Folliculitis vs Ingrown Hairs

An ingrown hair is a hair that curls back into the skin instead of growing out of it, leaving a tender bump. It is most common and most stubborn in coarse, tightly curled hair, where it has a name of its own: pseudofolliculitis barbae, better known as razor bumps.

Reviewed by Dr. Schwarz, Board-Certified Dermatologist · Research updated 2026-10-23
The back of the neck and upper back on fair skin, covered in small red bumps of even size, each one at a hair opening, several with a pinpoint of yellow-white pus.A few firm pink bumps scattered under the jaw and along the upper neck on light skin, with a dark loop of hair visible over one of them.

Key differences

The same eight facts on every condition comparison.

Usual age
Any age
After puberty
Where
Hair-bearing skin
Beard, legs, armpits, bikini line
Main sign
Small pus spots, each at a hair
Tender bumps at shaved hairs
Itch or pain
Itchy or tender
Tender, itchy
Contagious
Usually not
No
Long term
Settles once the cause stops
Recur with shaving
Scars
Rarely; dark marks possible
Dark marks and keloids possible
Who gets it
Shaving, friction, hot tubs
Coarse, curly hair; shavers

What is it?

Folliculitis
Ingrown Hairs
What is it?

It is inflammation of hair follicles.
It can be superficial or deeper.

It ranges in severity.
A small pustule can sit around a hair, while deeper infection can form a boil.

Not every case is infection.
Irritation after hair removal or reactions to products can look similar.

Scalp scarring needs attention.
Some follicle disorders can permanently damage hair.

Overview
Inflammation around hair follicles can produce itchy or sore bumps and pustules. Bacteria, yeast, irritation and occlusion are among the causes. This broad category includes Malassezia folliculitis; the cause determines treatment. Inflammation around hair follicles can produce itchy or sore bumps and pustules. Bacteria, yeast, irritation and occlusion are among the causes. This broad category includes Malassezia folliculitis; the cause determines treatment.

A hair grows back into skin.
A curved or sharply cut hair pierces the skin or follicle wall.

The skin reacts to it.
The body treats the embedded hair as foreign material.

Curly hair is more prone.
Coarse, curved hair increases risk, but any hair type can be affected.

Deep lumps need assessment.
Painful lumps, drainage or scarring may signal infection or another disorder.

What it looks like

Folliculitis

mild folliculitis on an adult thigh, close-up small field of skin with fine leg hair and a few discrete small red papules and tiny white pustules centered exactly on hair follicles. No large abscesses, no boils.

Bacterial folliculitis Staph infection, the most common.

hot-tub folliculitis on an adult upper torso, a small field of discrete red follicle-centered papules and a few tiny pustules, scattered across chest and flank, mild realistic findings. No swimwear, no hot tub scene, no exaggerated infection.

Hot-tub folliculitis From bacteria in poorly treated water.

Malassezia (yeast) folliculitis on an adult chest, showing numerous small monomorphic follicle-centered red papules and a few tiny pustules, all similar size. No comedones, no nodules, no confluent rash.

Yeast folliculitis Uniform itchy bumps on chest and back.

pseudofolliculitis barbae, razor bumps on the anterior neck below an adult beard, showing scattered small inflamed follicular bumps with short tightly curled dark stubble and a few visible curved ingrown hairs; medium-brown skin. No pus-filled abscesses.

Razor bumps (pseudofolliculitis) From hairs curling into skin.

Ingrown Hairs

Ingrown Hairs: Bumps after shaving; Razor bumps.

Razor bumps Pseudofolliculitis barbae in the beard area.

Representative image of an ingrown hair bump in a skin fold.

Bikini-line ingrown hairs Bumps after shaving or waxing.

A firm raised skin lump with a curled hair, representing an ingrown-hair cyst.

Ingrown-hair cyst A deeper, larger lump.

Ingrown Hairs: Trapped hair.

Individual ingrown hair A hair visible under the skin.

