Symptoms, Razor Bumps, Causes, and Treatments

Written by WebMD Editorial Contributors

• What Is Folliculitis?
• Folliculitis Symptoms
• Types of Folliculitis
• Folliculitis Causes and Risk Factors
• Folliculitis Diagnosis
• Folliculitis Treatments
• Folliculitis Prevention
• More

Folliculitis is a common skin problem that happens when you get bacteria or a blockage in a tiny pocket in your skin called a hair follicle. You have hair follicles just about everywhere except your lips, your palms, and the soles of your feet. Folliculitis can make these hair follicles red and swollen.

You can get this condition anywhere you have hair, but it’s most likely to show up on your neck, thighs, buttocks, or armpits. You can often treat it yourself, but for more severe cases you may need to see your doctor.

Different kinds of folliculitis have other names you might have heard, such as:

• Barber’s itch
• Hot tub rash
• Razor bumps
• Shaving rash

Your symptoms will vary based on the exact type of folliculitis you have and how bad it is. You may have:

• Groups of small red bumps like pimples, some with whiteheads on them
• Blisters that break open, ooze, and become crusty
• Large areas of red, swollen skin that may leak pus

These areas of your skin may be itchy, tender, and painful as well.

There are two main types of folliculitis. Superficial folliculitis is when only part of the follicle is damaged, while deep folliculitis is when the whole follicle is damaged.

It can be hard to tell which type of folliculitis you have. Other types include:

• Bacterial folliculitis: The most common form, this type causes itchy, white bumps filled with pus. You can get it if you cut yourself and bacteria (usually Staphylococcus aureus, also called staph) gets in.
• Hot tub folliculitis (pseudomonas folliculitis): You can get this from swimming in a pool or sitting in a hot tub where pH or chlorine levels aren’t balanced. You’ll see a rash of red, round, itchy bumps a day or so after being in the water.
• Razor bumps (pseudofolliculitis barbae): This type is caused by ingrown hairs linked to shaving or a bikini wax. You’ll have dark bumps, or keloids, on your face or neck after shaving or in your groin area after a wax.  It’s more common in men of African and Asian descent. 
• Pityrosporum folliculitis: This type happens along with a yeast infection. It causes red, itchy, pus-filled pimples that show up on your upper body, mostly on your back and chest, but you can also have them on your neck, shoulders, arms, and face.
• Sycosis barbae: This is when the whole follicle gets infected after shaving. It causes large, red, pus-filled bumps and can lead to scarring in some cases.
• Gram-negative folliculitis: This type is caused by the use of long-term antibiotics to treat acne. It happens if the bacteria become resistant to the antibiotics and make the acne worse.
• Boils and carbuncles: A boil (a red bump that can be tender or painful) happens when a hair follicle is seriously infected. A carbuncle is a cluster of several boils.
• Eosinophilic folliculitis: This type typically affects babies or people who have a condition that affects their immune system. It causes itchy, pus-filled bumps that show up most often on the shoulders, upper arms, neck, and forehead.

Staph, a kind of bacteria, is most often to blame. You have staph on your skin all the time, and it normally doesn’t cause any issues. But if it gets inside your body, say through a cut, then it can cause problems.

These other things can also cause folliculitis:

• Blockages from skin products, such as moisturizers with oils
• A fungus
• Hair removal, such as shaving, waxing, and plucking
• Ingrown hairs
• Other bacteria, such as the kind you might find in a hot tub
• Some drugs, such as corticosteroids that are used to ease inflammation

In general, you’re more likely to get the condition if you have damaged follicles. This can happen from things such as shaving, skin injuries, sticky bandages, and tight clothes. 

You also might be more likely to have folliculitis if you:

• Have acne, especially if you use a steroid cream or long-term antibiotic for it
• Are a man who has curly hair and shaves
• Wear tight clothes, rubber gloves, or boots that don’t let sweat or heat out
• Spend time in a pool or hot tub that’s not cleaned regularly
• Have an illness that affects your immune system, like diabetes, leukemia, or HIV/AIDS

Your doctor can usually tell if you have it by looking at your skin closely and asking questions about your medical history.

You don’t usually need tests unless treatments don’t work. In that case, your doctor may use a swab to take a skin sample and find out exactly what’s causing the problem.

Mild folliculitis might go away without any treatment. To help yourself heal and ease symptoms, you can:

Clean the infected area: Wash twice a day with warm water and antibacterial soap. Be sure to use a fresh cloth and towel each time.

