What is the treatment for facial folliculitis?

From the Guidelines

Folliculitis on the face can be effectively treated with topical benzoyl peroxide, as recommended by the guidelines of care for the management of acne vulgaris 1. The treatment of face folliculitis involves a combination of topical and oral medications, along with proper skincare practices. For mild cases, start with gentle cleansing twice daily using an antibacterial soap containing benzoyl peroxide (2.5-5%) or chlorhexidine. Some key points to consider in the treatment of folliculitis include:

• Apply over-the-counter topical antibiotics like mupirocin or clindamycin to affected areas 2-3 times daily for 7-10 days.
• For moderate to severe cases, oral antibiotics such as doxycycline (100mg twice daily) may be necessary, as conditionally recommended for patients with acne 1.
• Avoid picking or squeezing the bumps, which can worsen infection and cause scarring.
• Use a fresh towel and pillowcase daily to prevent reinfection.
• If you have recurrent folliculitis, consider using diluted tea tree oil (mix 5 drops with 1 tablespoon of carrier oil) as a natural antimicrobial or try washing with an antiseptic solution like chlorhexidine. These treatments work by killing the bacteria (commonly Staphylococcus aureus) that infect hair follicles. It is essential to note that the guidelines recommend limiting the use of systemic antibiotics when possible to reduce the development of antibiotic resistance and other antibiotic-associated complications 1. If symptoms don't improve within a week or worsen, consult a healthcare provider as you may need prescription-strength treatments or have a different condition requiring alternative management.

From the FDA Drug Label

Apply a thin film of Clindamycin Phosphate Topical Solution, Clindamycin Phosphate Lotion, or Clindamycin Phosphate Gel twice daily to affected area. A small amount of mupirocin ointment should be applied to the affected area three times daily. For the treatment of face folliculitis, topical antibiotics such as:

• Clindamycin phosphate (TOP) [ 2 ] can be applied twice daily
• Mupirocin (TOP) [ 3 ] can be applied three times daily are recommended.

From the Research

Treatment Options for Face Folliculitis

• The treatment for face folliculitis can vary depending on the cause and severity of the condition 4.
• For bacterial folliculitis, oral antibiotics such as cefadroxil, flucloxacillin, azithromycin, and cefaclor may be effective 5.
• However, the use of antibiotics can lead to the development of resistant bacteria and may not be effective in achieving long-term remission 6.
• Alternative treatments such as oral isotretinoin have shown promise in achieving stable remission in patients with folliculitis decalvans 6.
• Topical antifungals may be effective in treating Pityrosporum folliculitis, a type of fungal folliculitis that can occur on the face 7.
• It is essential to properly diagnose the type of folliculitis to determine the most effective treatment option 8, 4.

Considerations for Treatment

• The choice of treatment should be based on the severity and cause of the folliculitis, as well as the patient's medical history and other factors 5.
• It is crucial to consider the potential risks and benefits of each treatment option, including the risk of adverse events and the development of resistant bacteria 5.
• Further research is needed to determine the most effective treatments for bacterial folliculitis and to compare the efficacy and safety of different treatment options 5.