloidalis nuchae and pseudofolliculitis barbae: Are prevention and effective treatment within reach? Dermatologic Clinics. 2014;32:183.
- AskMayoExpert. Folliculitis. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2017.
- Jackson JD. Infectious folliculitis. https://www.uptodate.com/content/search. Accessed July 17, 2017.
- Compton GA. Bacterial skin and soft tissue infections in older adults. Clinics in Geriatric Medicine. 2013;29:443.
- Fraes Diernaes JE, et al. Successful treatment of recalcitrant folliculitis barbae and pseudofolliculitis barbae with photodynamic therapy. Photodiagnosis and Photodynamic Therapy. 2013;10:651.
- Panchaprateep R, et al. Clinical, dermoscopic and histopathologic features of body hair disorders. Journal of the American Academy of Dermatology. 2015;72:890.
- Jasterzbski TJ, et al. Pseudofolliculitis cutis: A vexing disorder of hair growth. British Journal of Dermatology. 2015;172:878.
- Laureano AC, et al. Facial bacterial infections: Folliculitis. Clinics in Dermatology. 2014;32:711.
- Gibson LE (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 21, 2017.