Folliculitis: Red Flags

Folliculitis is a common skin infection that affects hair follicles. It can happen anywhere except for the palms and soles. Folliculitis looks like an outbreak of pimples. You can see a red ring around the infected hairs. Some people don’t feel anything, while others complain of pain or itching.

You get folliculitis from bacteria or fungi that find their way into hair follicles through areas of skin damage caused by things like:

  • Shaving, plucking, waxing
  • Dirty hot tubs
  • Tight clothing or equipment
  • Weight gain
  • Medications

The two main types of folliculitis are superficial and deep. The superficial type involves part of the follicle, and the deep type involves the entire follicle and is usually more severe.

Types of folliculitis, with the most common listed first, include:

  • Bacterial folliculitis. This common type is a rash of itchy, pus-filled bumps. It occurs when hair follicles become infected with bacteria, usually Staphylococcus aureus (staph). Staph bacteria live on the skin all the time. And they can cause problems when they enter the body through a cut or other wound.
  • Hot tub rash (pseudomonas folliculitis). This type is a rash of round, itchy bumps that can show up 1 to 2 days after exposure to the bacteria that causes it. Hot tub folliculitis is caused by pseudomonas bacteria, which can be found in hot tubs, water slides and heated pools in which the chlorine and pH levels aren’t correct.
  • Razor bumps (pseudofolliculitis barbae). This rash can look like folliculitis but it’s caused by ingrown hairs, not infected follicles. It mainly affects people with curly hair who shave too close and is most noticeable on the face and neck. People who get bikini waxes may get razor bumps in the groin area.
  • Pityrosporum (pit-ih-ROS-puh-rum) folliculitis. This type is a rash of itchy, pus-filled bumps, most often on the back and chest. It’s caused by a yeast infection.
  • Gram-negative folliculitis. This type causes pus-filled bumps around the nose and mouth. It sometimes develops in people who are receiving long-term antibiotic therapy for acne.
  • Eosinophilic (e-o-sin-o-FILL-ik) folliculitis. This type causes intense itching and recurring patches of bumps and pimples that form near hair follicles of the face and upper body. It mainly affects people with HIV/AIDS. The cause of this condition isn’t fully understood.
  • Boils (furuncles) and carbuncles. These occur when hair follicles become deeply infected with staph bacteria. A boil tends to appear suddenly as a painful inflamed bump. A carbuncle is a cluster of boils.
  • Sycosis barbae. This type affects people who shave.

If you have folliculitis, it’s best to see your dermatologist. You might need an antibiotic or antifungal medicine to clear it. They will also give you tips on how to avoid getting it again.