Ask Curology: Is it folliculitis?

Welcome to Ask Curology, penned by one of our in-house medical providers in response to your questions about all things skincare. This week: folliculitis, an annoying skin condition that can wreak havoc from your head to your toes. Here’s what you can do to help get rid of it.

Dear Curology,

A while ago, I started getting small, itchy bumps along my hairline. Now, they’re all over my scalp. It looks like acne, but I’ve never had pimples that itch like this. What can I do? Is it ever going to stop?!

Signed,

Wigging Out

Dear Wig,

That does sound super frustrating — and it sounds a lot like folliculitis, a type of skin infection that looks like acne, but acts a bit differently. Folliculitis is just a fancy way of describing inflamed hair follicles — we’ll get into the nitty gritty in just a sec!

The short answer is that you may be able to get your scalp under control relatively quickly with the right treatment. The long answer is that because of the nature of folliculitis, you might need a little bit more than a topical cream to get there. And just an FYI: we don’t treat folliculitis here at Curology, but sometimes treatments intended for acne may help. If the bumps remain stubborn though, you may want to see an in-person medical provider. Now onto the good stuff!

What causes folliculitis?

First, know that folliculitis is quite common! It’s a skin infection that develops in hair follicles and can occur anywhere (except the palms of our hands and soles of our feet). And I understand why you thought the bumps might be acne — they can look very similar!

One of the easiest ways to get folliculitis is by damaging hair follicles, especially by frequently touching or rubbing them (think shaving, tight clothing, and skin rubbing on skin). Once a hair follicle is damaged, it’s easier for bacteria and fungus to get in and cause an infection (eek!)¹. There are many different triggers for folliculitis, but here are a few of the most common ones:

• Soaking in a hot tub

• Wearing tight clothing on a hot sweaty day

• Shaving, waxing, and tweezing

• Certain topical products applied to the skin

• Certain oral medications

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Are fungal acne and folliculitis the same thing?

I get asked about fungal acne a lot. True acne is different from fungal acne; while true acne is caused by a type of bacteria, the latter is actually a type of folliculitis caused by a yeast that usually looks like small, round, uniform bumps. They’re usually pretty itchy (ugh), and they tend to pop up on the hairline, chest, and back². We’ll get into treatment options shortly!

How long does folliculitis last?

This is a tough one — there really isn’t a one-size-fits-all answer! It depends on a variety of factors, including where you’re dealing with folliculitis, what the specific triggers are, and how you’re treating it. For example, if you shave your face every day and tend to get folliculitis after shaving, it’s hard to guarantee that you’ll ever be 100% clear of it. That said, there are always treatment options that can help.

How do you get rid of folliculitis?

Folliculitis can resolve on its own, but here are a few options that might help:

• Antimicrobial zinc soap: Zinc pyrithione is a great fungus-fighting ingredient! We’ve mentioned it on the blog many times before (we’re obviously big fans). You can find some of our favorite products here and here!

• Dandruff shampoo: Shampoos that target dandruff often contain ketoconazole,³ zinc pyrithione, or selenium sulfide — three powerhouse fungus fighters!! There are lots of great choices out there, but we often recommend Free & Clear Medicated Anti-Dandruff Shampoo and Selsun Blue Max Strength.

• Warm compress: Applying a warm compress to the area can often help. You can apply the compress 3–4 times a day for about 15–20 minutes⁴. Light some candles, put on some good tunes, and you’ve got yourself an anti-folliculitis spa day!

• Lifestyle changes: Making some simple lifestyle changes can produce big results! Try wearing loose moisture-wicking clothing, change out of wet bathing suits ASAP, use clean well-maintained hot tubs, and optimize your shaving technique⁵.

I hope that helps! Feel free to sound off in the comments if you have more questions, or get in touch with your Curology medical provider. If you’re not a member yet, you can sign up for a free month of Curology (just pay $4.95 + tax to cover shipping and handling). Members get paired with an in-house medical provider (like me!) for a custom skincare experience.

All my best,Nicole Hangsterfer, PA-C

We’re here to share what we know — but don’t take it as medical advice. Talk to your medical provider if you have questions.

P. S.

We did our research so you don’t have to.

1. American Academy of Dermatology. Acne-like breakouts could be folliculitis. (2020, n.d.).

2. Amanda Oakley. Malassezia folliculitis. DermNet NZ. (September 2020).

3. Amanda Oakley. Scalp folliculitis. DermNet NZ. (June 2014).

4. American Academy of Dermatology, ibid.

5. American Academy of Dermatology, ibid.

Written by

Nicole Hangsterfer, PA-C