Skin tones
The back of the neck and upper back on fair skin, covered in small red bumps of even size, each one at a hair opening, several with a pinpoint of yellow-white pus.
The back of the neck and upper back on medium olive skin, with small dull pink-brown bumps of even size, each one at a hair opening, a few with a pale point of pus.
The back of the neck and upper back on brown skin, with small bumps of even size that read brown and violet rather than red, each one sitting at a hair opening.
The back of the neck and upper back on deep brown skin, with bumps of even size at the hair openings that read dark brown, and a few flat darker marks beside them where earlier bumps have healed.
A few firm pink bumps scattered under the jaw and along the upper neck on light skin, with a dark loop of hair visible over one of them.
Firm bumps grouped under the jaw and along the upper neck on medium olive-toned skin. The bumps read dusky pink to tan rather than red, and a dark loop of hair is visible over one of them.
Firm bumps crowded under the jaw and along the upper neck on brown skin. The bumps look brown to violet rather than red, and a dark loop of hair is visible over one of them.
Firm bumps crowded under the jaw and along the upper neck on deep brown skin. The bumps read brown to violet rather than red, with mottled darker marks between them and one firm raised scar along the jaw.
Diagram
Folliculitis mechanism diagram. A follicle becomes irritated: Microbes or physical irritation can start inflammation. Immune cells gather: The response surrounds the affected follicle. A small pustule may form: A tender bump appears around the opening.
Ingrown Hairs mechanism diagram. A short hair curves back: Curly hairs can re-enter nearby skin. The tip pierces the surface: The hair becomes trapped in the skin. A local reaction forms: Inflammation causes a tender raised bump.
In the skin

Infection, irritation or blockage can cause inflammation around a hair follicle. The response may produce a small tender bump or pustule around the follicular opening.

A hair curves back into nearby skin instead of continuing outward. The trapped hair triggers a local inflammatory reaction that can form a tender raised bump.

Where it shows up

Hair-bearing skin
Shaved or plucked areas

When it usually starts

010203040506070+

Folliculitis. Folliculitis Any age There is no single typical starting-age range. Bumps can follow shaving, friction, sweating or hot-tub exposure. Recurrent or unexplained episodes deserve an assessment of the cause.

Ingrown Hairs. Usually begins after shaving or other hair removal, particularly after puberty.

Causes and triggers

Causes

Folliculitis is inflammation of hair follicles, usually from bacteria, yeast or irritation.

Folliculitis describes a pattern of inflammation rather than one organism. Damaged or occluded follicles may become infected; shaving-related irritation can produce similar bumps without infection.

Ingrown hairs happen when a cut or broken hair curls back into the skin. The body treats the hair as a foreign object and becomes inflamed.

Family tendency

Most everyday folliculitis is not considered an inherited disorder. Skin conditions and individual susceptibility can influence risk.

Tightly curled hair is inherited and is the biggest single risk.

Risk factors
Shaving, Diabetes, Obesity, Weakened immunity, Shaving or waxing, Sweat and occlusion, Reduced immunity
Curly or coarse hair, Frequent shaving, Waxing and plucking
Trigger
● Folliculitis
● Ingrown Hairs
Shaving and waxing
Well established
Not listed
Hot tubs
Well established
Not listed
Tight clothing and sweat
Strong link
Not listed
Antibiotics or steroid creams
Possible
Not listed
Stress
Not a typical trigger
Not listed
Hormonal changes
Not a typical trigger
Not listed
Pore-clogging products
Can contribute
Not listed
Sun exposure
Not a typical trigger
Not listed
Heat and sweating
Common trigger
Not listed
Alcohol
Not a typical trigger
Not listed
Spicy foods
Not a typical trigger
Not listed
Harsh skin care
Can contribute
Not listed
Friction and tight clothing
Common trigger
Not listed
Shaving or waxing
Common trigger
Not listed
Poorly maintained hot tubs
Can contribute
Not listed
Prolonged antibiotic use
Can contribute
Not listed
Close shaving
Not listed
Well established
Shaving against the grain
Not listed
Strong link
Dull razors
Not listed
Strong link
Tight clothing
Not listed
Possible

