From the Guidelines
Folliculitis should be treated with a combination of warm compresses, topical antibiotics, and good hygiene practices to reduce inflammation and prevent recurrence. The treatment approach depends on the severity and origin of the folliculitis, whether it's bacterial, fungal, or irritant-induced. For mild cases, warm compresses applied to affected areas 3-4 times daily for 15-20 minutes can help reduce inflammation and promote drainage 1. Topical antibiotics like clindamycin 1% or mupirocin 2% applied twice daily for 7-10 days are effective for bacterial folliculitis. It's essential to avoid greasy creams for basic care, as they might facilitate the development of folliculitis due to their occlusive properties 1.
Some key considerations in managing folliculitis include:
- Avoiding manipulation of the skin to prevent infection 1
- Refraining from hot blow-drying of the hair and wearing tight shoes, which can irritate the skin and exacerbate folliculitis 1
- Using topical treatments under the supervision of a dermatologist, especially when considering retinoids or steroids, due to potential side effects 1
- Maintaining good hygiene, using antibacterial soap, and not sharing personal items to prevent the spread of infection
In cases of secondary infection, calculated anti-infective treatment should be started based on bacterial swabs, and abscesses may require incision and drainage to prevent sepsis 1. For fungal folliculitis, antifungal creams like ketoconazole 2% or econazole 1% can be used twice daily for 2-4 weeks. Overall, the goal of treatment is to eliminate the infectious agent, reduce inflammation, and prevent recurrence, thereby improving morbidity, mortality, and quality of life outcomes.
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.