Don’t Shave Too Close! 6 Ways to Treat Folliculitis

Folliculitis is a common skin disorder that causes the hair follicles to become inflamed and sometimes infected. Dermatological conditions such as hot tub rash, barber’s itch, and razor burn also fall within the category of folliculitis. With an average of 5 million hairs on the human body, folliculitis can occur anywhere. It affects people of all ages and results in itchy and sore patches that can be embarrassing when they appear on the face, scalp, neck, arms, and legs.

While some cases of folliculitis are naturally sterile (meaning not infectious), many are caused by bacterial or fungal infections. When hair follicles become infected, they may initially appear as white-head pimples or red bumps. These bumps eventually break open and turn into crusty sores that do not heal easily.

Eruptions that occur quickly are often due to the Staphylococcus aureus bacteria, while chronic or recurring folliculitis may be related to concurrent medical conditions that make a person more susceptible to infections. The infection can spread, leading to a more widespread problem, so proper treatment is necessary.

Although folliculitis is not considered a serious health condition, without effective management and treatment, it can cause skin damage, including dark spots and scarring. Similar to pruritus, a common skin condition, it can be challenging to find the right treatment, but there are a wide range of conventional and natural remedies that may provide relief and prevent further discomfort and damage.

What Is Folliculitis?

Folliculitis is an extremely itchy rash that affects the hair follicles, causing a pimple-like rash and leaving the skin painful and tender. The initial signs may be clusters of small red bumps or whitehead pimples filled with pus. If the infection progresses, the pus-filled bumps will break open and crust over.

This common skin condition can be caused by various factors, including certain bacteria, viruses, fungi, parasites, yeast, ingrown hairs, and certain medications. It can also be triggered when moisture is trapped against the skin due to tight clothing, tight hair braids, or by wearing rubber gloves or boots for an extended period.

Folliculitis is not life-threatening, but when it appears in visible areas, this benign skin disorder can be embarrassing and may lead to scarring and skin damage.

Conventional Treatment

In many cases, folliculitis will resolve within a week or two with good hygiene and self-management. However, if you have a severe case or if the folliculitis frequently recurs, it is advisable to visit a doctor.

For a diagnosis, a physical examination and medical history are required. To determine the type of infection, the doctor may swab the skin to collect samples of the infecting agent to determine the appropriate treatment course.

In rare cases, a skin biopsy may be necessary to rule out more serious underlying medical conditions.

The treatment will depend on the type of folliculitis you have and its severity. Some of the possible conventional treatments that can be recommended include:

• Antibiotic creams, gels, or lotions
• Antifungal creams, shampoos, or oral medications
• Corticosteroids, either topically or orally, to reduce inflammation and itching
• Surgical procedures to drain pus from boils
• Laser hair removal

According to the American Osteopathic College of Dermatology, laser hair removal may be effective when other treatments fail, particularly on the lower legs.

Natural Home Remedies

1. Apple Cider Vinegar Pack

According to a study by researchers from the University of Birmingham in the United Kingdom, acetic acid, or vinegar, has been shown to inhibit the growth of certain strains of bacteria. They studied the responses of many bacteria to vinegar and found that Pseudomonas aeruginosa, Acinetobacter baumannii, Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Klebsiella pneumoniae, and Enterobacter were the most positively affected by vinegar at a concentration of 0.16% to 0.3%.

Lead researcher Dr. Mark Webb emphasizes in the study that vinegar has been used as medicine for 6,000 years to treat the plague as well as ear, chest, and urinary tract infections. The team at the University of Birmingham was motivated to find a natural, effective, and cost-effective treatment to fight bacteria in burn patients with open wounds. He further encourages further research but is excited by the promise of their initial trial.

Apple cider vinegar typically has an acidity level ranging from 2.5% to 3.0% in strength. When applying it to areas affected by folliculitis, it is important to reduce its concentration.

For the vinegar pack, mix 1 tablespoon of vinegar and ½ cup of water together. Dip cotton balls into the mixture and apply it to the affected areas for 20 minutes twice a day.

You should start to see results within a few days, but it may take a week or more for some tough cases.

