Folliculitis (foh LICK you LIE tiss) is a common inflammation of the hair follicles. Follicles are the openings in the skin where the hair grows (Picture 1). The rash appears as small red bumps or pus bumps that can itch or be mildly painful.
Folliculitis is common on the buttocks, arms and legs - especially the thighs. Most improve in 7 to 10 days. Sometimes after the rash is gone, dark marks can be left behind. These are not scars, and the dark marks will go away with time.
There are several reasons why hair follicles might become inflamed (red or irritated):
- Bacterial infections. An infection by common or normal bacteria on the skin surface is the most common cause of folliculitis. It can also come from bacteria that grow in hot tubs.
- Ingrown hairs. This may occur after shaving the hair anywhere on the body. As the hair regrows, it can curl into the skin, causing irritation.
- Friction (rubbing) from tight clothing or sports equipment.
- Blocked follicles. Thick moisturizers, medicines, tight bandages, sports equipment, casts or braces can plug hair follicles.
- Excessive sweating.
Diagnosis and Treatment
A doctor can diagnose folliculitis by physical examination. If there is concern that it might be caused by bacteria, the doctor may swab a pus bump to be tested by the lab.
For folliculitis caused by a bacterial infection, the doctor may suggest or prescribe:
- Topical antibiotics. This is a cream or ointment that is put on the skin.
- Bleach baths. Add ¼ cup of bleach to ½ of tub of warm water. Soak in a bleach bath twice a week for 10 to 15 minutes. This may help keep bacterial folliculitis from coming back.
What to Do at Home
Folliculitis may be avoided by following these strategies:
- Shaving: Shave with care. Use an electric razor or a new blade every time you shave. Keep the shaved area clean and try to avoid cuts and nicks. Apply a moisturizing lotion after you shave.
- Clothing: Avoid constrictive clothing. Tight clothes, especially jeans and athletic wear, can cause chafing and irritation of the hair follicle.
- Hot Tubs: Avoid hot tubs that are not well-maintained. If you own a hot tub, keep the chlorine levels and pH as recommended.
- Antibacterial soap: Use antibacterial bar soaps such as Dial® or Cetaphil®. Use skin washes that contain benzoyl peroxide.
When to Call the Doctor
- If these bumps are bothersome or painful.
- If they are not improving or continue to appear.
- If there is a large, painful, red area of skin that feels hard or has a lot of drainage.
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