Daily Care

Folliculitis
Ingrown Hairs
Daily care

Habits that help

  • Change how you shave
    Fresh single blade, with the grain, with gel, days off when sore.
  • Shower and change after sweating
    The most effective habit for trunk, buttocks and thighs.
  • Warm compresses on a tender lump
    Help a boil come to a head and drain.
  • A gentle cleanser and moisturizer
    An intact barrier means fewer inflamed follicles.
  • Loose clothing over the area
    Remove the occlusion and mild folliculitis often settles.
  • An antifungal shampoo as a body wash
    The standard approach for Malassezia yeast.
  • Prescription treatment when needed
    The wrong class is a common reason for failure.

Avoid

  • Avoid: Close shaving with a dull razor
    Cutting below the surface damages the follicle.
  • Avoid: Shaving against the grain
    Stretching the skin does the same.
  • Avoid: Dry shaving
    More drag, more nicks, more inflamed follicles.
  • Avoid: Staying in damp workout clothes
    A reliable way to bring on a crop.
  • Avoid: Tight, non-breathable fabrics
    Trap heat and sweat over the follicles.
  • Avoid: Squeezing and picking
    Pushes infection deeper, turning a spot into a boil.
  • Avoid: Scrubbing and exfoliating
    Damages the follicle openings and the barrier.
  • Avoid: Heavy oils and pomades
    Especially under clothing or a hat.
  • Avoid: Poorly maintained hot tubs and pools
    Weak disinfection lets Pseudomonas survive.
  • Avoid: Sharing razors and towels
    Moves Staphylococcus aureus around.

Habits that help

  • Stop shaving for three to four weeks
    The most effective single treatment.
  • Clippers or a guarded trimmer
    A millimeter of stubble keeps the tip out.
  • A single-blade or safety razor
    Cuts at the surface.
  • Shave with the grain
    Do not stretch, press or repeat.
  • Shave less often
    Every second or third day, never over bumps.
  • Soften first, then lubricate
    Warm water, then gel.
  • An electric foil or rotary shaver
    Cuts above the skin.
  • Sun protection
    Protect healing skin from sunlight to limit darkening of marks.
  • A chemical depilatory cream
    Leaves a soft, feathered end.
  • Eflornithine cream
    Prescription, slows facial hair regrowth.

Avoid

  • Avoid: Shaving as close as possible
    The tip ends below the skin surface.
  • Avoid: Multi-blade cartridge razors
    Later blades cut below the surface.
  • Avoid: Stretching the skin taut while shaving
    The cut hair vanishes as skin relaxes.
  • Avoid: Shaving against the grain
    A closer cut, a sharper tip.
  • Avoid: Going over the same patch repeatedly
    Bumps come from the later passes.
  • Avoid: Shaving every day, or over bumps
    Inflamed skin needs time to settle.
  • Avoid: Dry shaving, or shaving with bar soap
    The blade drags and irritates.
  • Avoid: A dull or dirty blade
    Tugs the hair and leaves a worse tip.
  • Avoid: Waxing, tweezing and epilating
    The regrowing hair has to reopen its way out.
  • Avoid: Digging a hair out with a needle
    Turns a bump into a wound.
  • Avoid: Picking and squeezing
    The same damage, more often.
  • Avoid: Gritty scrubs and stiff brushes
    Inflammation, and the hair stays put.
  • Avoid: Alcohol-heavy aftershaves
    Sting broken skin, add irritation.
  • Avoid: Tight collars, straps and underwear
    Friction pushes hairs back in.
  • Avoid: Sun on healing marks
    Makes marks deeper and slower to fade.

Treatment differences

Evidence labels come from each condition’s own treatment list.

