Is my rash psoriasis or folliculitis?
The additional symptoms that these conditions cause are not the same, and they have different causes. Psoriasis is a chronic skin condition, while folliculitis is a temporary infection of the hair follicles.
Folliculitis is quite common, and anyone can get this skin problem. Although psoriasis is relatively prevalent, it will only affect 2–3 percent of people worldwide.
In this article, we look at the differences in the symptoms and causes of these two conditions to help people distinguish between them. We also cover treatment options and when to see a doctor.
Psoriasis vs. folliculitis
Although they both affect the skin, psoriasis and folliculitis are very different conditions.
Psoriasis can cause red, scaly patches of skin.
Psoriasis is an autoimmune inflammatory condition. There are several types of psoriasis, each of which has slightly different symptoms.
The types of psoriasis that can resemble folliculitis include:
- Plaque psoriasis, which causes dry, red patches on the skin. The patches may be raised, itchy, and painful.
- Guttate psoriasis, which produces small, scaling lesions on the skin. This form of psoriasis occurs as a result of bacterial infection and will usually resolve without treatment once the infection clears.
- Pustular psoriasis, an uncommon type of psoriasis that causes pus-filled skin blisters together with itching, fever, chills, and diarrhea.
People are most likely to mistake guttate or pustular psoriasis for folliculitis because all of these conditions can cause patches of small, red or yellow spots on the skin.
Folliculitis is a mild skin infection that results from bacteria entering the base of a hair follicle. It can occur anywhere on the body that has hair.
Unlike psoriasis, which is a chronic condition that often requires long-term treatment, folliculitis is a temporary bacterial infection that will usually clear up quickly with treatment.
Folliculitis presents as small, red or yellow bumps containing pus. The bumps often appear after a person shaves, wears tight clothing, or comes into contact with hot water.
Symptoms of psoriasis and folliculitis
There is an overlap in the symptoms of psoriasis and folliculitis. For example, some forms of psoriasis cause small, red or yellow skin bumps that resemble folliculitis.
However, there are also differences between the symptoms of these conditions. 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 symptoms of psoriasis include:
- red, 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
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
Gaining weight or wearing tight clothing can increase the risk of folliculitis.
Psoriasis is an autoimmune condition, and it is not contagious. The exact cause of psoriasis is not clear, but there are some known risk factors and triggers.
Folliculitis is an infection. Bacteria are usually responsible for this condition, but viruses and fungal infections can also cause it. Folliculitis can be contagious, and people may pass the infection to others through close skin contact.
The risk factors for psoriasis and folliculitis are different.
Risk factors for psoriasis include:
- having a family history of psoriasis
- getting a viral or bacterial infection
- injuring the skin
- being obese
Various triggers can cause psoriasis flares to occur. These differ between people but often include stress, diet, and other lifestyle factors.
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
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.
For some types of psoriasis, and especially if symptoms are moderate to severe, current guidelines recommend using a biologic, a type of drug that affects the immune system. These drugs can help reduce the number of flares and the severity of symptoms.
Folliculitis treatment aims to clear the infection, after which there should be no lasting effects.
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
When to see a doctor
A person who suspects that they have psoriasis should see a doctor for a diagnosis.
Folliculitis is not harmful and will go away on its own. However, any individuals who suspect that 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 they believe that it is severe or spreading.
Anyone with an unexplained rash should seek medical attention. Delayed diagnosis can make the symptoms worse and delay recovery.
What else could the rash be?
People may sometimes mistake psoriasis and folliculitis for other skin conditions, including:
Psoriasis and folliculitis can cause similar symptoms, but they are separate conditions with different causes.
Psoriasis is an autoimmune condition that it is possible to manage but not cure. Folliculitis is a bacterial infection that tends to resolve in a few days with home care or antibiotics.