Clinical Derma



Folliculitis is an inflammation or infection of the hair follicles, the small openings that surround the roots of your hair. It can occur anywhere on your skin or scalp that contains hair follicles.

Clinical factors that contribute to the development of folliculitis include:

  1. Bacterial infections: Most cases of folliculitis are caused by the bacterium Staphylococcus aureus.
  2. Fungal infections: The yeast-like fungus Pityrosporum ovale, also known as Malassezia, can also cause folliculitis.
  3. Viral or parasitic infections: Although less common, viruses and parasites can also cause folliculitis.

Non-clinical factors that may increase your risk of developing folliculitis include:

  1. Friction from shaving or tight clothing: Constant friction on the skin can cause damage to your hair follicles, making them more susceptible to infection.
  2. Injuries to your skin: Cuts, scrapes, and surgical wounds can leave your hair follicles exposed to infectious agents.
  3. Sweating: The excessive moisture and heat can create an ideal environment for bacterial growth.
  4. Certain medications: Some medications like steroid creams or long-term antibiotic therapy can alter the balance of bacteria on your skin and make you more prone to infections.
  5. Immunosuppression: Conditions that reduce your immunity like diabetes, chronic leukemia, organ transplantation, HIV/AIDS can make you more susceptible to folliculitis.
  6. Exposure to contaminated water or certain chemicals: Hot tubs or heated pools that aren’t properly treated with chlorine can be a breeding ground for bacteria and fungi, leading to a particular type of folliculitis known as ‘hot tub folliculitis’. Exposure to certain chemicals or oils can also block or damage hair follicles.

Folliculitis often appears as red, pus-filled bumps that can be itchy or tender. In most cases, it’s a relatively minor condition and can be treated with topical antibiotics or antifungal medications. For more severe cases, oral medications may be necessary. It’s always recommended to see a healthcare provider or a dermatologist if you have symptoms of folliculitis that are not improving or are getting worse.


Let’s look into the causes and factors that may predispose an individual to this condition:

Clinical Factors:

  1. Aging: Older adults are more prone to nail fungus due to a slower growing nail and increased years of exposure to fungi.
  2. Poor Circulation: Conditions that affect blood circulation, like peripheral artery disease or diabetes, increase the risk of developing nail fungus.
  3. Immunosuppression: A weakened immune system due to conditions like HIV/AIDS or certain medications can lead to a higher risk of fungal infections.
  4. Skin Injury: Any minor injury near the nail, like a cut or an ingrown nail, can provide an entry point for the fungus.
  5. Pre-existing skin conditions: Certain skin conditions, such as psoriasis or dermatitis, can also increase the susceptibility to nail fungus.

Non-Clinical Factors:

  1. Environment: Fungi are microscopic organisms that don’t need sunlight to survive. They often thrive in warm, moist environments, like showers, swimming pools, and locker rooms.
  2. Occupational Hazard: Jobs that require hands to be wet for long periods, like bartending or housekeeping, can lead to fungal nail infections.
  3. Lifestyle Habits: Wearing socks and shoes that hinder ventilation and do not absorb perspiration can provide an ideal environment for fungi to thrive.
  4. Personal Hygiene: Not maintaining proper hygiene and cleanliness can predispose to fungal infections.
  5. Sharing items: Sharing items such as nail clippers, shoes, or socks with a person who has a nail fungus can also increase the risk of getting a fungal nail infection.

The diagnosis of fungal nails is typically confirmed through laboratory tests, including KOH tests, fungal cultures, or nail biopsies. Antifungal medications, both oral and topical, are commonly used treatments. In some severe cases, the affected nail may need to be removed.

It’s important to note that nail fungus can be stubborn, and recurrences are common. Therefore, prevention plays a key role in managing this condition. Maintaining good hygiene, wearing breathable footwear, and avoiding shared grooming tools can help to prevent nail fungus.



Folliculitis typically appears as small red or white-headed pimples around hair follicles – the tiny pockets from which each hair grows. The infection can cause:

  1. Clusters of small red bumps or white-headed pimples that develop around hair follicles
  2. Pus-filled blisters that break open and crust over
  3. Red

Prognosis and Impact


Folliculitis usually has a good prognosis with appropriate treatment. Most cases are relatively mild and will resolve on their own within 2 weeks, though more persistent cases can last a few months. Chronic folliculitis, however, can be difficult to treat and may come and go over many months or years.


