Folliculitis

Summary

• Folliculitis is a bacterial infection and inflammation of the hair follicles
• It is usually caused by the bacterium Staphylococcus aureus
• It is treated with oral or topical antibiotics

What is folliculitis?

Folliculitis is a superficial or deep bacterial infection and inflammation of the hair follicles.

What causes folliculitis?

The most common cause is the bacterium Staphylococcus aureus.

What are the symptoms and signs of folliculitis?

The acute lesion consists of a superficial pustule (pimple) or area of inflammation surrounding the hair.

Infected hairs are easily removed, but new papules, or raised spots on the skin, tend to develop in the same area.

Folliculitis can become chronic when the hair follicles are deep in the skin, as in the beard area in men. This is called sycosis barbae.

Stiff hairs in the beard area may emerge from the hair follicle, curve, grow back and re-enter the skin. This produces a chronic, low-grade irritation without significant infection. This is called pseudofolliculitis barbae. This is not an infection.

How is folliculitis treated?

The treatment is similar to that of impetigo. Either oral or topical (applied to the skin) antibiotics are used.

Cloxacillin is often the oral antibiotic used because this is effective against this particular type of staphylococcus.

The topical antibiotic used is mupirocin or fusidic acid ointment. It needs to be continued for several weeks.

When to see your doctor

See your doctor if you develop an irritation of the skin around hair follicles, which then become infected, particularly if this is in the beard area in men.

Reviewed by Dr D. Presbury (MB BC, FRCP).