Use salt: Put warm saltwater — 1 teaspoon table salt mixed with 2 cups of water — on a washcloth and place it on your skin. You can also try white vinegar.

Gels, creams, and washes: Use over-the-counter antibiotics that you rub on your skin. If you’re itchy, you can try oatmeal lotion or hydrocortisone cream. It also helps to avoid shaving, scratching, and wearing tight or rough clothes on the infected area.

If these self-care treatments don’t work, your doctor may give you:

• Antibiotic cream if the folliculitis is caused by bacteria (pills for very severe cases only)
• Antifungal creams, shampoos, or pills if it’s caused by fungus
• Steroid cream to help reduce swelling

To lower your chances of getting folliculitis, your best bet is to stop shaving for at least 3 months, but for a lot of people that won’t do. You might want to try an electric razor or hair removal products (depilatories) or other ways to remove hair. If those don’t work for you, then be sure to:

• Wash your skin with warm water and a gentle cleanser.
• Apply plenty of gel or shaving cream, not soap, and let it sit 5-10 minutes to soften your hair.
• Use a new blade each time you shave so you know it’s clean and sharp; single blades are ideal.
• Shave in the direction your hairs grow.
• Rinse with warm water and use moisturizing lotion.

It can help to shave only every other day. 

You also should not wear clothes that irritate your skin or trap heat and sweat, such as Lycra, rubber gloves, and high boots.

Limit your use of oils and other greasy skin products. They can cause blockages and trap bacteria. Other things you can do:

• Dip into hot tubs only if you know for sure they are clean and well-maintained.
• Use clean towels, razors, and other personal care items, and avoid sharing them with anyone else.
• Wash your hands often.

Top Picks

Vaginal Folliculitis and Treatment Options

Updated

03 February 2023

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Published

02 April 2019

Fact Checked

Reviewed by Dr. Andrei Marhol, General practitioner, medical advisor, Flo Health Inc., Lithuania

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Vaginal folliculitis, or genital folliculitis, is very common and can occur on and off throughout your lifetime. Folliculitis looks like acne in the genital region. The main difference is that acne is a clogged or infected pore, while a folliculitis bump is actually an infected hair follicle. You can spot the difference between the two by identifying a hair in the middle of a folliculitis bump.

Although genital folliculitis may be a bit painful, you can easily prevent it and treat it at home. Without prompt attention, however, an infected follicle can develop into a genital abscess, which will need medical attention.

What causes genital folliculitis?

Folliculitis, even in the genital region, is generally not contagious. However, due to the proximity of hair follicles to one another in the vaginal region, the infection can spread from one to the next, eventually looking like a patch of acne. 

Folliculitis happens when your hair follicles are damaged. When they’re damaged, it’s easy for germs to get inside the follicles and cause an infection. The infection can be caused by bacteria, usually by Staphylococcus aureus (staph), viruses, or fungi.

Hair follicles can be damaged by:

• Touching or rubbing your skin frequently
• Wearing tight clothing
• Shaving

The initially infected follicle may occur as a result of an ingrown hair, caused by a follicle blocked by sweat and dead skin cells. Genital folliculitis is more common in areas of the body where hair is rough and often shaved, including the vaginal region. There, the hair is coarser, the skin is more sensitive, and the risk of bacterial infection from razors or other hair removal products is higher.

The skin around the vagina and inner thighs is thinner and more sensitive than the skin on other parts of the body. Tight clothing and elastic underwear bands can cause excess friction; that, coupled with sweat from vigorous exercise or even just continuous walking creates an environment that is ideal for folliculitis to occur. Tight clothing can slough off dead skin cells, and then sweat and oils in that area become trapped in the hair follicles. Skin is especially susceptible after shaving.

Dirty hot tubs and spas can also cause folliculitis, as bacteria thrive in inadequately chlorinated warm water. Make sure to clean in between your legs and around your vagina thoroughly after sex and after using a hot tub to reduce your chances of infected hair follicles. You may also experience higher occurrences of vulvar folliculitis during your period due to the shifts in hormone levels.

Main types of vulvar folliculitis

Irritant folliculitis. Redness, chafed skin, and itchiness is commonly referred to as “razor burn” and occurs within 36 hours of shaving. The injured follicles are highly susceptible to becoming infected. The sensitive skin of the inner thighs and vaginal region is especially susceptible to irritation, for example, from tight clothing against the skin or from a partner who has recently shaved. To clear your skin more quickly and get relief, you can try applying warm compresses to the area. You can also try to relieve itchy skin with a soothing lotion. 

