Psoriasis and folliculitis are skin conditions that can cause inflamed bumps on the skin. However, psoriasis is an autoimmune condition, and folliculitis is an infection or inflammation of the follicles.
Psoriasis and folliculitis share some symptoms, but also have distinct differences. Psoriasis is a long term, inflammatory autoimmune condition, and folliculitis is a temporary infection of the hair follicles.
Folliculitis is quite common, and anyone can develop it. Although psoriasis is relatively common, it will only affect 2% to 3% of people worldwide.
This article looks at the differences in the symptoms and causes of these two conditions to help people distinguish between them. It also covers treatment options and when to see a doctor.
There can be overlap in the symptoms of psoriasis and folliculitis. Some forms of psoriasis cause small, red or yellow skin bumps that resemble folliculitis. Both conditions can cause inflammation, pain, and itchy skin.
However, the conditions have distinct differences. Folliculitis is more likely to affect areas of skin where friction occurs, such as the thighs and buttocks, or areas that people have recently shaved. Conversely, psoriasis symptoms can appear anywhere on the body.
The table below compares key features of psoriasis and folliculitis.
| Psoriasis | Folliculitis | |
|---|---|---|
| Causes | long-lasting autoimmune condition that sometimes runs in families | • temporary bacterial infection • inflammation from ingrown hairs • reactions to medication |
| Symptoms | discolored, scaly, raised patches of inflammation | • pus-filled blisters that may erupt and ooze • red, itchy bumps • white-headed pimples |
| Risk factors | • family history • having an infection • smoking • obesity | • hot tub use • shaving, waxing, or plucking • wearing tight clothing |
| Treatment | • medications • light therapy | • warm compresses • keeping the area clean • antiseptic lotion • anti-inflammatory medications • topical antibiotics or pills • topical antifungals or pills |
Psoriasis is an inflammatory autoimmune condition. There are several types, each with slightly different symptoms.
The types of psoriasis that can resemble folliculitis
- Plaque psoriasis: This causes dry, red patches on light skin tones. On dark skin tones, the patches may be purple-brown and thicker. The patches may be raised, itchy, and painful.
- Guttate psoriasis: This produces small, scaling lesions on the skin. This form of psoriasis may occur as a result of bacterial infection, certain medications, skin injury, or stress.
- Pustular psoriasis: This is an uncommon type of psoriasis that causes pus-filled skin blisters, itching, fever, chills, and diarrhea.
People are most likely to mistake guttate or pustular psoriasis for folliculitis because they can all cause patches of small, discolored spots on the skin.
Symptoms of psoriasis
The symptoms of psoriasis include:
- red or gray-purple, inflamed, and raised patches of skin with a covering of thick, silvery scales
- small areas of scaly skin
- dry skin that may crack or bleed
- itching, burning, and soreness around the patches
- thick, pitted, and ridged nails
- swollen and painful joints, in people who also have psoriatic arthritis
Risk factors for psoriasis
Psoriasis is an autoimmune condition that is not contagious. The exact cause of psoriasis is unclear, but there are some known risk factors and triggers.
Risk factors for psoriasis include:
- having a family history of psoriasis
- getting a viral or bacterial infection
- injuring the skin
- obesity
- smoking
Various triggers can cause psoriasis flares. These differ between people but often include stress, diet, and other lifestyle factors.
Psoriasis treatment
People with psoriasis may require long-term treatment to manage their symptoms.
Psoriasis treatments may include:
- topical corticosteroids to control inflammation and itching
- retinoids to manage inflammation
- moisturizers for dry skin
- coal tar products to remove scales and soften skin
- oral or injected medication
- salicylic acid for scaling
- light therapy
If topical treatment does not relieve symptoms, a doctor may prescribe systemic medications, which a person can take by mouth or as an injection. These affect the whole body.
Current guidelines recommend using a biologic, a drug that affects the immune system, to treat some types of psoriasis, especially if symptoms are moderate to severe. These drugs can help reduce the number of flare-ups and the severity of symptoms.
Folliculitis is inflammation of the hair follicles or a mild skin infection or that results from bacteria entering the base of a hair follicle. It can occur anywhere on the body that has hair.
Unlike psoriasis, folliculitis is temporary and usually clears up quickly with treatment.
Folliculitis often causes small, pus-filled bumps that may develop after a person shaves, wears tight clothing, or comes into contact with hot water.
The symptoms of folliculitis include:
- small pus-filled blisters that may erupt and ooze
- small or large infected bumps on the skin
- a painful, itching, or burning sensation
Risk factors for folliculitis
Folliculitis is sometimes caused by an infection. Bacteria, viruses, and fungal infections can cause it. Folliculitis can be contagious, and people can pass the infection to others through close skin contact.
The following factors can increase a person’s risk of folliculitis:
- using an improperly maintained hot tub
- shaving, plucking, or waxing
- wearing tight clothing
- using some topical medications, such as coal tar
- gaining weight
- having a suppressed immune system
Folliculitis treatment
Folliculitis treatment aims to clear the infection or inflammation. There may be scarring or skin color changes once the inflammation clears.
Folliculitis treatments may include:
- avoiding triggers
- warm compresses
- keeping the area clean
- antiseptic lotion
- topical or oral antibiotics, if the infection does not clear up on its own
- anti-inflammatory medications
Folliculitis is not harmful and will go away on its own. However, anyone who suspects they have psoriasis should see a doctor for an accurate diagnosis and treatment plan.
People should also see a doctor if they have any symptoms of infection, such as worsening pain, swelling, or fever, especially if they believe that the infection is severe or spreading.
Anyone with an unexplained rash should seek medical attention. Delayed diagnosis can make the symptoms worse and delay recovery.
People may sometimes mistake psoriasis and folliculitis for other skin conditions, including:
- fungal skin infections
- eczema or dermatitis
- pityriasis rosea
- dandruff
- acne
Psoriasis and folliculitis can cause similar symptoms, but they are separate conditions with different causes, risk factors, and treatments.
Psoriasis is a chronic autoimmune condition that is more likely in people with a family history, people who smoke, and those with obesity. People can manage it with medications and light therapy, but there is no cure.
Folliculitis can be caused by an infection or inflammation of the hair follicles. It may develop when someone’s clothes rub their skin or after hair removal. It tends to resolve in a few days with home care or medications.
Anyone with a rash and other symptoms, such as a fever or vomiting, should seek urgent medical care. If a rash lasts longer than a few days, it is a good idea to contact a doctor for advice.