2. Tea Tree Oil

Known for its ability to fight bacteria and fungi, tea tree oil can be easily added to your favorite shampoo and body wash. This is particularly beneficial for recurrent folliculitis as it has been shown to be effective against bacteria that occur on the skin, including staph and most gram-negative bacteria. Additionally, it demonstrates great antifungal properties.

Before using, do a small test patch in an inconspicuous area as tea tree oil can cause an adverse reaction in some people. If you do not react to the test, mix 4 to 5 drops of tea tree oil with your favorite shampoo or body wash for each shower. Massage it well, allow it to sit on your skin or hair for about 5 minutes, and then rinse thoroughly.

This is a great option for those with recurring outbreaks – keep tea tree oil in your shower.

3. Turmeric

With its anti-inflammatory, antimicrobial, and antioxidant properties, there is growing evidence suggesting that turmeric is effective in treating a variety of dermatologic diseases, according to a systematic review published in the journal Phytotherapy Research. Researchers examined the results of 18 studies and found that 10 studies showed significant improvement in skin disease severity with turmeric/curcumin treatment.

When fighting a folliculitis outbreak, take 600 milligrams of a high-quality turmeric supplement three times a day. Make sure to select one that contains black pepper or piperine to enhance turmeric’s absorption.

Topically, a turmeric paste can help fight an infection, but be warned that the bright yellow tone of the turmeric may stain your skin for a couple of days.

Mix ½ teaspoon of turmeric powder with either coconut oil or just a bit of water to form a paste. Spread it gently over the affected areas and cover with a bandage overnight. Reapply as necessary until the symptoms subside.

4. Witch Hazel

Used for generations to treat skin ailments, witch hazel is safe and effective for a multitude of hair and skin conditions, including folliculitis. Witch hazel fights bacteria while soothing irritation, including itching and inflammation, according to a study published in the International Journal of Trichology.

Apply witch hazel with a sterile cotton pad on and around the bumps and pimples. For the scalp, mix several drops of witch hazel into your shampoo and conditioner, and then wash, condition, and style as usual.

5. Grapefruit Seed Oil and Geranium Oil

According to a study published in the journal Burns, grapefruit seed extract and geranium oil, when used together, fight staph and MRSA. The researchers from the Department of Biological Sciences at the Manchester Metropolitan University tested a variety of essential oils, including patchouli, tea tree, geranium, lavender, and grapefruit seed oil, to determine their antibacterial activity against the three different strains of staph.

In addition to the combination of geranium and grapefruit seed oil, researchers found geranium oil and tea tree oil to be most effective against methicillin-sensitive S. Auerus. For either combination, mix the oils in a 50:50 ratio and apply it to the affected areas, covering with gauze overnight. Repeat for several days until the infection is gone.

6. Neem Oil

Due to its powerful antiseptic and antifungal properties, neem oil can rid the skin of bacteria and certain fungal infections, including Candida albicans, while reducing redness and inflammation. It may even help prevent scars.

In a study published in the Brazilian Journal of Microbiology, researchers praised the antifungal effects of neem at a 20% concentration.

To relieve a bacterial or fungal infection on the skin or scalp, mix 3 drops of neem oil with 1 tablespoon of coconut oil or almond oil. Apply it to the affected areas and gently massage it into the surrounding areas to help kill any surface-level infection. Leave it on overnight if possible, or at least for 6 to 8 hours.

Neem oil can also be applied directly to the infected areas, but use it with caution the first time to ensure there is no adverse reaction.

Causes

The recognized causes of folliculitis include:

