Folliculitis

Diagnosis

A healthcare provider can usually diagnose folliculitis by visually examining the skin and reviewing your medical history.

If the infection does not improve with early treatments, additional tests may be done, such as:

• Skin scraping to check for yeast under a microscope

• Swab culture to determine the cause of infection

• Skin biopsy, in rare cases, to rule out other skin conditions

Treatment

Treatment for folliculitis depends on the cause, severity, and response to previous treatments. The goal is to relieve discomfort, clear the infection, and prevent scarring or recurrence.

If over-the-counter treatments haven’t worked after a few weeks, a healthcare provider or dermatologist may recommend prescription medications or procedures to manage symptoms and prevent complications.

Medications

• Antibacterial treatments: Mild bacterial infections may be treated with antibiotic lotions or gels. Oral antibiotics are reserved for severe or recurrent infections.

• Antifungal treatments: Creams, shampoos, or pills may be used for folliculitis caused by yeast or fungi. Antibiotics are not effective in these cases.

• Anti-inflammatory treatments: Steroid creams can reduce itching and inflammation, especially in mild eosinophilic folliculitis. In people with HIV/AIDS, antiretroviral therapy may also help improve symptoms.

Other Interventions

• Minor surgery: Large boils or carbuncles may need to be drained through a small incision to relieve pain, speed recovery, and reduce the risk of scarring. The area is usually covered with sterile gauze afterward.

• Laser hair removal: For persistent pseudofolliculitis barbae, laser hair removal may be recommended when other treatments fail. Multiple sessions are often needed, and possible side effects include scarring or changes in skin color such as lightening (hypopigmentation) or darkening (hyperpigmentation).

Discuss all treatment options and potential side effects with your healthcare provider to find the most effective approach for your skin condition.