Treatment
● Folliculitis
● Ingrown Hairs
Filter by type
Folliculitis type

Select one or more.

Ingrown hair pattern

Select one or more.

Over-the-counter
Three acne wash tubes on white: Differin Deep Cleanser, CeraVe Acne Foaming Cream Cleanser and PanOxyl.

Benzoyl Peroxide wash

Limited evidence

A 4 to 10 percent wash lathered on in the shower and left for a minute before rinsing, for the bacterial kind on the thighs, buttocks, chest and back. It lowers the bacteria on the skin without an antibiotic, which is why it also works as a maintenance measure for people who keep getting crops. It bleaches towels, sheets and colored clothing, so use white ones.

Existing Dermapedia illustration of chlorhexidine wash.

Chlorhexidine wash

Limited evidence

An antiseptic wash used two or three times a week over the affected area, and a good option for someone whose bumps keep coming back in the same place. It lowers the bacterial load on the skin rather than treating an established infection. Keep it away from the eyes and ears, and stop if it stings or dries the skin, since damaged skin is the problem you started with.

Existing Dermapedia image for Ketoconazole shampoo as a wash.

Ketoconazole shampoo as a wash

Limited evidence

The standard first move for the yeast kind: itchy, uniform bumps on the chest, back and shoulders, often worse after a course of antibiotics. Use the shampoo as a body wash a few times a week and leave it on for several minutes before rinsing. It does nothing for bacterial folliculitis or razor bumps, and yeast folliculitis tends to come back, so many people keep using it once a week.

A plain white ointment tube lying on its side, labeled Hydrocortisone with a blue swoosh

Hydrocortisone

Limited evidence

It is the obvious thing to reach for because the bumps itch, and it is usually the wrong one. Steroid cream quietens the itch for a few days while the infection in the follicles carries on underneath, and the rash that comes back is often more widespread. It also changes how things look, which makes the diagnosis harder afterward. Cool compresses and a medicated wash are the safer starting point.

Paula's Choice 2% BHA exfoliant, La Roche-Posay Effaclar cleanser and a CeraVe psoriasis cream pump

Salicylic Acid

Limited evidence

A leave-on 2 percent lotion or pad on the beard, neck or bikini line, where the problem is hairs curling back into the skin rather than an infection. It keeps the follicle opening clear so fewer hairs get trapped, and it is used between shaves rather than on raw skin. It will not touch a bacterial or yeast folliculitis, and on already inflamed skin it stings and can make things worse.

Five dark glass tea tree essential oil bottles with glass droppers and one green box on white

Tea Tree Oil

Limited evidence

It does have some activity against bacteria and yeast in the laboratory, which is why it appears in so many folliculitis remedies. There are almost no proper trials of it in folliculitis, and undiluted tea tree oil is a common cause of allergic contact dermatitis, which produces an itchy rash on top of the one you were treating. A benzoyl peroxide or antifungal wash is the better use of the same shower.

Paula's Choice 2% BHA exfoliant, La Roche-Posay Effaclar cleanser and a CeraVe psoriasis cream pump

Salicylic Acid

Limited evidence

Does much the same job as glycolic acid and suits oilier skin and the bikini line better, because it gets into the follicle itself. Two or three times a week is enough. It is not an exfoliating scrub, and it will not free a hair that is already trapped.

Illustration: Generic topical cream tube and white cream.

Depilatory cream

Limited evidence

A chemical hair remover dissolves the hair rather than cutting it, leaving a soft feathered end that does not spear the skin. Used every few days instead of shaving it genuinely reduces bumps. The trade-off is real: it smells strong and it irritates or burns some people, so test a small patch and never use it on skin that already has active bumps.

Existing reference image of Microneedling vs Microdermabrasion — At Home.

Exfoliating scrubs and brushes

Limited evidence

Gritty scrubs and stiff brushes are sold for this and they are the wrong tool. Scrubbing does not free a hair that is already through the follicle wall, and it adds inflammation to skin that has too much. If you want exfoliation here, use a gentle glycolic or salicylic acid instead.

