Folliculitis is a common skin condition that can affect any area of the body including the face. It’s characterized by red bumps that are tender and sometimes filled with pus. Because of its appearance, some people mistakenly believe it’s acne. Unlike blemishes, folliculitis isn’t caused by excess sebum production - but by skin bacteria. Men frequently get it in areas where they shave their face and it may be a recurring problem. The type that men get on their face from shaving is called pseudofolliculitis barbae or barber’s itch. Fortunately, there are steps you can take to treat folliculitis and keep it from coming back.
Folliculitis is typically caused by bacteria, although yeast play a role in some cases. The bacteria that cause this skin condition are ones that normally live on the skin and around hair follicles. These bacteria usually don’t cause problems unless the skin or hair follicles are damaged or injured. One of the ways hair follicles can be irritated or damaged is through shaving. Shaving irritates the skin. This may cause normal skin bacteria to overgrow, leading to inflammation and infection.
Hair follicles can also be irritated by repeated rubbing. An example is when you wear a pair of tight jeans, and the fabric rubs against your skin causing irritation. This irritation can lead to folliculitis, usually around the thigh or groin area. The bumps that form with follicultis are typically red and tender, but they can be itchy as well. In some cases, the bumps open up and release a clear or yellow fluid.
Exposing skin to certain cosmetic products, household products or industrial products can cause folliculitis to develop. Such products irritate skin follicles allowing skin bacteria to overgrow. Some topical skin medications like steroid creams also predispose to folliculitis because they suppress local skin immunity and make it easier for skin bacteria to grow and cause an infection.
There’s another type of folliculitis called hot tub folliculitis. As the name suggests, it comes from soaking in a hot tub, whirlpool, swimming pool or bathtub that hasn’t been adequately maintained. Normally chlorine and other treatments are used to kill bacteria and make public pools and tubs safe for soaking. When the water isn’t properly treated, a bacteria called Pseudomonas aeruginosa can grow and thrive. If this bacteria comes into contact with damaged hair follicles or areas where the skin was abraded by wearing a tight swimsuit it can cause an infection. It’s more likely to affect areas that have been recently shaved or otherwise irritated.
Certain risk factors predispose a person to this skin problem. Frequent shaving is a risk factor since it irritates hair follicles. It’s also more common in athletes who sweat a lot. Heat and high humidity create a perfect environment for the bacteria that cause folliculitis to grow and thrive.
Folliculitis usually goes away on its own in one to two weeks, but the bumps can be tender and itchy in the meantime. The best way to treat the symptoms is to cleanse the area with anti-bacterial soap twice a day. After cleansing, soak a clean washcloth with warm water. Wring out the excess water and apply it to the affected areas for ten minutes twice a day. This helps to relieve the itching and skin irritation. If itching is severe, soak a washcloth in a warm, dilute vinegar solution and place it on the affected areas.
At one time, topical antibiotic ointments available at most drugstores were effective, but many of the bacteria that cause folliculitis have become resistant to these products. If the symptoms are severe, you may need an oral antibiotic. Anti-fungal creams are also effective in cases where yeast is involved.
Until the bumps completely heal, don’t shave the affected areas, avoid hot tubs and don’t wear tight clothing. Loose cotton clothing allows skin to breathe and sweat and moisture to evaporate more easily. Avoid scratching or picking at the bumps since this can cause further irritation.
When you shave, use a sharp blade and a non-irritating shaving cream to allow the razor to glide more smoothly over the skin. If the problem becomes recurrent, ditch the razor, and switch to a depilatory cream. Wash areas where you shave with an anti-bacterial soap. Wear loose, cotton clothing when you exercise and when in hot, humid environments. Avoid wearing tight jeans and constrictive clothing. If you frequent hot tubs, make sure they’re well-maintained and wash with an anti-bacterial soap as soon as you get out of the water. Don’t rub oil into areas you’ve recently shaved. The oils can irritate and block the hair follicle making it easier for bacteria to overgrow and cause an infection.
If the symptoms clear up in a week or two, see your doctor. Other skin conditions like impetigo can mimic folliculitis and may require more aggressive treatment.