Folliculitis

Definition

Folliculitis is inflammation of one or more hair follicles. It can occur anywhere on the skin.

Alternative Names

Pseudofolliculitis barbae; Tinea barbae; Barber's itch

Causes, incidence, and risk factors

Folliculitis starts when hair follicles are damaged by friction from clothing, blockage of the follicle, or shaving. In most cases of folliculitis, the damaged follicles are then infected with the bacteria Staphylococcus (staph).

Barber's itch is a staph infection of the hair follicles in the beard area of the face, usually the upper lip. Shaving makes it worse. Tinea barbae is similar to barber's itch, but the infection is caused by a fungus.

Pseudofolliculitis barbae is a disorder that occurs mainly in black men. If curly beard hairs are cut too short, they may curve back into the skin and cause inflammation.

Symptoms

Common symptoms include a rash, itching, and pimples or pustules near a hair follicle in the neck, groin, or genital area. The pimples may crust over.

Signs and tests

A diagnosis is primarily based on how the skin looks. Lab tests may show which bacteria or fungus is causing the infection.

Treatment

Hot, moist compresses may promote drainage of the affected follicles. Treatment may include antibiotics applied to the skin (mupirocin) or taken by mouth (dicloxacillin), or antifungal medications to control the infection.

Support Groups

Expectations (prognosis)

Folliculitis usually responds well to treatment, but may come back.

Complications

• Folliculitis may return
• Infection may spread to other body areas

Calling your health care provider

Apply home treatment and call your health care provider if symptoms come back frequently, if they last longer than 2 or 3 days, or if the infection spreads.

Prevention

To prevent further damage to the hair follicles and infection:

• Reduce friction from clothing
• Avoid shaving the area if possible (if shaving is necessary, use a clean, new razor blade or an electric razor each time)
• Keep the area clean
• Avoid contaminated clothing and washcloths

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References

Habif TM. Principles of diagnosis and anatomy. In: Habif TP, ed. Clinical Dermatology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 1.

Habif TM. Bacterial infections. In: Habif TP, ed. Clinical Dermatology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 9.

Swartz MN, Pasternack MS. Cellulitis and subcutaneous tissue infections. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 6th ed. Philadelphia, Pa: Churchill Livingstone Elsevier; 2005: chap 86.