Skin Care Guidelines

General Skin Care

Wear fine cotton clothes instead of synthetic materials to reduce irritation, and use hypoallergenic moisturizing creams and emollients to prevent skin dryness, as recommended by the American College of Oncology 1
Wear protective clothing and hats to prevent skin damage, as advised by the American College of Oncology 1
Gentle skin care with pH5 neutral soaps and shampoos, tepid water, and patting skin dry is recommended to prevent folliculitis, as suggested by the American Academy of Dermatology 1
Avoiding greasy creams and wearing fine cotton clothes instead of synthetic materials can help prevent folliculitis due to occlusive properties, as recommended by the American Academy of Dermatology 1

Consider chlorhexidine washes or antibacterial soaps to prevent infections, and thoroughly launder clothing, towels, and bedding to prevent the spread of infection, as recommended by the Infectious Diseases Society of America 2
Consider prophylactic measures during outbreaks in team settings, as advised by the Infectious Diseases Society of America 2
Culture is a diagnostic method to identify specific bacterial or fungal pathogens, as stated by the Infectious Diseases Society of America and the British Association of Dermatologists 2, 3
Wood's lamp examination may show fluorescence in certain fungal infections, according to the British Association of Dermatologists 3
Dermoscopy can help visualize characteristic features like black dot hair stubs or comma-shaped hairs, as stated by the British Association of Dermatologists 3
Bleach baths (1/4-1/2 cup of bleach per full bath) can be used for prevention of recurrences, as suggested by the Infectious Diseases Society of America 4

Poor personal hygiene is a risk factor for developing folliculitis, as stated by the Infectious Diseases Society of America 2
Diabetes, especially for carbuncles on the back of the neck, is a risk factor for folliculitis, according to the Infectious Diseases Society of America 2
Close personal contact with infected individuals can spread folliculitis, as stated by the Infectious Diseases Society of America 2
Nasal carriage of S. aureus, present in 20-40% of the general population, is a risk factor for folliculitis, according to the Infectious Diseases Society of America 2

A 5-day course of oral antibiotics is as effective as a 10-day course if clinical improvement occurs, according to the Infectious Diseases Society of America 4
Topical clindamycin 1% solution/gel twice daily for 2-3 weeks is recommended as a first-line treatment for mild beard folliculitis, as suggested by the American Academy of Dermatology 5
Oral antibiotics such as tetracycline 500 mg twice daily for up to 4 months may be used for moderate to severe cases, as suggested by the American Academy of Dermatology 5
Doxycycline may be used as an alternative to tetracycline, although the specific dosage is not provided 5
Clindamycin 300 mg twice daily with rifampicin 600 mg once daily for 10 weeks may be considered for extensive disease or treatment failures 5
Topical antimicrobial therapy, such as clindamycin solution, erythromycin solution, benzoyl peroxide, or chlorhexidine, should be applied twice daily for at least 14 days 4

Patients with extensive or severe disease, recurrent episodes, development of scarring, or immunocompromised patients should be referred to a dermatologist for proper management 6, 7, 1
Reassess after 2 weeks of treatment, and escalate to the next level of treatment or refer to a dermatologist if no improvement or worsening occurs 8, 1
Referral to a dermatologist is recommended for patients with extensive or severe disease, recurrent episodes, development of scarring, immunocompromised status, or no improvement after 2-4 weeks of appropriate treatment 5

Laser therapy can provide long-term resolution by targeting the hair follicle, and may be the most definitive treatment option for patients with chronic or severe PFB 8, 1
Prophylactic antibiotics, such as oral penicillin or erythromycin, for 4-52 weeks, or intramuscular benzathine penicillin every 2-4 weeks, may be used to prevent recurrent folliculitis, as suggested by the Infectious Diseases Society of America and the American Academy of Dermatology 4