Does Folliculitis Cause Hair Loss? Symptoms, Causes and Treatment Options

Key Takeaways

• What does folliculitis look like? Folliculitis appears as raised red bumps around individual hair pores. These bumps may contain pus, giving them a yellow or whitish centre.

• What causes folliculitis? Folliculitis can have infectious or non-infectious causes.

• What are the symptoms? You may feel itching alongside tenderness of the affected area.

• Can folliculitis cause hair loss? Permanent hair loss does not usually result if the inflammation is limited to the skin surface (superficial). 

• When should you see a doctor? If the condition doesn’t go away, spreads, repeatedly returns, becomes very painful or is accompanied by hair loss or scarring, seek an assessment from your GP, dermatologist or another qualified healthcare professional.

Folliculitis is the inflammation of a hair follicle (the opening in the skin from which hair grows).

It can develop anywhere there is hair-bearing skin, including the scalp, face, back, neck, chest, and thighs. Our focus here will mainly be on scalp folliculitis and how it might affect hair growth on one of our body’s most visible areas.¹

What Causes Folliculitis?

The causes of folliculitis can be infectious or non-infectious. They include bacterial infection, irritation, physical trauma, and certain medications. To identify a cause, your doctor may ask about shaving, friction, prolonged headwear, water exposure, medication use, and health conditions that affect how your immune system works.^1,2

What separates the severity of folliculitis is the depth at which the inflammation is present. When on the surface, the follicle likely remains largely unaffected. It is when the inflammation has reached the deeper parts of the follicle that it can sustain more lasting damage. Scarring of the follicle causes the cells to lose their function and they are no longer able to produce hair as normal. This is why it is vital to get your scalp checked by a professional and not ignore it when things don’t feel quite right.

Dr Dilan Fernando, Hair Transplant Surgeon, The Treatment Rooms London

Bacterial folliculitis

It is the most common cause of folliculitis, and Staphylococcus aureus causes most bacterial folliculitis cases. It usually lives harmlessly on the skin but causes infection when the skin barrier or follicle is disrupted.²

Fungal / yeast (Malassezia folliculitis)

Some cases are caused by fungi, with Malassezia folliculitis (formerly pityrosporum folliculitis) being the best-known example. Fungal folliculitis is commonly mistaken for acne because both conditions can affect areas such as the upper torso, shoulders, and face. Using antibiotics will not treat the underlying fungal infection and may delay the correct treatment.³ Antifungals are the correct remedy in this case

Viral

Herpes-family viruses are an important culprit of viral folliculitis. It presents as clusters of painful, fluid-filled blisters called vesicles.²

Irritation, friction, and blockage

Physical trauma to the follicle can contribute to inflammation. Some of these triggers are preventable, so identifying and reducing them may help stop further episodes. Things that can add to the inflammation are: prolonged headwear use, repeated rubbing or scratching, shaving, excessive heat and sweat, and using heavy oils or pomades.^1,3

Medication-related

Some medications like corticosteroids and certain targeted cancer treatments can cause acne-like follicular eruptions rather than a true infection.

If you believe your folliculitis is brought on by a medication, you should discuss it with your prescribing doctor to find a suitable resolution.⁴  Avoid stopping or changing medications without consulting your doctor first.

Eosinophilic folliculitis

Eosinophilic folliculitis occurs primarily in the context of advanced HIV and produces an intensely itchy rash centred on the hair follicles.⁵

What Are the Symptoms?

Superficial folliculitis most often causes small raised red bumps, often with a yellow or whitish centre that are itchy or tender. 

Deep folliculitis extends further into the follicle, usually causing swellings that are larger and more painful, alongside a higher risk of scarring. There may be crusting and oozing in more severe cases.

A few mild bumps may settle with gentle care and avoiding known triggers. It is best to get it checked out if you notice any of the following:

• Smooth or shiny hairless patches

• Several hairs emerging from a single opening (tufting)

• Soft, swollen lumps that feel as though they contain fluid

• Pain, rapid spread, or repeated recurrence

• Anything persisting despite treatment

Your GP or dermatologist will be able to guide you further in these circumstances.

How Folliculitis Is Diagnosed

Your doctor will usually start with a medical history and scalp examination. They may ask about timing, recurrence, hair products, headwear, shaving, medicines, health conditions, and recent surgery. By asking these questions, they are trying to find out a potential source of the inflammation. Depending on what the examination shows, they may also take a bacterial swab, arrange fungal testing, examine the scalp with a dermatoscope (a handheld magnifying device), or recommend a biopsy.^1,6

Can Folliculitis Cause Hair Loss?

