Severe Scalp Folliculitis: What to Know

Folliculitis is inflammation around hair follicles. On the scalp, it may look like pimples or small skin bumps, with itching, soreness, crusting or pus. Friction, sweat, occlusive hair products, shaving, ingrown hairs and bacterial or yeast overgrowth can contribute. More extensive inflammation may make brushing uncomfortable and can sometimes irritate follicles enough to cause temporary shedding. It is not the same as ordinary dandruff, although an itchy scalp can occur with both.

Wash gently with lukewarm water and a mild cleanser, then pat the scalp dry. Pause heavy oils, tight headwear, picking and close shaving until the skin settles. Do not squeeze bumps or share combs, towels or pillowcases. A clinician may examine the scalp and decide whether topical antibiotic therapy or antibiotics for a skin infection are appropriate; treatment depends on the cause and extent, so avoid using leftover medicine.

Arrange prompt medical care for rapidly spreading redness, increasing warmth, severe tenderness, repeated pus, fever, swollen glands, open sores or noticeable patches of hair loss. Seek urgent help if you feel very unwell or swelling affects the face or eyes. A persistent or recurring eruption deserves dermatology review even when pain is modest, because scarring can develop in some forms of scalp folliculitis.

Ask whether the pattern suggests bacterial folliculitis, yeast-related inflammation, ingrown hairs or another scalp condition. Discuss whether a swab, treatment wash or prescription medicine is needed, how long to use it, and which hair products or grooming habits should be avoided.