From the Guidelines
Folliculitis should be treated with warm compresses, over-the-counter antibacterial soaps, and topical antibiotics for mild cases, while more severe cases may require oral antibiotics or antifungal treatments. The treatment approach for folliculitis depends on its severity and the causative agent. For mild cases, applying warm compresses to the affected area for 15-20 minutes several times daily can help reduce inflammation and promote drainage 1. Over-the-counter antibacterial soaps containing benzoyl peroxide (2.5-10%) or chlorhexidine can be used to cleanse the area twice daily. Some key points to consider when treating folliculitis include:
- Avoiding greasy creams for basic care, as they might facilitate the development of folliculitis due to their occlusive properties 1
- Avoiding manipulation of the skin, as it poses a risk of infection 1
- Avoiding hot blow-drying of the hair, wearing of tight shoes, and using topical acne medications or topical steroids without supervision, as they may irritate and worsen the condition 1
- Using topical antibiotics like mupirocin (Bactroban) applied 2-3 times daily for 7-10 days for localized infections
- Considering oral antibiotics like cephalexin, dicloxacillin, or doxycycline for 7-14 days for more widespread or persistent cases
- Using antifungal treatments like ketoconazole shampoo (2%) for fungal folliculitis To prevent recurrence, it is essential to practice good hygiene, avoid tight clothing, change razor blades frequently, and avoid sharing personal items. Proper maintenance of hot tubs and pools is also crucial, as they can harbor bacteria that cause folliculitis. Treatment aims to eliminate the infectious agent causing the inflammation of hair follicles and reduce the body's inflammatory response to the infection.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION A small amount of mupirocin ointment should be applied to the affected area three times daily. The treatment for folliculitis is applying a small amount of mupirocin ointment to the affected area three times daily 2.
- Key points:
- Apply a small amount of mupirocin ointment
- Apply to the affected area
- Apply three times daily
- The area treated may be covered with a gauze dressing if desired
- Patients not showing a clinical response within 3 to 5 days should be re-evaluated 2
From the Research
Treatment Options for Folliculitis
- The treatment for folliculitis typically involves antibiotics, either topical or oral, due to their anti-inflammatory and antimicrobial properties 3.
- Topical antibiotics such as mupirocin have been shown to be effective in treating primary and secondary skin infections, including folliculitis 4.
- Oral antibiotics like fusidic acid, cefadroxil, and azithromycin have also been used to treat folliculitis, with varying degrees of success 3, 5.
- In some cases, antifungal medications like fluconazole may be used to treat folliculitis, particularly when it is caused by a fungal infection 6.
- Other treatment options include topical antiseptics, phototherapy, and incision and drainage of boils 5.
- Tacrolimus ointment has also been used to treat eosinophilic pustular folliculitis, a specific type of folliculitis characterized by eosinophilic infiltration 7.
Comparison of Treatment Options
- Comparative trials have not identified significant differences in efficacy or safety outcomes between different oral antibiotics for treating bacterial folliculitis or boils 5.
- The choice of treatment may depend on the severity and type of folliculitis, as well as the patient's medical history and other factors.
- Further research is needed to determine the most effective treatment options for folliculitis and to compare the efficacy and safety of different treatments 5.