Folliculitis means inflammation of hair follicles (hair roots).
Folliculitis has many different appearances, ranging from acne-like bumps on the skin to just generalized redness around hair follicles.
There are many reasons that can lead to folliculitis. The most common trigger is a hair follicle plugged with keratin (one of the main proteins found in skin and hair). For example, something blocks a hair follicle, causing a backup and accumulation of keratin and sebum (lipid secretion from sebaceous glands) that would normally be extruded by the follicle. The body responds to this backup with inflammatory cells. The accumulation of inflammatory cells and/or a plug appears as a red, black or white bump on the skin. Hormones and some medications can lead to increased sebum production, which appears to play a role in the clogging of hair follicles and subsequent inflammation. Folliculitis can also be due to an infection of the hair follicle caused by bacteria, viruses or fungi. This causes the body to send inflammatory cells to the follicle in response to the infection.
There are other rare causes of folliculitis related to how hair forms within the follicle that can lead to irritation and inflammation.
There are both topical and systemic treatments that can be given to treat folliculitis.
Salicylic acid: This is available over-the-counter and acts to remove the extra dead skin that may be blocking the hair follicle.
Benzoyl peroxide: This is available over-the-counter and acts to kill local bacteria and unclog the hair follicles. Typically this is used as a benzoyl peroxide wash in the shower and needs to be rinsed off well. Otherwise, it can bleach towels and clothing.
Antibiotics: These agents are obtained as a prescription from a qualified health provider. They can reduce bacterial overgrowth in the inflamed hair follicles and reduce inflammation.
Antibiotics: If there is extensive involvement or persistence of the condition despite the use of topical medications, an oral antibiotic is often used to decrease inflammation associated with the hair follicle even if there is no infection present. If infection is present, then an antibiotic, antiviral or antifungal agent should be selected that will target the specific pathogen responsible for the infection.