Folliculitis is an infection of the hair follicles, most often caused by staphylococcus bacteria, although more rarely it can be caused by fungus or a mite called demodex1.
Differential diagnosis can be achieved via dermoscopy2 (looking at the skin with a magnifying glass/microscope), although to differentiate between different types of bacteria/pathogen you might need to take a biopsy (piece of skin is removed, this is the extreme option).
The preferred treatment is topical antiseptics. A course of systemic oral antibiotics may be viable but should only be used as a last resort since it’ll kill off your gut microbiome and is likely to have unpleasant side effects and weaken your immune system3. There are also some topical antibiotics such as clindamycin and gentamicin available.
How I treated my folliculitis
I struggled with it for about a year, it was a huge source of dysphoria and extremely resilient, saw a dermatologist and was told "you'll probably have it for life, there’s not much I can do" at which point my innate hate for the medical establishment kicked into full gear and i became rather obsessed with treating it. If you want a job done properly you have to do it yourself.
I performed dermoscopy using a 10x handheld loupe and subsequently at ~40x using a stereo microscope. I suspected I had folliculitis due to some strain of bacteria. Just in case, I used permethrin (an anti-parasite medication) over the course of a few days, although (as expected) this did not help. I also tried using ketoconazole (brand name Nizoral), an antifungal, and this did not help either.
I proceeded to use chlorhexidine wash daily in my showers (pictured, Hibiscrub), as well as leaving benzoyl peroxide cream on my entire lower body overnight, using exfoliant a few times a week. there are other OTC antiseptics available, including zinc oxide, cetrimide, octenidine, among others.
I changed all my clothes daily and bedsheets twice a week.
Continuing this over the course of a few weeks, I had completely gotten rid of my folliculitis. It took a lot of effort but well worth it. And don’t take the word of doctors as gospel!
Folliculitis and Other Follicular Disorders | Plastic Surgery Key. https://plasticsurgerykey.com/folliculitis-and-other-follicular-disorders/ (accessed 2023-01-01).
Durdu, M.; Errichetti, E.; Eskiocak, A. H.; Ilkit, M. High Accuracy of Recognition of Common Forms of Folliculitis by Dermoscopy: An Observational Study. J. Am. Acad. Dermatol. 2019, 81 (2), 463–471. https://doi.org/10.1016/j.jaad.2019.03.054.
Lin, H.; Lin, P.; Tsai, Y.; Wang, S.; Chi, C. Interventions for Bacterial Folliculitis and Boils (Furuncles and Carbuncles). Cochrane Database Syst. Rev. 2018, 2018 (8), CD013099. https://doi.org/10.1002/14651858.CD013099.
How much does this cost you per month? Those benzoyl peroxide tubes look like they wouldn't last long if you use them on your entire lower body.