The Bottom Line

Scalp folliculitis means the hair follicles on your scalp are inflamed or infected. It shows up as small, tender, pimple-like bumps that can itch or burn. Most cases are caused by bacteria (usually Staph aureus) and respond well to antibiotic treatment. Catching it early and treating it properly prevents the infection from spreading or leaving scars.

What Is Scalp Folliculitis?

Each hair on your head grows from a tiny pocket in the skin called a follicle. When bacteria, fungi, or other irritants get into these follicles, they can become inflamed — a condition called folliculitis. On the scalp, this usually looks like clusters of small red bumps or pus-filled pimples near the hairline or across the top of the head.

Scalp folliculitis ranges from mild (a few irritated bumps that clear on their own) to severe (deep, painful boils that can scar). The dense network of follicles on the scalp and the difficulty getting topical treatments through the hair make scalp folliculitis somewhat harder to treat than folliculitis elsewhere on the body.

What Does It Look Like?

  • Small red or pink bumps at the base of hair shafts
  • Bumps with a white or yellow pus-filled center (pustules)
  • Itching, tenderness, or burning in the affected area
  • Crusting or weeping after the bumps break open
  • In severe cases: larger, deeper lumps (furuncles or carbuncles) that are more painful

What Causes Scalp Folliculitis?

Bacteria cause the majority of cases. Staphylococcus aureus (Staph) is responsible for 70–90% of bacterial scalp folliculitis. Community-acquired MRSA (antibiotic-resistant Staph) is becoming more common and may not respond to standard antibiotics.

Other causes include:

  • Malassezia yeast — the same yeast linked to dandruff; can trigger follicle inflammation on oily scalps
  • Herpes simplex or varicella-zoster virus — viral folliculitis, less common
  • Scalp injury — scratching, tight hairstyles, helmets, or sweatbands that trap bacteria against the skin
  • Seborrheic dermatitis — a flaky, oily scalp condition that predisposes follicles to secondary infection

Treatment Options

Mild Cases (Few Bumps, No Deep Infection)

  • Gentle antiseptic washes (chlorhexidine 2%) to reduce bacteria
  • Topical antibiotic cream (mupirocin, clindamycin) applied directly to the bumps
  • Medicated antifungal or antibacterial shampoos used several times a week
  • Avoiding tight hairstyles, hats, or helmet pressure while healing

Moderate to Severe Cases

When bumps are widespread, deeply painful, or don't clear with topical treatment, a doctor may prescribe oral antibiotics. Dicloxacillin and cephalexin (500 mg twice daily for 10–14 days) work well for typical Staph infections. If MRSA is suspected, trimethoprim-sulfamethoxazole is used instead. Response rates for appropriate oral antibiotics reach 80–90%.

For Malassezia (fungal) folliculitis, antifungal shampoos such as ketoconazole 2% or selenium sulfide 2.5% are used first; stubborn cases may need oral antifungals.

Viral Folliculitis

Folliculitis caused by herpes simplex or varicella-zoster requires antiviral medication (such as acyclovir) — antibiotics will not help in these cases.

When to See a Dermatologist

  • Bumps are growing larger, becoming more painful, or spreading
  • A boil or abscess forms (a large, swollen, pus-filled lump)
  • You have a fever, swollen lymph nodes, or feel generally unwell
  • The rash doesn't improve after 1–2 weeks of home care
  • You keep getting folliculitis in the same area — recurrence suggests a treatable underlying cause
  • You're unsure whether this is folliculitis, ringworm, or another scalp condition

Frequently Asked Questions

Is scalp folliculitis contagious?

Bacterial folliculitis carries a small risk of spreading through shared combs, brushes, towels, or very close contact. Fungal and viral forms are generally not very contagious in everyday settings. Avoid sharing hair tools and wash linens regularly while you have an active infection.

Will scalp folliculitis cause permanent hair loss?

Mild or moderate folliculitis causes temporary shedding, and hair regrows once the infection clears. Permanent hair loss only happens if deep or repeated infections scar the follicles. Early treatment greatly reduces this risk.

What makes folliculitis come back?

Recurrence is common when the full course of antibiotics isn't completed, when predisposing habits continue (tight braids, helmet use, sweaty scalp), or when an underlying condition like seborrheic dermatitis isn't controlled. Some people carry Staph bacteria on their skin long-term and may need a decolonization strategy from their dermatologist.

Can I treat scalp folliculitis with just shampoo?

Medicated shampoos help with Malassezia-related folliculitis and as maintenance prevention. However, bacterial folliculitis — the most common type — usually needs a topical or oral antibiotic to fully clear. See a dermatologist if shampoo alone isn't working within 2 weeks.

  1. Hardin JS, et al. Scalp Folliculitis. Cutis. 2011;87(3):146-150.
  2. Naldi L, et al. Epidemiology of Folliculitis. J Eur Acad Dermatol Venereol. 2009;23(1):1-6.
  3. Sperling LC. Folliculitis. Dermatol Clin. 2014;32(2):149-157.
  4. Faergemann J. Pityrosporum Ovale and Atopic Dermatitis. Semin Dermatol. 2003;22(4):335-341.
  5. Rosen T. Antibiotic Resistance in Staphylococcus Aureus. Semin Cutan Med Surg. 2009;28(1):39-45.

Trusted Resources

Always consult a board-certified dermatologist before starting or changing any treatment for scalp conditions.