From the Guidelines
Folliculitis is characterized by small, red, pimple-like bumps or pustules centered around hair follicles, often accompanied by itching, tenderness, or pain, and is typically caused by bacterial infection, often Staphylococcus aureus, as noted in the guidelines for the diagnosis and management of skin and soft-tissue infections 1. The condition commonly affects areas with hair such as the scalp, beard area, arms, back, buttocks, and legs. Some people experience mild burning or irritation before visible symptoms appear. In more severe cases, folliculitis can cause larger, more painful bumps called boils or carbuncles. Systemic symptoms like fever are rare but may occur with extensive infection. The condition can be acute (appearing suddenly) or chronic (recurring over time), with chronic cases sometimes leading to permanent hair loss or scarring in the affected areas. Key characteristics of folliculitis include:
- Small, red, pimple-like bumps or pustules centered around hair follicles
- Itching, tenderness, or pain in the affected area
- Pus-filled bumps that can develop a crust or scab as they heal
- Commonly affects areas with hair, such as the scalp, beard area, arms, back, buttocks, and legs
- Can be caused by bacterial infection, fungi, viruses, or non-infectious irritation of hair follicles from shaving, tight clothing, or exposure to certain chemicals, as differentiated from furuncles and carbuncles in the practice guidelines for the diagnosis and management of skin and soft tissue infections 1.
From the Research
Symptoms of Folliculitis
The symptoms of folliculitis can vary depending on the type and severity of the condition. Some common symptoms include:
- Inflammatory destruction of the hair follicle, leading to scarring alopecia 2
- Papules or pustules, often with a central hair follicle, which can be painful and itchy
- Hyperpigmentation and scarring, particularly in darker skin types 3
- Follicular contact dermatitis, characterized by individual papules with a central hair follicle, spongiosis, and vesicle formation of the follicular epithelium 4
- Monomorphic papules and pustules, often on the chest, back, posterior arms, and face, in the case of Malassezia (Pityrosporum) folliculitis 5
Types of Folliculitis
There are several types of folliculitis, including:
- Folliculitis decalvans, a rare form of folliculitis that leads to scarring alopecia 2
- Pseudofolliculitis barbae (PFB), also known as razor bumps, which occurs when hair follicles penetrate the skin and cause an inflammatory response 3
- Follicular contact dermatitis, which can be caused by allergens or irritants, including topical antibiotics such as neomycin 4
- Malassezia (Pityrosporum) folliculitis, a fungal acneiform condition that can be misdiagnosed as acne vulgaris 5