From the Guidelines
The initial treatment for folliculitis typically involves keeping the affected area clean with gentle washing using antibacterial soap twice daily. Over-the-counter topical antibiotics like bacitracin, neomycin, or polymyxin B (such as Neosporin or Polysporin) can be applied to the affected areas 2-3 times daily for 7-10 days. For mild cases, benzoyl peroxide 5-10% wash or cream can help reduce bacteria. Warm compresses applied for 15-20 minutes several times daily can relieve discomfort and help drain pustules. It's essential to avoid shaving the affected area until the infection clears and to refrain from sharing personal items like towels or razors to prevent spread. These measures work by reducing the bacterial load on the skin and decreasing inflammation in the hair follicles. If symptoms worsen, spread, or don't improve within 7-10 days, or if fever develops, prescription oral antibiotics may be necessary, and medical attention should be sought 1. Recurrent folliculitis may require investigation for underlying causes such as diabetes or immune disorders. Some key considerations in managing folliculitis include:
- Keeping the affected area clean and dry
- Avoiding sharing personal items
- Applying warm compresses to relieve discomfort
- Using over-the-counter topical antibiotics or benzoyl peroxide
- Seeking medical attention if symptoms worsen or don't improve within 7-10 days. Recent guidelines do not specifically address folliculitis, but general principles of skin infection management can be applied 1.
From the Research
Initial Treatment for Folliculitis
The initial treatment for folliculitis can vary depending on the severity and cause of the infection.
- For mild cases of folliculitis, treatment may involve the use of topical antibiotics or antiseptics, such as topical benzoyl peroxide 2.
- In more severe cases, oral antibiotics such as cefadroxil, flucloxacillin, azithromycin, or cefaclor may be prescribed 2.
- However, the use of oral antibiotics should be carefully considered due to the risk of adverse events and the development of antibiotic-resistant bacteria 2, 3.
- For cases of folliculitis decalvans, oral isotretinoin has been shown to be an effective treatment option, with a high success rate in achieving long-term remission 3.
- It is also important to practice good hygiene and avoid sharing personal care items to prevent the spread of infection 4.
Considerations for Treatment
When considering treatment options for folliculitis, it is essential to take into account the potential risks and benefits of each treatment.
- The use of oral antibiotics should be reserved for severe cases of folliculitis, and patients should be closely monitored for adverse events 2.
- Topical treatments, such as topical antibiotics or antiseptics, may be a safer and more effective option for mild cases of folliculitis 2.
- In cases of folliculitis decalvans, oral isotretinoin may be a viable treatment option, but patients should be carefully selected and monitored due to the potential risks associated with this medication 3.