What is folliculitis?

Folliculitis is a common condition involving the hair follicle. The hair in the follicle which normally grows in an upward direction curves and re-enters the skins surface resulting in the appearance of small white pimples or clusters of red bumps around the hair follicle. Bearded areas (sycosis barbae) on the facial skin are often infected with the bacteria Staphylococcus aureus , resulting in pain, swelling and redness of the skin.

Folliculitis Picture from Dartmouth College

Folliculitis is commonly referred to as an ‘ingrown hair’ and can occur anywhere on the body except areas that do not have hair follicles such as the palms of hand or soles of the feet. Follicular pustules or pimples occur in and around the hair follicle area. This condition affects individuals of all age groups but is common in people suffering with diabetes mellitus,  HIV, cancer or individuals on chemotherapy treatment. Ingrown hair is also more prevalent amongst individuals with curly or wavy hair due to the stiff structure of the hair composition which may be based on ethnic or genetic traits. The ingrown hairs are easily removed but the development of pimples may still persist.

Causes of Folliculitis

• Irritation of the hair shaft or follicle opening in the skin.
• Friction on the shaved area which is often caused by tight clothing.
• Excessive perspiration is often a common irritant to the hair follicle.
• Injury to the skin caused by cuts and nicks during shaving, leaves the skin susceptible to bacteria.
• Close or frequent shaving can result in irritation of the skin.
• Bacterial infection (staph skin infection) through skin abrasions results in folliculitis.

Preventing Folliculitis

• The use of an electric shaver may be a better option than the razor as it is more hygienic.
• If the use of the razor is essential, a new blade should be used for every shave.
• Avoid repetitive shaving over the same area to prevent the occurrence of cuts and knicks.
• Shave in the direction of the hair growth to minimize the occurrence of ingrown hair.
• Do not shave over skin that appears dry or irritated.
• Avoid the use of tight clothing for 2 to 3 days after shaving.
• Daily or frequent shaving should be avoided.
• Exfoliation of the skin can help to keep the area clean preventing the spread of bacteria.

Treatment and Management of Folliculitis

• Hydrocortisone creams are effective alleviating dry itchy skin.
• The application of an antibiotic ointment will sterilize the area preventing the spread of bacteria.
• Topical anesthetic ointments aids in the relief of pain and soreness of the ingrown hair.
• Oral antibiotics may be administered for bacterial skin infections.
• A warm moist towel should be applied twice a day to the affected area to keep the hair soft.
• Permanent hair removal such as electrolysis can aid in the prevention of ingrown hairs and pimples.
• If the condition does not rectify itself or becomes a recurrent chronic condition, seek medical advice.
• Avoid squeezing ingrown hair pimples that occur to prevent possible scarring.