Five adapalene gel 0.1% tubes and boxes lined up on white, including Differin, Effaclar, PanOxyl and Neutrogena

Adapalene

Limited evidence

A retinoid gel used at night on the shaved area. It thins the plug over the follicle opening so a growing hair is more likely to find its way out, and it slowly evens the dark marks left by old bumps. It takes six to twelve weeks and it does not stop a hair curving back in, so it works alongside a change of razor rather than instead of one.

Four glycolic acid toner and liquid bottles lined up on white, one with its box

Glycolic Acid

Limited evidence

A leave-on lotion or toner used two or three times a week keeps the follicle openings clear, which is the point where a curved hair gets stuck. It also helps the flat dark marks fade. Use it on days you do not shave, because acid on freshly shaved skin stings and adds irritation.

Three acne wash tubes on white: Differin Deep Cleanser, CeraVe Acne Foaming Cream Cleanser and PanOxyl

Benzoyl Peroxide

Limited evidence

Worth adding when the bumps carry pinpoints of pus, because bacteria have joined in on top of the trapped hair. A wash or a low-strength gel on the shaved area is enough. It does nothing about the hair itself, and it bleaches towels and collars, so keep the strength low and the expectations modest.

Five azelaic acid tubes and bottles on white, most marked 10 percent, from Peach Slices, Paula's Choice, Facetheory, The Ordinary and Naturium

Azelaic Acid

Limited evidence

Aimed at the marks rather than the bumps. It calms inflammation and slowly lifts the flat dark patches left along the jaw and neck, and it is gentle enough for skin that is shaved regularly. It works over months, not weeks, and only once new bumps have stopped forming.

Prescription topicals
Mupirocin — Header Image

Mupirocin

Moderate evidence

Clearing Staph from the nose. Some people carry Staphylococcus aureus in the nostrils or skin folds, which is one reason boils keep returning to the same person. A course of antibiotic ointment inside the nostrils, together with antiseptic washes and hot washing of towels and bedding, can reduce that. It is used for repeated boils rather than for a single episode, and it does not always hold, so household measures matter alongside it.

A white metal tube lying at an angle on a white background, white ribbed cap to the left, labeled Clindamycin in black lettering with a teal swoosh curving beneath the word.

Clindamycin

Limited evidence

A lotion or solution for bacterial folliculitis spread over a wider area than an ointment can cover, such as the beard or the back. It is usually paired with a benzoyl peroxide wash, which both improves it and reduces resistance. It is not the answer if the same patch keeps returning, because that is a shaving, friction or occlusion problem rather than an antibiotic one.

A plain white ointment tube lying on its side, labeled Hydrocortisone with a blue swoosh

Hydrocortisone

Limited evidence

A low-strength steroid cream calms a badly inflamed patch quickly and takes the soreness out of it. It is a short course of days, prescribed for a specific flare, not something to keep using. Facial and neck skin thins with repeated steroid use, and it does nothing about the hair that caused the bump.

A white metal tube lying at an angle on a white background, white ribbed cap to the left, labeled Clindamycin in black lettering with a teal swoosh curving beneath the word.

Clindamycin

Limited evidence

An antibiotic lotion, usually prescribed with benzoyl peroxide, for when a lot of the bumps have gone pustular. It settles the infected ones faster than benzoyl peroxide alone. It is a short course rather than a permanent fix, because the trapped hair, not the bacteria, is what starts each bump.

Eflornithine

Moderate evidence

Eflornithine cream. A prescription cream that slows facial hair regrowth, so there is less hair to cut and shaving can be done less often. It is used twice a day on the face and neck alongside your usual hair removal, not instead of it. It does not remove hair, and the effect fades within weeks of stopping.

