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

Key Takeaways

• What does Folliculitis look and feel like? Folliculitis appears as small raised red bumps around individual hair pores. Some of these bumps may contain pus, which can give them a yellow or whitish looking centre. The area can also feel itchy, tender or sore.
  
• What causes folliculitis? Folliculitis can be a result of an infection, but it can also arise from inflammation that isn’t related to infection, such as physical irritation, friction and blocked pores.
  
• Can folliculitis cause hair loss? It can, but most of the time, when it is limited to the superficial skin, it doesn’t typically cause permanent hair loss. If the inflammation or infection spreads deep enough to cause scarring to the follicles, then the hair loss can be permanent. 
  
• When should I see a doctor about folliculitis? If you notice that the raised bumps aren’t going away, they are spreading, repeatedly returning, becoming very painful, or are accompanied by hair loss or scarring, then seek an assessment from your GP or dermatologist. They can investigate the cause further and help prevent lasting damage to your hair follicles.

Folliculitis is inflammation of the 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. In this article, our main focus will be on scalp folliculitis and how it can impact the growth of hair on such a visible part of our body.¹

What Causes Folliculitis?

Folliculitis can be the result of an infection, or it can occur from inflammation that isn’t linked to an infectious cause. This can include bacterial infection, irritation, physical trauma, and certain medications. Your doctor may ask you about shaving, friction, prolonged headwear, water exposure, medication use, and health conditions that affect how your immune system works.^1,2

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

This information can help them find out what triggered your folliculitis and is key in formulating a treatment plan to allow you to start healing as soon as possible. Common causes of folliculitis are:

Bacterial folliculitis

Bacteria is the most common cause of folliculitis. Most cases are the result of Staphylococcus aureus, which usually lives harmlessly on the skin, but can cause infection when the skin barrier or follicle is disrupted.²

Fungal / yeast (Malassezia folliculitis)

Some cases are caused by fungal infection, with Malassezia folliculitis (formerly pityrosporum folliculitis) being the best-known example. Fungal folliculitis can be mistaken for acne because both conditions affect similar areas such as the upper torso, shoulders, and face. Using antibiotics will not tackle a fungal infection and may delay the correct treatment.³ Instead, you will need a course of antifungals to deal directly with this type of infection.

Viral

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

Irritation, friction, and blockage

If the follicle sustains physical trauma, then it can become inflamed. You can prevent some of these triggers, so it is important to identify and reduce them to help stop further outbreaks.

For example, using headwear for prolonged periods of time, repeatedly rubbing or scratching your head, shaving, excessive heat and sweat, and using heavy oils or pomades can all contribute to mechanical folliculitis.^1,3

Medication-related

Some medications like corticosteroids and certain targeted cancer treatments can cause you to break out in acne-like follicular eruptions. 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 people with advanced HIV and produces an intensely itchy rash which is centred on the hair follicles.⁵

What Are the Symptoms?

Superficial folliculitis often appears as small raised red bumps, sometimes with a yellow or whitish centre, that tend to be itchy or tender. 

Deep folliculitis reaches further into the follicle, usually causing swellings that are larger and more painful. When it is more severe, you may see crusting and oozing of the affected scalp. 

Mild cases can settle if you care for the area gently and avoid any triggers which bring on the inflammation. Don’t hesitate 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 assess you more thoroughly and guide your further treatment in these circumstances.

How Folliculitis Is Diagnosed

Your doctor will usually start with your medical history and a scalp examination. They may ask about:

• When it began and how long it has been present
  
• Whether it is happening on and off on separate occasions
  
• What hair products you use
  
• Whether you use any headwear
  
• Your shaving habits and if you shave your scalp
  
• Any medicines you might be taking
  
• Any current or previous health conditions
  
• Whether you have recently had 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 decide to take a bacterial swab, arrange for fungal testing, examine the scalp with a dermatoscope (a handheld magnifying device), and/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 of folliculitis early, as this gives you the best chance of minimising the risk of scarring to follicles, which can lead to permanent hair loss. If you have a scarring disease, treatment can contain the spread and protect the follicles that remain healthy.^6,7

Will My Hair Grow Back?

Regrowth of hair is possible 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 is targeted at the original cause of the folliculitis. This is the most effective way of bringing it under control.

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 add-on treatments considered for symptom control. 

If brought on by a particular medication, you will need to liaise with your prescribing doctor, who can suggest a different dosage or perhaps an alternative medication which won’’t cause this side effect.^2-5,8

Even if rashes appear similar to each other in appearance, they may still have very different causes. It is best to consult a GP or dermatologist before starting any particular line of treatment if symptoms are persistent, recurrent, or severe. They are experienced professionals and will know what to do to help your scalp start healing again. 

Treating folliculitis decalvans

Folliculitis decalvans is a chronic inflammatory condition that causes scarring to the hair follicles and leads to irreversible hair loss. We don’t yet fully understand what causes it, although it appears to be a result of an abnormal immune response to a bacterium that usually lives harmlessly on the skin, Staphylococcus aureus. With this condition, the aims of treatment are to control inflammation, relieve symptoms, and prevent further scarring.

Current recommended treatments 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, there is currently a lack of studies carried out in this area.^7,9 It should be taken seriously, and treatment for this condition should be guided by your doctor.

Medication for hair regrowth.

You cannot use hair-growth medication as a substitute for treating active folliculitis. Your 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 either as a result of physical irritation from surgery or potentially an infection picked up when your scalp is vulnerable.

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 decide to self medicate. Continue only with the aftercare agreed with your surgeon and contact the clinic that carried out the procedure for more advice.

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 your diagnosis is uncertain or there is evidence of ongoing inflammation, then you will need a specialist review before surgery can be considered.^7,12,13

Conclusion

Folliculitis is an umbrella term for inflammation around hair follicles. Most superficial folliculitis does not end up permanently damaging the follicle. However, folliculitis can cause permanent hair loss when destructive inflammation damages the cells needed for future hair growth and replaces them with scar tissue. 

Treatment must be directed at the specific cause of the folliculitis, and if you have persistent symptoms or signs of scarring, then make sure to seek a professional assessment promptly. 

Hair transplantation may be considered only in carefully selected cases where any underlying disease is inactive.

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.