Yes, folliculitis can cause hair loss. This depends on the type of folliculitis. The biggest determining factor is whether the inflammation is confined to the surface or extends deeper into the follicle. This is what primarily determines whether the hair can return or not after the inflammation settles.

Non-scarring folliculitis

Superficial folliculitis does not usually destroy the follicle, so permanent hair loss is unlikely. Even if shedding occurs, regrowth is still possible once the underlying inflammation is controlled.

Types less likely to cause scarring include superficial bacterial folliculitis, Malassezia folliculitis, irritant or occlusive folliculitis, and medication-related types.^1-4

Scarring (cicatricial) folliculitis

Hair cannot be expected to regrow from follicles that have already been replaced by scar tissue. Conditions more likely to cause scarring include folliculitis decalvans and deep or recurrent bacterial folliculitis.^1,6,7

Why Early Treatment Matters

It is important to recognise symptoms early as this gives you the best chance of minimising the extent of scarring to follicles, which can lead to permanent hair loss. In scarring disease, the realistic goal is to control progression and protect the follicles that remain healthy.^6,7

Will My Hair Grow Back?

Regrowth of hair remains a possibility as long as the follicle itself is not damaged by the inflammation. If scar tissue has developed in place of the follicle, the hair will not grow back from that damaged follicle.

How Is Folliculitis Treated?

Treatment depends on the cause.

Treatment will be guided by the cause. Bacterial disease may require antibiotics. Fungal-related disease requires antifungal treatment, while viral folliculitis may require antiviral medication. 

For HIV-associated eosinophilic folliculitis, antiretroviral therapy is the primary treatment, with additional treatments considered for symptom control. Medication-related eruptions require input from the prescribing doctor rather than a one-size-fits-all approach.^2-5,8

Remember, even when rashes appear identical, the underlying cause may be very different. It is best to consult a qualified doctor before starting any particular line of treatment if symptoms are persistent, recurrent, or severe.

Treating folliculitis decalvans

Folliculitis decalvans is a chronic inflammatory condition that causes scarring to the hair follicles, leading to irreversible hair loss. Its cause is not fully understood, although an abnormal immune response to the bacterium Staphylococcus aureus is widely believed to be involved. Treatment aims to control inflammation, relieve symptoms, and prevent further scarring.

Current recommendations include taking isotretinoin for mild active disease, oral antibiotics for moderate or severe disease, and, in highly active cases, a short course of systemic corticosteroids. Although combination approaches may help, the certainty of the evidence remains limited.^7,9 Treatment for this condition should be guided by your doctor.

Medication for hair regrowth.

Hair-growth medication is not a substitute for treating active folliculitis. A first priority is to identify and control the underlying cause. After all, medication cannot restore follicles that have already been destroyed by scarring.⁶

Self-care and prevention

Prevention is mainly relevant where mechanical or environmental triggers can be reduced. Sensible measures include avoiding unnecessary friction, repeated picking or scratching, and other follicular irritation. Recurrent disease or symptoms suggesting deeper or scarring disease require professional assessment.^1,2

Can Folliculitis Occur After a Hair Transplant?

Follicular bumps can occur after hair transplantation, but they do not all have the same cause or require the same treatment. Inflammation may develop around grafted or existing follicles, and its timing and appearance can vary. 

Patients should contact the clinic that performed the procedure so the cause and appropriate next step can be assessed. 

If you notice these spots, do not squeeze them or begin self-treatment. Continue only with the aftercare agreed with your surgeon and contact the clinic that carried out the procedure. 

You can provide photographs of your skin to your treating clinic to aid diagnosis by the surgeon who performed the hair transplant. If you notice worsening pain, spreading redness, marked swelling, discharge, fever, or feeling unwell, then it is best to seek further advice promptly.^3,10,11

You may notice small red bumps on your scalp after a hair transplant and wonder what is going on. This is typically a direct result of the disturbance caused by the procedure and is not usually infectious. It should resolve on its own with minimal treatment. We can tell if there is a more serious bacterial process ongoing if the spots feel more outright painful than simply tender and they begin to collect pus. The best thing to do if you are concerned is to contact the clinic where your procedure was carried out. Your surgeon will be able to look at your scalp and recommend the right treatment to get it healing again. 

Dr Dilan, Hair Transplant Surgeon, The Treatment Rooms London

Can You Get a Hair Transplant If You Have Folliculitis?