Tretinoin — Header Image

Tretinoin

Limited evidence

The prescription-strength version of the retinoid approach, used at night on the beard and neck. It keeps follicle openings clear and does more for the dark marks than anything else on a shelf. It makes skin drier and more easily irritated by a razor for the first month or two, so build up slowly and shave more gently while you do.

Prescription pills
Cephalexin

Cephalexin

Moderate evidence

The usual first antibiotic tablet for bacterial folliculitis that is deep, spreading or too widespread for a cream, and for boils with surrounding redness. A course is normally about seven days. It has no effect on yeast folliculitis or razor bumps, and if the same area keeps flaring after each course, the cause is still there rather than the antibiotic being wrong.

Trimethoprim-sulfamethoxazole

Trimethoprim-sulfamethoxazole

Moderate evidence

Used when resistant Staphylococcus aureus is likely or has been grown on a swab, which is the situation in which the first antibiotic did not work. This is the main reason for swabbing a spot before starting treatment. It is avoided in pregnancy and with some other medicines, so tell the prescriber everything you take.

16:9 hero for Fluconazole. Never cropped: the tone strip and the corner logo depend on the full frame.

Fluconazole

Limited evidence

An antifungal tablet, usually a short weekly course, for yeast folliculitis that is widespread or has not cleared with washes alone. It works faster and more completely than topical treatment on the chest and back. The yeast lives on everyone and comes back, so it is normally followed by an antifungal wash once a week to hold it.

An amber prescription bottle lying on its side on a white background with a plain white label reading Doxycycline, and six small round white tablets spilled out in front of it.

Doxycycline

Limited evidence

A longer course is sometimes used for stubborn or recurring folliculitis, partly for the bacteria and partly because it calms inflammation. It is a second choice rather than a first one, since it can allow yeast folliculitis to take hold. It also causes sunburn easily, so it needs daily sunscreen on anything the sun reaches.

None listed
Injections
None listed
Editorial illustration for Cortisone Injection, based on the entry’s treatment or equipment reference.

Cortisone Injection

Limited evidence

A steroid injected directly into a firm raised or keloid scar left by old bumps. It flattens and softens the scar over a series of visits a few weeks apart. It treats what is already there and does nothing to prevent the next one, and repeated injections can leave a pale or dented patch.

Procedures
Editorial illustration for Incision and Drainage, based on the entry’s treatment or equipment reference.

Incision and Drainage

Moderate evidence

Draining a boil. A boil that has come to a head is opened with a small blade under local anesthetic and the pus is let out, which relieves the pain almost immediately. It is often the whole treatment, with antibiotics only added if the redness is spreading. Done properly it heals with a much smaller mark than a squeezed boil, which is the argument for having it done rather than attempting it at home.

Editorial illustration for Laser Hair Removal, based on the entry’s treatment or equipment reference.

Laser Hair Removal

Limited evidence

For folliculitis and razor bumps driven entirely by shaving, particularly in the beard and neck, reducing the hair removes the cause instead of treating the result. It usually takes six or more sessions and works best with a device suited to your skin tone, since the wrong one can burn or leave marks on deeper skin. It is worth considering after months of the same bumps rather than after one crop.

Editorial illustration for Laser Hair Removal, based on the entry’s treatment or equipment reference.

Laser Hair Removal

Strong evidence

The most durable treatment there is for this, because it reduces the number of hairs that can become ingrown at all. It usually takes a series of sessions and it thins rather than eliminates hair for most people, with occasional touch-ups. It is the option to ask about when scarring is starting or when a job requires close shaving.

Editorial illustration for Nd:YAG Laser, based on the entry’s treatment or equipment reference.

Nd:YAG Laser

Strong evidence

The specific device used for hair removal on deeper skin tones, at a wavelength of 1064 nm. It passes more safely through pigment in the skin to reach the hair, and it is used routinely for razor bumps. Ask what wavelength a clinic uses, ask how often they treat skin like yours, and have a test patch first, because settings and cooling matter more than the marketing.

