Folliculitis is often a self-limited condition. Care to hygienic measures, wearing loose clothing, and warm compresses applied to the affected area can help speed up recovery.
If the bumps do not go away or they get bigger, we think of infectious folliculitis produced by bacterial or fungal infection.
Folliculitis often does not produce symptoms and is mainly a cosmetic issue, but patients sometimes complain of mild irritation or itching.
If the cause of the folliculitis is a bacterial infection, the most commonly involved bacteria is Staphylococcus aureus. Occasionally, Pseudomonas aeruginosa causes bacterial folliculitis, usually in patients with recent exposure to spa or hot tub that has not been adequately cleaned. Fungal folliculitis is produced by dermatophytes sometimes self-inoculated from tinea pedis or with fungal folliculitis of the legs spread by shaving.
Irritant folliculitis can be produced by friction, occlusion of skin folds, and persistent moisture of sweat (especially in the hot weather) or urine. Shaving also leads to folliculitis when either the tops of hair follicles are irritated by the razor, or when the short, stiff, curly hair curves back into the skin to pierce it.
The treatment of folliculitis depends upon the underlying cause. Bacterial folliculitis, if severe enough, may require topical or oral antibiotic therapy. Fungal folliculitis requires oral therapy since topical medications do not penetrate follicles sufficiently. In the case of irritant folliculitis, local measures to reduce friction and moisture generally produce improvement. Antibiotics may be useful in certain cases. Improvement requires several weeks and maximal improvement often requires 2 or 3 months.