Having folliculitis does not rule out the possibility of having a hair transplant. There are, however, certain criteria that need to be met, and it is important to discuss them before undergoing any transplant procedure.

Hair transplant surgery is NOT recommended while the scalp is actively inflamed or infected. In folliculitis decalvans and other primary scarring alopecias (hair loss), hair transplantation remains a treatment option only after the disease has been inactive for a while and the scalp is judged to be in a stable state.

A hair transplant redistributes follicles; it does not treat an active inflammatory scalp disease. If the diagnosis is uncertain or there is evidence of ongoing inflammation, specialist review is required before considering surgery.^7,12,13

Conclusion

Folliculitis is an umbrella term for inflammation around hair follicles. Most superficial folliculitis does not permanently damage the follicle. Permanent hair loss becomes a concern when destructive inflammation damages the cells needed for future growth and replaces them with scar tissue. 

Treatment must match the cause, and persistent symptoms or signs of scarring should be assessed promptly. 

Hair transplantation may be considered only in carefully selected cases where any underlying disease is inactive. You can discuss this, or any other concerns, during an initial consultation.

With the correct approach, it is possible to identify the causes and manage folliculitis so you can keep your scalp and hair in top shape.

References

1. Primary Care Dermatology Society. Folliculitis and boils (furuncles/carbuncles) [Internet]. Updated 6 July 2025 [cited 21 July 2026]. Available from: https://www.pcds.org.uk/clinical-guidance/folliculitis-an-overview
2. MSD Manual Professional Edition. Folliculitis [Internet]. Reviewed May 2026 [cited 21 July 2026]. Available from: https://www.msdmanuals.com/professional/infectious-diseases/bacterial-skin-infections/folliculitis
3. Chalupczak NV, Lipner SR. Malassezia folliculitis: an underdiagnosed mimicker of acneiform eruptions. J Fungi (Basel). 2025;11(9):662. doi:10.3390/jof11090662.
4. Ulrich P, Drexler K, Berneburg M, Kurz B, Niebel D. Acneiform drug eruptions—update on pathophysiology and culprit drugs. Front Med (Lausanne). 2026;13:1769362. doi:10.3389/fmed.2026.1769362.
5. World Health Organization. Evidence and recommendations on eosinophilic folliculitis. In: Guidelines on the treatment of skin and oral HIV-associated conditions in children and adults. Geneva: WHO; 2014. Available from: https://www.ncbi.nlm.nih.gov/books/NBK305422/
6. Zvezdina IV. Primary cicatricial alopecia: a literature review. Russian Journal of Skin and Venereal Diseases. 2021;24(1):5–16. doi:10.17816/dv58729.
7. Waśkiel-Burnat A, Starace M, Iorizzo M, et al. Management of folliculitis decalvans: the EADV task force on hair diseases position statement. J Eur Acad Dermatol Venereol. 2025;39(8):1385–1394. doi:10.1111/jdv.20687.
8. Lin H-S, Lin P-T, Tsai Y-S, Wang S-H, Chi C-C. Interventions for bacterial folliculitis and boils (furuncles and carbuncles). Cochrane Database Syst Rev. 2021;(2): CD013099. doi:10.1002/14651858.CD013099.pub2.
9. Sideris E, Xie D, du Plessis J, de Zwaan S. Management of folliculitis decalvans: a systematic review. Australas J Dermatol. 2025;66(8):448–461. doi:10.1111/ajd.14603.
10. Liu RH, Xu LJ, McCarty JC, Xiao R, Chen JX, Lee LN. A scoping review on complications in modern hair transplantation: more than just splitting hairs. Aesthetic Plast Surg. 2025;49(3):585–595. doi:10.1007/s00266-024-04316-3.
11. Zhou Y, Zhang J, Yi Y, Xie X, Lei R, Fan Z, et al. Characterization and risk factors of folliculitis after hair transplantation: a multicenter retrospective study. Plast Reconstr Surg. 2024;154(6):1115e–1122e. doi:10.1097/PRS.0000000000011175.
12. Ekelem C, Pham C, Atanaskova Mesinkovska N. A systematic review of the outcome of hair transplantation in primary scarring alopecia. Skin Appendage Disord. 2019;5(2):65–71. doi:10.1159/000492539.
13. Yii V, Moussa A, Triwongwaranat D, Smith BRC, Bhoyrul B. A systematic review of follicular unit graft survival rates after hair transplantation in primary cicatricial alopecia. Dermatol Surg. 2025;51(11):1052–1057. doi:10.1097/DSS.0000000000004707.