In most cases, folliculitis is more of a nuisance than a serious health problem. It can, however, cause discomfort due to itchiness and pain, and can potentially impact a person’s self-esteem or body image, particularly if it’s widespread or in a highly visible area.

Repeated or chronic episodes of folliculitis can lead to scarring or permanent hair loss if the hair follicle becomes severely damaged. In rare cases, if an infection becomes severe, it may enter the bloodstream and spread throughout the body, leading to a potentially life-threatening situation known as sepsis.

Treatment Options

Topical treatments: For mild cases of folliculitis, a topical antibiotic cream or gel, such as mupirocin, may be prescribed. Over-the-counter treatments like benzoyl peroxide can also be effective. Antifungal medications, anti-itch creams, or lotions may be used depending on the underlying cause.

Oral medications: For more severe cases, or folliculitis that isn’t responding to topical treatments, oral antibiotics, antiviral drugs, or antifungal medications may be prescribed.

Medicated shampoos: If the scalp is involved, medicated shampoos can be useful, especially those that contain antifungal agents such as ketoconazole or ciclopirox.

Laser hair removal: If other treatments aren’t successful, or if you have recurrent episodes of folliculitis, laser hair removal may be an option. This can help by reducing the number of hair follicles, thereby lessening the chances of folliculitis.

Lifestyle modifications: Home care can assist in managing folliculitis, including the use of a warm compress to soothe the skin, avoiding friction from clothing, shaving less often, and making sure to shower or bathe after sweating heavily.

Risks and Side Effects

Topical treatments: These may cause skin irritation, including redness, itching, or a burning sensation. Prolonged use of certain topical antibiotics can lead to antibiotic resistance.

Oral medications: Antibiotics, antifungal, or antiviral medications can cause a range of side effects, including upset stomach, diarrhea, and, in rare cases, severe allergic reactions. There’s also a risk of developing antibiotic resistance with overuse.

Medicated shampoos: Some people may experience scalp irritation, dryness, or changes in hair texture with medicated shampoos. In rare instances, these shampoos may cause a rash or an allergic reaction.

Laser hair removal: Risks can include skin irritation, changes in skin color (either lighter or darker patches), and very rarely, scarring or blistering. It’s essential to have this procedure done by a certified professional to minimize potential risks.

Lifestyle modifications: Generally, the risks associated with these adjustments are minimal, but depending on the specific changes, there could be impacts on the quality of life.

FAQ Section

What is folliculitis? 

Folliculitis is an inflammation or infection of the hair follicles, which are the small pockets from which each hair grows. It usually appears as small red or white bumps around hair follicles and can occur anywhere on the body that has hair.


What causes folliculitis? 

Folliculitis is typically caused by bacterial or fungal infections, with the most common bacterium being Staphylococcus aureus. Other factors that can contribute to folliculitis include friction from shaving or tight clothing, injuries to the skin, excessive sweating, certain medications, and conditions that suppress the immune system.


How can I treat folliculitis? 

The treatment of folliculitis depends on the severity and cause. Mild cases can often be managed with topical antibiotics or over-the-counter treatments like benzoyl peroxide. For more severe cases, oral antibiotics, antifungal, or antiviral medications may be necessary. Lifestyle modifications, such as using a warm compress, can also help manage the condition.


Are there any side effects to the treatments for folliculitis? 

Like all treatments, those for folliculitis can have side effects. Topical treatments may cause skin irritation, while oral medications can cause upset stomach or diarrhea. Laser hair removal, which may be used in recurrent cases, can lead to skin color changes or, rarely, scarring.


Can folliculitis be prevented? 

Certain steps can help reduce the risk of folliculitis, including maintaining good skin hygiene, avoiding tight clothing that causes friction on the skin, not sharing towels or washcloths, and showering promptly after activities that cause you to sweat.


Is folliculitis contagious? 

In some cases, folliculitis can be contagious if caused by an infectious agent such as bacteria or fungi. It can be spread through direct skin-to-skin contact or sharing personal items like towels or razors.


For the topic of folliculitis, a good starting place for more information could be:

  1. Mayo Clinic website
  2. American Academy of Dermatology
  3. Centers for Disease Control and Prevention (CDC)
  4. National Institute of Allergy and Infectious Diseases
  5. WebMD

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