• Bacterial Infection: S. aureus bacteria and Pseudomonas bacteria cause painful, weeping boils. These types of bacteria are commonly found on the skin and thrive in the heated waters of a hot tub or swimming pool that is not properly chlorinated.
• Yeast Infection: Pityrosporum ovale and Candida albicans are the two types of yeast most commonly associated with folliculitis. For young adults, P. ovale affects the upper chest and back, while C. albicans can affect any skin fold as well as around the beard on males.
• Fungi: Ringworm of the scalp can cause folliculitis symptoms and result in scaly hair loss.
• Viral Infection: Certain common viruses, including the herpes simplex virus and herpes zoster (shingles) virus, can cause folliculitis. In infants and young children, the virus molluscum contagiosum can be the root cause of clusters of painful bumps in skin folds.
• Parasitic Infection: This type of infection mainly affects immunosuppressed adults and healthy seniors. Hair follicle mites can infect the scalp and face. In some cases, scabies can trigger folliculitis, resulting in painful, weeping sores that heal slowly.
• Ingrown Hairs: Often a result of improper shaving, electrolysis, plucking, or waxing. Generally, it does not become infected unless there is bacteria on the skin.
• Contact Reaction: Certain topical preparations, including paraffin-based ointments, moisturizers, certain chemicals, and the overuse of topical steroids, are associated with folliculitis.
• Medications: Certain medications, such as corticosteroids, androgens, ACTH, lithium, isoniazid, phenytoin, B-complex vitamins, protein kinase inhibitors, and certain medications for metastatic melanoma, can cause folliculitis.
• Underlying Skin Diseases: Acne, acne-like disorders, lichen planus, and discoid lupus erythematosus can cause folliculitis.

Signs and Symptoms

The most common symptoms of folliculitis are the appearance of clusters of red bumps or white, pus-filled bumps that resemble pimples. Intense itching and soreness are common.

There are two groups of folliculitis – superficial folliculitis and deep folliculitis – each including several types with different root causes. The superficial group affects only a small part of the follicle, while the deep folliculitis group is more severe, affecting the entire follicle.

Superficial Folliculitis:

• Bacterial Folliculitis. This is a very common type. It is characterized by itchy, white, pus-filled bumps often caused by the S. aureus bacteria. The staph bacteria are always present on the skin but generally only cause a problem when entering the body through a cut, scrape, or wound.
• Hot Tub Folliculitis. Generally, this type appears as a rash of round red bumps that is extremely itchy. It typically occurs 24 to 48 hours after exposure to the Pseudomonas bacteria, which is often found in hot tubs and heated pools that are not properly chlorinated and pH balanced.
• Razor Bumps/Burn or Pseudofolliculitis Barbae. Most commonly caused by ingrown hairs, especially on the face and lower legs. It is most common in men with curly hair who shave too close to the skin. It can also affect the lower legs and bikini line. This type may leave dark, raised scars.
• Pityrosporum Folliculitis. Caused by a yeast infection, this type of folliculitis produces chronic, red, pus-filled bumps on the back, chest, neck, shoulders, upper arm, and sometimes the face.

Deep Folliculitis:

• Sycosis Barbae. Typically affects younger men and adolescents who have just started to shave.
• Gram-Negative Folliculitis. Individuals receiving long-term antibiotic therapy for acne are the most common group affected by this type.
• Boils and Carbuncles. Generally, it appears suddenly as clusters of boils or painful pinkish red bumps as a result of a staph bacterial infection deep in the follicle.
• Eosinophilic Folliculitis. This type is associated with individuals with HIV/AIDS and is a recurring problem. It causes intense itching and widespread patches of pimples near the face and on the upper body.

Risk Factors

The recognized risk factors include:

• HIV/AIDS
• Diabetes
• Chronic leukemia
• Hepatitis
• Certain types of cancer
• Acne
• Dermatitis
• Seborrheic dermatitis
• Long-term antibiotic therapy for acne
• Immune-suppressing drugs
• Chemotherapy treatments
• Being a male with curly hair who shaves
• Soaking in a hot tub or swimming in a heated pool that is not properly chlorinated
• Wearing clothing that traps heat and sweat against the body

Precautions

Folliculitis is not a fatal disease – however, recurrent infections can spread and cause a widespread outbreak.

Boils may develop under the skin, and permanent skin damage is possible. This can include scarring, dark spots, and permanent hair loss.

Treating underlying conditions and consulting with your physician about any medications that may be the root cause is important. Consult your doctor before stopping any prescribed medications.

Final Thoughts

• Folliculitis is a common skin condition that can be caused by bacterial, viral, fungal, or parasitic infections, as well as shaving too close, using a hot tub, and wearing tight clothing.
• It often presents as pinkish-red or white, pus-filled bumps that itch intensely.
• Left untreated, folliculitis can cause permanent skin damage, including scarring, dark spots, and permanent hair loss. </li