Editorial illustration for Chemical Peel, based on the entry’s treatment or equipment reference.

Chemical Peel

Limited evidence

A course of light salicylic or glycolic peels aimed at the mottled dark marks across the beard and neck once the bumps have stopped. On deeper skin tones it has to be done cautiously and by someone who treats them regularly, because too strong a peel causes exactly the darkening you are trying to clear. It does nothing for the bumps themselves.

Editorial illustration for Electrolysis, based on the entry’s treatment or equipment reference.

Electrolysis

Limited evidence

Destroys hairs one follicle at a time with a fine probe, so it can permanently clear a small stubborn patch. It is slow and uncomfortable over a beard-sized area, which is why laser is the usual choice here. It is worth considering for a few repeatedly troublesome spots rather than a whole neck.

Outlook

Long term

Many superficial cases settle with appropriate care, but repeated episodes need assessment for an ongoing contributor such as shaving, friction or infection. The course depends on the type; deeper inflammation can take longer to heal and may scar.

A single ingrown hair follows a short, predictable course; the long-term picture depends on what happens to it. Stop removing the hair and this condition stops - beards grown out for three to four weeks usually clear almost completely. Established scarring does not reverse, which is the argument for changing course early.

Complications

Possible complications
  • Boils and carbuncles
  • Cellulitis
  • Keloid scars
More details

Boils and carbuncles
When the infection goes further down the follicle it becomes a boil: a tender, swollen lump that comes to a head over several days. Several joined together are called a carbuncle. Squeezing is what turns a surface bump into one of these, so warm compresses and leaving it alone are the right first move. Boils often need draining or oral antibiotics, and they can leave a scar.

Cellulitis
Sometimes the infection leaves the follicle and spreads into the surrounding skin. The signs are redness, swelling and warmth spreading outward from the spot rather than staying in it, sometimes red streaks running away from it, and often a fever. That is a same-day problem needing oral antibiotics, and it is more likely in people with diabetes or a weakened immune system.

Keloid scars
Deep folliculitis on the chest, shoulders, jawline and the back of the neck can heal into raised, thickened scars, and that risk is higher on deeper skin tones. At the nape there is a specific pattern, acne keloidalis nuchae, where the bumps become firm and permanent and the hair in that patch is lost. It responds far better to early treatment than to waiting, so firm bumps building at the back of the neck are a reason to be seen rather than to keep treating at home.

  • Dark marks that outlast the bumps
  • Raised and keloid scars
  • Bumps at the nape of the neck
More details

Dark marks that outlast the bumps
Every inflamed bump can leave a flat darker patch behind, and those patches routinely take several months to fade. They are the most common thing people are left with, and on deeper skin tones they are the most noticeable. They will not clear while new bumps keep forming, so stopping the bumps does more for them than anything applied on top. Daily sunscreen helps, because sun makes them deeper and slower to go.

Raised and keloid scars
Where bumps keep forming in the same place and are shaved over or picked, the skin can build firm raised scars, and in some people keloids that grow beyond the original bump. They form most readily along the jawline, the front of the neck and the nape, and more readily on deeper skin tones. Once a keloid is there it is difficult to treat, so changing the shaving early is worth much more than anything applied later.

Bumps at the nape of the neck
Firm bumps along the hairline at the back of the head are a separate problem called acne keloidalis nuchae. They can thicken into keloid-like scars and leave permanent bald patches, and it is far more common in people with tightly curled hair. It needs treating earlier and harder than bumps anywhere else, because that scarring does not reverse. Bumps in this spot are a reason to book rather than wait.

When to get help

When to get help

Arrange assessment if the rash persists, keeps returning, is extensive or has not responded to treatment. A pustule swab may help distinguish bacteria and guide treatment.

Seek prompt medical care for fever, rapidly spreading redness or warmth, worsening pain, a large deep lump, or feeling unwell. Seek care earlier if your immune system is suppressed.

