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Folliculitis
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Folliculitis

Diseases & Conditions A-Z

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WOMEN'S HEALTH

Hair/Nails/Skin

With common names like hot tub folliculitis and barber'sitch, folliculitis may sound more like a bad joke than a skin disorder. But this infection of the hair follicles is no laughing matter. Severe cases may cause permanent hair loss and scarring, and even mild infections can be uncomfortable and embarrassing.

Folliculitis usually appears as small, white-headed pimples around one or more hair follicles - the tiny pockets from which each individual hair grows. Most infections are superficial, affecting just the upper part of the follicle, and although they may itch, they're seldom painful. The pimples can occur almost anywhere on your body, but they are especially common on the face, scalp, thighs, legs and in the groin area.

Treatment

Sometimes folliculitis goes away on its own in two or three days, but persistent or recurring cases are likely to require treatment. The therapy your doctor recommends depends on the type and severity of your infection.

  • Pseudomonas folliculitis (hot tub folliculitis). Hot tub folliculitis rarely requires treatment, although your doctor may prescribe an oral or topical medication to help relieve itching (anti-pruritic). More serious cases may require an oral antibiotic.
  • Barber's itch. Your doctor may advise not shaving the affected area until the infection heals. If you must shave, use an electric razor or clean razor blade every time. If the problem persists, you may need topical or oral antibiotics.
  • Tinea barbae. This infection — especially the inflammatory form — can be effectively treated with oral anti-fungal medications.
  • Pseudofolliculitis barbae. The best treatment for this condition is preventive. Shaving with an electric razor, which doesn't cut as closely as a razor blade does, can help. If you do use a blade, massage your beard area with a warm, moist washcloth or facial sponge to lift the hairs so they can be cut more easily. Use a shaving gel instead of cream, and shave in the direction of the hair growth. When you're finished, rinse thoroughly with warm water and apply a moisturizing aftershave. If these measures don't help, your doctor may prescribe the acne medication tretinoin (Retin-A).
  • Pityrosporum folliculitis. Topical or oral antifungals are the most effective treatments for this type of folliculitis. Because the condition often returns once you've finished the course of oral medication, your doctor may recommend using topical ointments indefinitely. Antibiotics aren't helpful in treating pityrosporum folliculitis and may make the infection worse by upsetting the normal balance of bacteria on your skin.
  • Herpetic folliculitis. If you're a healthy adult, herpetic folliculitis may clear without treatment in seven to 10 days. But if you're living with HIV/AIDS or you experience frequent cold sores, your doctor may prescribe an oral antiviral medication such as acyclovir (Zovirax), famciclovir (Famvir) or valacyclovir (Valtrex). Although these drugs can clear the infection, they won't necessarily prevent it from recurring. They also may cause side effects such as headache, diarrhea, nausea and abdominal pain.
  • Gram-negative folliculitis. Although this type of folliculitis results from long-term antibiotic therapy for acne, it's usually treated with certain antibiotics or with isotretinoin (Accutane).
  • Boils and carbuncles. Your doctor may drain a large boil or carbuncle by making a small incision in the tip. This relieves pain, speeds recovery and helps lessen scarring. Deep infections that can't be completely cleared may be covered with sterile gauze so that pus can continue to drain. Sometimes your doctor may prescribe antibiotics to help heal severe or recurrent infections.
  • Eosinophilic folliculitis. A number of therapies are effective against eosinophilic folliculitis but topical corticosteroids are often the treatment of choice. Your doctor may prescribe a short course of oral corticosteroids if you have a severe infection. All steroids can have serious side effects and should be used for as brief a time as possible. If you're living with HIV/AIDS and have mild eosinophilic folliculitis, your doctor may prescribe topical steroids in conjunction with oral antihistamines. More severe cases may require treatment with isotretinoin (Accutane) for several months.

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