| Specialty: | Dermatology |
| Symptoms: | Small red bumps in skin |
| Onset: | Any age |
| Types: | Pseudofolliculitis barbae |
| Causes: | Occlusion, friction, hair removal, application of some medications, contact with irritant chemicals |
| Risks: | Obesity |
| Diagnosis: | Visualisation, history, negative microbiological culture |
| Treatment: | Avoid trigger, tetracycline |
Irritant folliculitis is an inflammation of the hair follicle.[1] It characteristically presents with small red bumps in the skin at sites of occlusion, pressure, friction, or hair removal; typically around the beard area in males, pubic area and lower legs of females, or generally the inner thighs and bottom.[1] [2] An associated itch may or may not be present.[1] [3] Pseudofolliculitis barbae is a type of irritant folliculitis in the beard area.[3]
Mechanical factors that typically trigger irritant folliculitis include hair removal by razor, waxing, electrolysis, and by plucking.[3] Repeated rubbing of skin such as friction on the inner thighs, may result in the irritation.[2] Sunlight, and prolonged pressure such as sitting on one's bottom for long periods of time, may also trigger irritant folliculitis.[2] Irritant folliculitis may occur following the use of some medications or contact with irritant chemicals such as cutting fluids and coal tar.[2] Tight hair styles may cause irritant folliculitis on the scalp. Other factors that increase chances of skin friction and moisture include obesity.[1]
Diagnosis is generally by history and visualisation of the rash.[2] The condition is not due to infection and swabs of the spots are typically negative.[4] It may appear similar to acne and other types of infectious folliculitis.
Treatment considers removing the triggering factor, particularly to stop shaving.[5] Prolonged use of the antibiotic doxycycline may be an option.[1] If shaving is necessary, the condition may be prevented by avoiding soap and applying a generous amount of shaving gel.[3] Rubbing may be reduced by using powders.[1]
Any age may be affected.[1] It is common on the lower legs of women who shave there.[3]
Irritant folliculitis is a type of folliculitis, an inflammation of the hair follicle, not caused by infection.[2] Types include pseudofolliculitis barbae and perioral dermatitis.[2] [3]
The condition characteristically presents with small red bumps in the skin at sites of occlusion, pressure, friction, or hair removal; typically around the beard area in males, pubic area and lower legs of females, or generally the inner thighs and bottom.[1] [2] An associated itch may or may not be present.[1] [3]
Mechanical factors that typically trigger irritant folliculitis include hair removal by razor, waxing, electrolysis, and by plucking.[3] Other triggers may include sunlight, prolonged pressure such as sitting on one's bottom for long periods of time, and contact with chemicals such as cutting fluids and coal tar.[1] [2] Lithium, halogens, corticosteroids, ACTH, isoniazid, phenytoin and some TNF-alpha inhibitors may cause irritant folliculitis.[2] Perioral dermatitis typically occurs following prolonged use of topical corticosteroid to face.[3] Tight hair styles may cause irritant folliculitis on the scalp.[6] Thick greasy moisturisers may trigger the condition.[3] Other factors that increase chances of skin friction and moisture include obesity.[1]
Diagnosis is by history and visualisation of the rash.[2] A swab for culture does not grow bacteria or fungi.[3]
Pseudofolliculitis barbae may be distinguished from infectious causes folliculitis of the beard area by the absence of fever and lymphadenopathy and the tendency to be more diffuse than localised.[7]
Treatment involves removing the triggering factor, particularly shaving.[2] Sometimes doxycycline works as an anti-inflammatory medication.[1] Ceasing to shave for several months may help.[3] If shaving is necessary, the condition may be prevented by avoiding soap and applying a generous amount of shaving gel after a few months of stopping shaving and letting the skin settle.[3] Rubbing may be reduced by using powders.[1]
Any age may be affected.[1] It is common on the lower legs of women who shave there.[3]