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Treatments and drugs
By Mayo Clinic staffMild cases of folliculitis will likely go away on their own. Persistent or recurring cases are likely to require treatment, however. The therapy your doctor recommends will depend on the type and severity of your infection.
- Staphylococcal folliculitis. Your doctor may prescribe an antibiotic that you apply to your skin (topical) or that you take by mouth (oral). Your doctor may also recommend that you avoid shaving the affected area until the infection heals. If you must shave, use either an electric razor or clean razor blade every time.
- Pseudomonas folliculitis (hot tub folliculitis). This condition rarely requires specific treatment, although your doctor may prescribe an oral or topical medication to help relieve itching (anti-pruritic). More-serious cases may require an oral antibiotic.
- Tinea barbae. This infection — especially the inflammatory form — can be effectively treated with oral antifungal medications.
- Pseudofolliculitis barbae. Self-care measures usually clear this condition. Shaving with an electric razor, which doesn't cut as closely as a razor blade does, can help. If you do use a blade, massage your beard area with a warm, moist washcloth or facial sponge to lift the hairs so that they can be cut more easily. Use a shaving gel instead of cream, and shave in the direction of the hair growth. When you're finished, rinse thoroughly with warm water and apply a moisturizing after-shave.
- Pityrosporum folliculitis. Topical or oral antifungals are the most effective treatments for this type of folliculitis. Because the condition often returns once you've finished the course of oral medication, your doctor may recommend using topical ointments indefinitely. Antibiotics aren't helpful in treating pityrosporum folliculitis and may make the infection worse by upsetting the normal balance of bacteria on your skin.
- Herpetic folliculitis. If you're a healthy adult, herpetic folliculitis may clear up without treatment. But if you're living with HIV/AIDS or you experience frequent cold sores, your doctor may prescribe an oral antiviral medication such as acyclovir (Zovirax), famciclovir (Famvir) or valacyclovir (Valtrex). Although these drugs can clear the infection, they won't necessarily prevent it from recurring.
- Gram-negative folliculitis. Although this type of folliculitis results from long-term antibiotic therapy for acne, it's usually treated with certain antibiotics or with isotretinoin (Accutane).
- Boils and carbuncles. Your doctor may drain a large boil or carbuncle by making a small incision. This relieves pain, speeds recovery and helps lessen scarring. Deep infections that can't be completely cleared may be covered with sterile gauze so that pus can continue to drain. Sometimes your doctor may prescribe antibiotics to help heal severe or recurrent infections.
- Eosinophilic folliculitis. A number of therapies are effective, but topical corticosteroids are often the treatment of choice. Your doctor may prescribe a short course of oral corticosteroids if you have a severe infection. All steroids can have serious side effects and should be used for as brief a time as possible. If you're living with HIV/AIDS and have mild eosinophilic folliculitis, your doctor may prescribe topical steroids in conjunction with oral antihistamines. More-severe cases may require treatment with isotretinoin (Accutane) for several months.
References
- Folliculitis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/print/sec10/ch119/ch119e.htm. Accessed July 30, 2009.
- Luelmo-Aguilar J, et al. Folliculitis recognition and management. American Journal of Dermatology. 2004;5:301.
- Baddour LM. Folliculitis. http://www.uptodate.com/home/index.html. Accessed July 30, 2009.
- Craft N, et al. Superficial cutaneous infections and pyodermas. In: Wolff K, et al. Fitzpatrick's Dermatology in General Medicine. 7th ed. New York, N.Y.: McGraw-Hill Medical; 2008. http://www.accessmedicine.com/content.aspx?aID=2994673. Accessed Aug. 4, 2009.
- Pseudomonas aeruginosa infection. In: Habif TP. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 4th ed. Philadelphia, Pa.: Mosby Inc; 2004. http://www.mdconsult.com/das/book/body/152685128-4/0/1195/59.html?tocnode=51440865&fromURL=59.html. Accessed Aug. 5, 2009.
- Stevens DL. Infections of the skin, muscle, and soft tissues. In: Fauci AS, et al. Harrison's Principles of Internal Medicine. 17th ed. New York, N.Y.: McGraw-Hill Medical; 2008. http://www.accessmedicine.com/content.aspx?aID=2860782. Accessed Aug. 4, 2009.
- Parker SRS, et al. Eosinophilic folliculitis in HIV-infected women. American Journal of Clinical Dermatology. 2006;7:193.
- Bacterial infections. In: Habif TP. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 4th ed. Philadelphia, Pa.: Mosby Inc; 2004. http://www.mdconsult.com/das/book/body/152685128-4/0/1195/53.html?tocnode=51440785&fromURL=53.html. Accessed Aug. 5, 2009.
- Folliculitis. In: Habif TP. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 4th ed. Philadelphia, Pa.: Mosby Inc; 2004. http://www.mdconsult.com/das/book/body/152685128-4/0/1195/54.html?tocnode=51440831&fromURL=54.html#4-u1.0-B0-323-01319-8..50011-X--cesec46_984. Accessed Aug. 5, 2009.