Bumps around the eye with eye pain, swelling, light sensitivity or vision change need prompt assessment. Do not apply body washes or skin medicines into the eye.

Seek care for recurring painful bumps, scarring or pus. A large painful swelling or spreading redness may need treatment for infection.

Common questions

Folliculitis:How do I tell folliculitis from acne?

Look for blackheads and whiteheads. Acne has them, folliculitis does not. Folliculitis bumps are all the same size, each sits at a hair, they itch more than they hurt, and they appear where you shave, sweat or rub - thighs, buttocks, beard, chest, back. Acne sits on the face, chest and upper back, has spots of different sizes, and is not itchy.

Folliculitis:Is it contagious?

Mostly not in ordinary contact. The bacteria can pass through shared razors, towels, unwashed sports gear and close skin contact - avoid those while it is active. Yeast folliculitis and razor bumps are not caught.

Folliculitis:Why does it keep coming back in the same place?

Because the cause is still there - the shaving method, friction, damp clothes, or a yeast cause treated as bacterial. Some people also carry Staphylococcus aureus long term, which can be tested and treated.

Folliculitis:Can I still shave?

Yes, but change how. A fresh single-blade or safety razor, with the grain, with gel, and no stretching the skin. Take days off while the skin is inflamed. For persistent razor bumps, laser hair reduction is a longer-term option.

Folliculitis:Should I use hydrocortisone on the itch?

Not on undiagnosed bumps. Steroid creams calm the itch for days while the infection carries on underneath, and the rash comes back more widespread. If itch is the main problem, a medicated wash and cool compresses are safer.

Folliculitis:Will it scar?

Superficial folliculitis heals without scarring, though flat dark marks take months to fade on deeper skin tones. Deep folliculitis and boils can scar, and firm raised bumps at the back of the neck can scar permanently - reasons to be seen early rather than keep treating at home.

Ingrown Hairs:Can I just pull the hair out?

Not out - free it. If a loop of hair crosses the bump, a sterilized needle can lift it from underneath and leave the hair rooted in the follicle. Pulling the whole hair out means the next one grows back through inflamed skin, which often makes another bump in the same place. Never dig for a hair you cannot see. That is how bumps become scars.

Ingrown Hairs:Will laser hair removal work if I have deep skin tone?

Yes. The concern comes from older devices. The standard choice now for deeper skin tones is a long-pulsed 1064 nm Nd:YAG laser, which reaches the hair with less risk to surrounding pigment. It takes a series of sessions, reduces rather than eliminates hair, and touch-ups are common. Ask what wavelength they use, how often they treat skin like yours, and have a test patch.

Ingrown Hairs:Do I have to stop shaving forever?

No. Most people go back to shaving once the bumps clear, as long as it is different from what caused the problem - usually a single blade or trimmer, with the grain, less often, without stretching the skin. If close shaving is unavoidable and bumps keep returning, laser lets you have both.

Ingrown Hairs:Why do I get them on my neck but not my cheeks?

The hair on the neck grows in swirls and changes direction over short distances, so a stroke with the grain in one spot is against it an inch away. The skin there is softer and easier to pull taut. The neck and under the jaw are the classic sites.

Ingrown Hairs:How long do the dark marks take to fade?

Longer than anyone wants. A mark from one bump commonly takes several months. Years of repeated bumps take longer, and nothing fades while new bumps keep forming. Two things speed it up: stopping the new bumps, and daily sunscreen.

Ingrown Hairs:Is this acne?

No, though they look similar and sometimes occur together. Acne begins with a clogged oil gland and features blackheads and whiteheads. This begins with a hair growing back into the skin, appears in shaved areas, and follows the shaving schedule. Some acne treatments help, but not the cause.

Sources

Sources and further reading

  1. DermNet: Folliculitis
  2. DermNet: Bacterial folliculitis
  3. American Academy of Dermatology: Acne-like breakouts could be folliculitis
  4. DermNet
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