Folliculitis is a common skin condition in which the hair follicles become inflamed. Hair follicles are tiny pockets in the skin from which hair grows. They can be found everywhere except for the lips, the palms and the soles of the feet.

If bacteria infect a follicle or there is a blockage in a follicle, it may become red and swollen. This condition is not life threatening but can cause itching and be embarrassing.

Types of Folliculitis

There are several forms of folliculitis, which can be superficial or deep. The superficial type involves part of the hair follicle and the deep type affects more of the hair follicle and is usually more severe.

Types of superficial folliculitis include-

• Pseudomonas folliculitis-Pseudomonas folliculitis, also known as hot tub folliculitis is caused by pseudomonas bacteria found in pools and bathtubs, where the pH balance and chlorine levels are not adequately regulated and monitored. Symptoms usually appear 1 to 2 days after exposure to the bacteria that causes it.
• Pseudofolliculitis barbae-Also known as barber’s itch, it is a skin irritation caused by ingrown hair. It is more common in men with curly hair. It may also affect people who get bikini waxes in the groin area.
• Bacterial folliculitis- Bacterial folliculitis is the most common type. It occurs when the hair follicle gets infected with staphylococcus aureus. Staph bacteria live on the skin all the time but they enter deeper tissues through a wound or cut.
• Pityrosporum folliculitis-It is caused by a yeast infection of the skin that produces chronic, red, itchy pustules on the back and chest, sometimes on the neck, shoulders, upper arms and face.

Types of deep folliculitis include-

• Sycosis barbae- It affects males who have begun to shave. It is a deeper form of barber’s itch that can cause scarring and permanent hair loss.
• Boils and carbuncles- These occur when hair follicles are deeply infected with staph bacteria.
• Eosinophilic folliculitis- This type usually affects people with HIV/AIDS.
• Gram-negative folliculitis- This type affects people receiving long term antibiotic therapy for acne.

Complications of Folliculitis

Possible complications of folliculitis include boils under the skin, recurrent or spreading infections, and permanent skin damage such as scarring or dark spots.

Causes of Folliculitis

Folliculitis is generally caused by-

• An infection of hair follicles with staphylococcus aureus (staph bacteria).
• Fungi, viruses and physical trauma to the follicles.

Risk factors of Folliculitis

Anyone can develop folliculitis but certain factors can increase the risk of having it. These include-

• Having acne or dermatitis.
• Long-term use of certain medications such as steroid creams.
• Regularly wearing clothing that traps heat and sweat such as high boots.
• A weakened immune system caused by medical conditions such as HIV or cancer.
• Being overweight.
• Using an unclean bathtub or swimming pool.

Symptoms of Folliculitis

Common symptoms include-

• Itchy or burning skin.
• A large swollen bump.
• Painful, tender skin.
• Pus-filled blisters.
• Swelling.
• Mild fever.
• Small red bumps.
• White-headed pimples.

Diagnosis for Folliculitis

To make a diagnosis, the doctor will review your medical history and perform a physical examination. During the physical examination, the doctor will examine the skin and take note of symptoms.

In cases where initial treatment doesn’t clear up your condition, the doctor may use a swab to take a sample of the infected skin or hair. This is sent to the laboratory for examination and to detect what is causing your condition.

In rare cases, a skin biopsy may be done to rule out other conditions.

Treatment for Folliculitis

Treatment options usually depend on the type and severity of your condition. Mild cases often only require home remedies. Severe cases may need medication or other therapies.

Medications-

Creams or pills to reduce inflammation, and fight fungal infections.

Therapies-

Minor surgery, if you have a large boil or carbuncle. Laser hair removal if another treatment option does not work.

Home Remedies for Folliculitis

Coconut oil- Daily application of virgin coconut oil to the infected area can reduce irritation and inflammation. It should be applied once a day for better results. Coconut oil contains fats that are beneficial not only for consumption in dishes, but also for the skin. These fatty acids are absorbed by the skin and aid in speedy recovery.

Neem- Neem leaves are effective in treating folliculitis due to the antibacterial and antifungal properties. Fresh neem leaves can be made into a paste and applied directly to the infected area.

Vinegar- Vinegar has great benefits in reducing rashes and redness that develops on the skin. For example, apple cider vinegar mixed with water and applied directly to the infected area for about 10 minutes is helpful for scalp folliculitis.

Garlic- Daily consumption of garlic cloves or garlic supplements helps reduce inflammation. Garlic contains sulphur which helps in reducing the inflammation that causes folliculitis.

Aloe vera- In Ayurveda, aloe vera juice, when applied to the infected area, soothes the itching. Its soothing properties make it an essential Ayurvedic remedy for the problem of folliculitis. Once the skin is cool and clean, the infection will heal faster.

When to see a doctor?

Make an appointment with your doctor if your condition worsens or signs and symptoms of folliculitis don't go away after a few days.