Razor bumps (pseudofolliculitis barbae). Razor bumps are the result of an inflammatory reaction surrounding ingrown hairs. They can occur on any part of your body where hair is shaved. New hairs that grow back after removal may become trapped beneath the top layer of skin and curl backward. As the hair grows, the layers of your skin become irritated and can become infected. You can remove ingrown hairs with sterilized tweezers or seek a professional dermatologist or aesthetician certified in genital hair removal.

Hot tub folliculitis (pseudomonas folliculitis). This shows up as a rash of red, round, itchy bumps. Hot tub folliculitis is caused by pseudomonas bacteria, which can be found in hot tubs and heated pools where the chlorine and pH levels are out of balance.

Genital folliculitis symptoms

Vaginal folliculitis looks like a pimple on the inner thighs, labia, or pubic mound area. You can tell the difference between an acne pimple and vaginal folliculitis by looking for a hair. If there’s a hair in the middle of the bump, it’s genital folliculitis or an infected hair follicle. If there’s no hair in the middle, then it’s probably vaginal acne. If you aren’t sure, visit your OB-GYN or dermatologist for a diagnosis.

Folliculitis, unlike genital acne, is typically painless, although the bumps may be red or sore. There are also sometimes symptoms of infection associated with folliculitis such as itching, crusty sores, and low fever. Folliculitis looks like a mosquito bite or raised bump. Vaginal folliculitis caused by ingrown hairs may look like a small splinter under the skin or a raised bump with a dark spot or line (this is the trapped hair).

Side effects of vaginal folliculitis

If left untreated, folliculitis can sometimes grow into boils or carbuncles. These are larger infections under the skin, full of pus, that can turn into abscesses. The risk of infection is higher the larger the boil is, and they should be treated in a sterile medical setting. While these may heal on their own, people with a compromised immune system may end up with a severe infection.

Permanent hair loss is a rare side effect. It occurs when the infection penetrates deep enough into the skin and damages the hair follicle, preventing regrowth.

Genital folliculitis treatment

Treatment for folliculitis includes medications and, in some cases, laser hair removal. Even if it helps, the infection may come back.

You need to be careful about treating folliculitis in the vaginal region to prevent transferring the infection and scarring. You can treat mild cases involving just a few infected hair follicles by using a warm compress to loosen the infection and allowing the skin to heal. If the infection was caused by shaving, plucking, or waxing, it’s best to skip those treatments for 30 days. 

Medications for genital folliculitis

• Creams or pills to control infection — Your health care provider may prescribe an antibiotic cream for mild cases. Oral antibiotics may be prescribed for a severe or recurrent infection.
• Creams, shampoos, or pills for fungal infections — Antifungals are for infections caused by yeast rather than bacteria. Antibiotics aren’t helpful in treating this type of infection.
• Minor surgery — If you have a large boil or carbuncle, your health care provider may make a small incision in it to drain the pus to relieve pain and speed recovery.
• Laser hair removal — This method permanently removes hair follicles in the treated area. There are possible side effects, such as blistering and scarring.

Preventing genital folliculitis

Preventing infected hair follicles in the pubic region includes practicing proper hygiene, including regular washing with warm water. Do not share towels, and change your washcloth often to prevent bacteria buildup. 

It’s especially important to practice good vaginal hygiene during your period. Not only do hormonal shifts cause the skin to be more sensitive, but there’s also a higher population of bacteria that can infect hair follicles and chafed skin.

Use an exfoliant recommended by your dermatologist. Do not use facial products on your vulva unless prescribed. If you choose to shave, use a sharp, clean razor and change it frequently, or switch to an electric razor. Shave in the direction of the follicle, not against it. Make sure not to stretch the skin. 

You can also consider alternative hair removal methods such as waxing, depilatories, or laser hair removal. These procedures remove the entire hair from the root. When the hairs grow back, they’re typically finer, with a smooth tip instead of the blunt, rough tip that shaved hairs have, reducing instances of ingrown hairs.

Genital folliculitis is generally mild and easily preventable with proper hygiene and care. However, it’s important to note that certain sexually transmitted infections (STIs) can look very similar to a folliculitis bump or vaginal acne. If you’re sexually active, make sure to get tested for STIs to be safe.

