Folliculitis (Barber’s Itch)

Medically reviewed by The Dermatologists and written by Dr. Alexander Börve

Folliculitis is inflammation around the hair follicle. This may occur from rubbing against clothing or shaving, which may damage or block the hair follicles.

This condition can be both infectious or noninfectious. For example, acne represents a noninfectious form of folliculitis. However, in most case, it is infectious, as the staphylococcus aureus (staph) bacteria or fungus infects the damaged follicles caused by ingrown hair. This disorder occurs mainly in people who have curly beard hairs that are cut too short.

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Symptoms

Folliculitis usually occurs anywhere on the skin, but particularly on the legs and groin, which rub against clothing consistently. It is also common in the pubic area, on the vagina or penis and on the labia. The face and scalp are also susceptible to bacterial infection, because shaving, sweating, oils and makeup can irritate the skin and hair follicle.

The infection presents itself a small red or white pimples, with a tiny strand of hair in the middle of the pus. The small bumps may sore, itch, burn, or ooze pus. When they burst, pus or blood can come out. These can be recurrent and difficult to treat.

If severe, it can cause deep, painful boils, scarring or permanent hair loss.

Psoriasis also shares similar characteristics. Here’s how to distinguish them:

What can I do?

To speed up the healing process, you can wash the infected area gently twice a day. Use antibacterial soap or over-the-counter antibiotic ointment.

Bactroban ointment should be applied into the front of the nose for several days to prevent a carrier state. While this may seem like it makes no sense, the inside front area of the nostrils is often a place where bacteria can survive a course of oral antibiotics. Later, they spread back to the skin to cause a relapse.

To relieve pain, you can apply a warm compress with white vinegar to the affected area. Do not share anything that has touched the infected area, as this condition can be infectious. Avoid shaving, picking or scratching your skin, and keep the affected area dry.

Also, avoid wearing tight fitting or heat trapping clothes in the affected area. Apply a non-greasy moisturizer such as Lac-hydrin cream (ammonium lactate 12%) plus mild prescription cortisone cream to the area if there is an associated atopic dermatitis.

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Should I seek medical care?

Most cases will go away on their own with 2 weeks. However, more severe infections may cause permanent hair loss or scarring, and prescription medication may be needed.

Contact your healthcare provider if you have a fever, a widespread flare, or if the situation does not improve after 2 weeks.

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Treatment

Washing the affected area with antibacterial shampoo, long term antibiotics may sometimes be used in combination. Some cases may require more complex treatment prescribed by your dermatologist. Your doctor may take a sample of fluid from some of the bumps and send it to a laboratory to find out exactly what kind of bacteria or fungus is causing the infection, to give more specific treatments. This is usually treated with oral cephalexin, dicloxacillin, tetracycline, minocycline, or similar oral antibiotic.

Source:

STD Triage

University of Maryland Medical Center. Elizabeth K Satter, MD. Medscape.

American Ostepathic College of Dermatology. 

Adas A, Arnault JP, Attencourt C, Lok C, Chaby G. J Eur Acad Dermatol Venereol. 2019 Nov 27.