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Folliculitis is a common skin problem. The little “pockets” that your hair grows in are called follicles. When bacteria or other debris get trapped in the follicles, they can become inflamed and swollen.
You have hair (and, therefore, follicles) covering most of your body, and folliculitis can occur anywhere there is hair. However, folliculitis most commonly occurs on your neck, thighs, buttocks, and armpits. Sometimes, folliculitis is referred to as “barber’s itch”, “hot tub rash”, “razor bumps”, or “shaving rash”.
What is folliculitis and how does it happen?
Depending on the area of the body where it occurs and how severe it is, your symptoms will vary. But, folliculitis often looks like:
- Groups of small red pumps
- Blisters that may break open and ooze
- Large areas of red, swollen skin
- Skin that is itchy, tender, or painful
Folliculitis is usually caused by Staphylococcus bacteria. These bacteria live on your skin all the time and usually cause no problems. But, when they get inside your body or under layers of your skin, they can cause infections. Other common causes of folliculitis include:
- Blocked follicles from skin care products such as oils
- Hair removal such as shaving, waxing, and plucking
- Ingrown hairs
- Bacteria (other than Staph)
Other risk factors for folliculitis include:
- Having acne
- Wearing tight clothes that trap sweat and heat against your body
- Using a pool or hot tub that is not cleaned properly or regularly
- Having an illness that compromises your immune system
Is folliculitis dangerous?
Folliculitis itself isn’t dangerous or life-threatening. However, it can be extremely uncomfortable or embarrassing, depending on its location. Severe or recurring cases of folliculitis can lead to spreading infections that can cause permanent hair loss and scarring.
Folliculitis is usually classified as “superficial” or “deep.” Superficial forms (meaning that it’s isolated to the surface of the follicle) include bacterial folliculitis, hot tub folliculitis, razor bumps, and folliculitis caused by yeast. Deep forms are rarer and include folliculitis caused by gram-negative bacteria (this form sometimes develops after you receive long-term antibiotics for acne), eosinophilic folliculitis (a form that usually only occurs in people with HIV/AIDS), and boils and carbuncles. Boils (also called furuncles) appear when a follicle becomes severely or deeply infected with Staph bacteria. (A mild case of folliculitis caused by Staph can become a boil if not treated promptly.) Carbuncles are clusters of boils.
How is folliculitis treated?
In most cases, folliculitis goes away on its own. Simple, at-home remedies are often effective at relieving symptoms: clean the infected area twice daily with warm water and antibacterial soap, making sure to use a clean cloth and towel every time you wash. Warm salt water compresses can also be placed on your skin to ease symptoms. Gentle moisturizers, such as oatmeal lotion, or over-the-counter hydrocortisone cream can be used to soothe itchy skin. Talk to your doctor or pharmacist before using any medications, even creams and lotions, while you are pregnant.
The best way to prevent folliculitis is to keep your skin healthy and practice good skin hygiene:
- Wash your skin with warm water and a gentle cleanser
- If you shave, shave with care
- Use plenty of shaving cream or gel – not soap
- Use a new blade every time you shave
- Shave in the direction your hair grows
- Apply a moisturizing lotion after shaving
- Consider other methods of hair removal if shaving irritates the skin
- Don’t wear tight clothes
- Limit the use of oils on your skin
- Only use pools and hot tubs if you are sure they are well-maintained
- Never share personal items (towels, razors, etc.) with other people
Can pregnancy cause folliculitis?
About 1 in 3000 pregnant women will develop pruritic folliculitis. It is a rash that appears as small red bumps that may or may not contain pus. It looks a little bit like acne, but there are no bacteria present in the bumps. The rash usually begins on the abdomen and then spreads outwards to the shoulders, upper back, arms, and chest. For some women, it is extremely itchy.
Pruritic folliculitis can easily be misdiagnosed as bacterial folliculitis, drug- or chemical-induced acne-like eruptions, and other pregnancy-specific rashes such as prurigo of pregnancy.
Pruritic folliculitis usually appears in the second or third trimester of pregnancy and resolves on its own within 2 months after delivery, sometimes going away even before delivery. It is believed to be caused by hormonal changes during pregnancy. The rash is not at all harmful and there are no reports of harmful effects to the baby.
The best treatment for the rash is to do nothing. It will go away on its own without causing any issues. If the rash is bothersome to you, it can be treated with mild cleansers, oral antihistamines, or corticosteroids, but ask your doctor or pharmacist before using any medications.
If you notice any skin changes during pregnancy, speak to your doctor to rule out other more serious causes of the symptoms.