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Just about anywhere on your body where you have hair, you can have folliculitis. The skin around the genitals is a prime target for this common bacterial infection.

Folliculitis is an infection of a hair follicle. The infection can extend around the hair follicle (perifolliculitis), into the walls of the hair follicle (superficial folliculitis), or deep and into surrounding tissue (deep folliculitis). Folliculitis is a lot like acne, except it's infectious (touching a red bump on your skin caused by folliculitis can transfer the infectious bacteria to a new location) and it's not caused by hyperkeratinization. That is, the problem isn't that your pore grew so fast that it couldn't drain and it trapped skin oils and bacteria inside. In folliculitis, the problem is that the immune system overreacts to the presence of a bacterial, viral, fungal, or parasitic infection specifically around hair follicle, or to an injury to a hair follicle.

There are lots of ways to injure the skin in ways that increase the likelihood of developing folliculitis:

  • Tight clothing or underwear.
  • Shaving too often or too close.
  • Exposure to heat and humidity.
  • Clothes that don't "breathe."
  • Diabetes.
  • Obesity.
  • Long-term antibiotic use.
  • Tight bandages.
  • Abrasive contact with metal rings, hooks, or zippers.

It's also possible to develop folliculitis after getting vaccinated for smallpox or anthrax, although this is mostly a problem for people in the military. Folliculitis can occur after treatment with epidermal growth factor receptor inhibitors, which are used for treating cancer.

Folliculitis often presents itself as red bumps, each with a hair in the middle, although the hair may not be readily visible. Larger nodules may be warm, painful, and draining. When the infecting agent is Staphylococcus aureus, there may be a yellow dome around the hair that eventually pops and drains pus. You may not notice the drainage while the lesion is healing.

Folliculitis is common around the genitals in both sexes, but it can occur anywhere on the body where there are hair follicles. Most people simply don't know why they have itching buttocks or an itching back, and the infection runs its course without formal treatment. 

What can you do about folliculitis?

The main home treatment for folliculitis anywhere on the body is warm compresses. Simply dip a clean cloth in hot (but not steaming) water and hold it to affected skin. You don't want to burn your skin. The warmth slows down the metabolic activity of the infectious microorganisms and stimulates circulation in the skin. Increased circulation carries away the cytokines that keep skin red, inflamed, painful, and hot. Feel free to reheat the compress for additional relief, but do not use it again for any other purpose until it has been laundered in hot water and soap and dried in a clothes dryer to kill any germs. If you can expose the affected area to sunlight and fresh air, without getting a sunburn, you will probably accelerate healing.

Antibiotic treatment is usually a must, but this is something you should get from a doctor. Neo-Sporin isn't strong enough. Even if you live in a country where you can buy penicillin or methicillin, you may have a form of MRSA that requires clindamycin, trimethoprim-sulfamethoxazole, minocycline, or linezolid. Let your doctor choose the right antibiotic for you, and then take the entire prescription even if the redness and swelling clear up. Since staph bacteria may be spread by nasal secretions, for you to overcome folliculitis, everyone in your household may have to take a nasal treatment to kill their own staph infections so you can get over yours.

In rare instances, folliculitis is caused by herpesvirus and requires antiviral therapy. However, if herpes is the actual cause of your infection, you'll typically remember having a kind of flu-like illness (with fever, fatigue, sore throat, and/or muscle ache) just before the first time you broke out, and you'll have had multiple breakouts every few months since. When herpes is the culprit, there's usually a tingly sensation a few days to a few hours before the bump pops up, and there are also more flu-like symptoms until the breakout resolves. Nearly everyone gets folliculitis, but about 75 percent of people will never develop herpes.

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