References

Margesson, Lynette J, and Hope K Haefner. “Vulvar Lesions: Differential Diagnosis Based on Morphology.” UpToDate, 2019, www.uptodate.com/contents/vulvar-lesions-differential-diagnosis-based-on-morphology.

“Acne-like Breakouts Could Be Folliculitis.” American Academy of Dermatology, www.aad.org/public/diseases/a-z/folliculitis.

“Folliculitis.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 8 Mar. 2018, www.mayoclinic.org/diseases-conditions/folliculitis/symptoms-causes/syc-20361634.

Oakley, Amanda, and Clare Morrison. “Folliculitis.” Folliculitis | DermNet NZ, Apr. 2014, dermnetnz.org/topics/folliculitis/.

Oakley, Amanda. “Folliculitis Barbae and Pseudofolliculitis Barbae.” Folliculitis Barbae and Pseudofolliculitis Barbae | DermNet NZ, 1998, dermnetnz. org/topics/folliculitis-barbae/.

“Folliculitis.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 18 Aug. 2020, www.mayoclinic.org/diseases-conditions/folliculitis/diagnosis-treatment/drc-20361662.

History of updates

Current version
(03 February 2023)

Reviewed by Dr. Andrei Marhol, General practitioner, medical advisor, Flo Health Inc., Lithuania

27 March 2019

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Treatment of pustular skin diseases

Pustular skin diseases (pyoderma) are skin diseases caused by staphylococcus and streptococcus bacteria.

Factors contributing to the onset of the disease:

• hormonal changes in the body during adolescence;
• excessive sweating;
• injuries and cuts;
• non-compliance with personal hygiene;
• immunosuppression;
• diseases of the stomach and liver;
• endocrine diseases.

Diagnosis and treatment of pustular skin diseases:

The manifestations of pyoderma are varied and depend on the bacteria that infect the skin, as well as on the protective abilities of the body. But most often, when infected with staphylococcus aureus, the hair follicle is affected with the formation of an inflamed purulent nodule. Streptococcal pyoderma manifests itself in the form of bubbles on the skin of the face, in the nose, in the corners of the lips.

Diagnosis of bacterial diseases is made on the basis of the clinical picture and anamnesis, in some cases additional laboratory tests are carried out to clarify the diagnosis.

It is important to remember – do not squeeze out purulent lesions on the skin on your own, otherwise the infection may spread to healthy skin.

Treatment of purulent skin diseases must be carried out in a complex and under the supervision of a physician. The main goals in preparing a treatment program are as follows:

• Identification and elimination of the cause of the disease;
• Prescription of a special diet to improve the general condition of the body;
• Immunity booster;
• Elimination of external signs of the disease: external treatment with ointments, antiseptic dressings. In the case of a severe stage of the disease, surgical treatment is possible.

The most common bacterial skin diseases are furunculosis, folliculitis, hydradenitis.

FUUNCULOSIS

Furunculosis is a chronic inflammatory disease characterized by the appearance of boils on various parts of the skin. Furuncle is an acute purulent lesion of the follicle, sebaceous gland and surrounding subcutaneous fat, which has clear boundaries and is caused by purulent bacteria. The appearance of boils on a person’s face is especially dangerous, which can lead to serious complications, such as meningitis or sepsis. Furunculosis is a recurrent disease that recurs over a period of several weeks to several years.

FOLLICULITIS

Folliculitis is an acute inflammation of the hair follicle characterized by the formation of bright red purulent nodules that are painful to touch.

The duration of the course of the disease is from 3 to 7 days.

Species:

• ostiofolliculitis – superficial folliculitis, in which the formation of purulent nodules ranging in size from 2 to 5 mm is noted. They have a spherical shape with a hair in the center. After a few days, the purulent nodule shrinks and forms a yellowish-brown crust, after rejection of which no skin scars remain.
• deep folliculitis is an acute purulent lesion of the hair follicle, in which inflammation spreads deep into the follicle. After the formation and falling off of the crust, the purulent nodule gradually resolves, leaving slight peeling and pigmentation on the skin. In a more severe form of deep folliculitis, an ulcer forms on the skin with a further transition to a pinpoint scar.

Folliculitis can be single (appearing in a limited area of ​​the skin) or multiple (scattered over the skin). Folliculitis can develop on any part of the skin where there is hair, more often on the face, scalp, extensor surface of the limbs.