Folliculitis (Infected Hair Follicles): Is It A Major Concern? Causes, Symptoms And Treatments

Types Of Folliculitis

There are four main types of folliculitis. They include:

1. Bacterial folliculitis (BFC): It is caused mainly due to Staphylococcus aureus bacteria. BFC is characterised by itchy and white pus-filled bumps. [1]
2. Pseudomonas folliculitis (PFC): It is also known as hot tub folliculitis caused mainly due to pseudomonas bacteria found in hot tubs or heated pools which are not properly chlorinated.
3. Pseudofolliculitis barbae (PB): It is also known as barber's itch. PB is mainly a skin irritation caused due to ingrown hair after shaving or bikini wax. They appear like a dark and raised scars. [2]
4. Pityrosporum folliculitis (PRFC): It is caused by a specific genus of yeast that infects the hair follicles. It recurs are regular intervals mostly in oily parts of the body. The bumps are itchy and look similar to acne.

Causes Of Folliculitis

There are basically two main causes of folliculitis.

• As aforementioned, some types of FC develop due to infections related to bacteria, viruses, yeast or parasites.
• Non-infection FC occurs due to use of medications, topical irritants, teenage pimples, shaving, sun exposure, nutrient deficiency or cloth irritation. [3]

Symptoms Of Folliculitis

• Many red bumps around hair follicles
• Pus-filled white bumps
• Itchiness near the follicles
• Swollen bumps
• Tenderness of the skin
• Red skin
• Burning sensation
• Inflamed bumps

Mild fever

Risk Factors Of Folliculitis

• Having a suppressed immune system, like in the case of HIV, cancer or diabetes. [4]
• Use of steroid creams or topical corticosteroids.
• Having preexisting skin conditions such as acne or dermatitis.
• Having dark complexion or curly hairs.
• Wearing high heat-trapping clothes or tight clothes
• Using hot water bathtubs which are not well chlorinated. [5]

Complications Of Folliculitis

Long term exposure to FC may cause complications such as

• spread of the infection to a large area,
• permanent scarring, dark marks or damage to the skin and
• permanent hair loss in the affected areas.

Diagnosis Of Folliculitis

• Physical examination: It includes looking at the affected skin areas and noting down the symptoms. A medical expert may also ask family or medical history of the patient.
• Swab test: To know the type of microorganism (bacteria, virus, fungi, yeast or parasites) behind the condition.
• Skin biopsy: To rule out other skin conditions. [6]

Treatment Of Folliculitis

The treatment methods for FC include:

• Medications: Topical antibiotics, antivirals, antifungal or antiparasitic to reduce infections. [7]
• Anti-inflammatory drugs or analgesics: To reduce pain.
• Creams or shampoos: To treat mild cases of FC.
• Warm Compress: To reduce itching.
• Surgery: For major forms of FC (large bumps)
• Photodynamic therapy: Used to kill microbial cells and treat acne.
• Laser hair removal: To permanently remove hair follicles, which is the main cause of infection of the skin.

How To Prevent Folliculitis

• Maintain good hygiene, especially in areas where you have shaved recently like the face or groin.
• Protect the skin from harsh chemical products.
• Avoid sunlight (afternoon sunlight).
• Avoid wearing tight clothes or clothes that irritate the skin.
• Prefer trimming and avoid shaving more.
• Avoid random hot tubs or heated pools. Go only in those pools which are properly chlorinated or cleaned.
• Avoid wearing sweaty attires for long.

Common FAQs

1. How long does folliculitis take to heal?

Ans. Folliculitis mainly takes around 7-10 days to go when treated properly. In most cases, FC goes by the use of antimicrobial medications, anti-inflammatory drugs or warm compress. Untreated FC can cause permanent hair loss or dark marks on the skin.

2. Should you pop folliculitis bumps?

Ans. Never pop folliculitis bumps as it may increase the chances of the spread of the infection and make the pain worse. Rather, warm compress the area. It is better to consult a medical expert if you notice the bumps often.

3. Is folliculitis an STD?

Ans. No, folliculitis is not a Sexually Transmitted Diseases (STD). However, if it caused by an infection, it may transfer through infected razors or bathtubs.