Folliculitis:
Teen information

Folliculitis is fairly easy to diagnose in most cases. Your physician may wish to perform a bacterial culture in order to determine the cause of the folliculitis. The procedure involves:

1. Penetrating the pustule with a needle, scalpel, or lancet
2. Rubbing a sterile cotton-tipped applicator across the skin to collect the pus
3. Sending the specimen away to a laboratory

Typically, the laboratory will have preliminary results within 48–72 hours if there are many bacteria present. However, the culture may take a full week or more to produce final results. In addition to identifying the strain of bacteria that is causing the folliculitis, the laboratory usually performs antibiotic sensitivity testing in order to determine the medications that will be most effective in killing off the bacteria. 

Depending on bacterial culture results, your physician may recommend the following treatments:

• Prescription-strength antibacterial wash such as hexachlorophene
• Topical antibiotic lotion or gel such as erythromycin or clindamycin
• Oral antibiotic pills such as cephalexin, erythromycin, or azithromycin

Occasionally, the bacteria causing the infection are resistant to treatment with commonly used antibiotics (methicillin-resistant Staphylococcus aureus, or MRSA). MRSA bacteria can sometimes cause a more severe form of folliculitis. Depending on the circumstances, your doctor may consider more aggressive treatment that includes prescribing:

• A combination of two different oral antibiotics, including rifampin, trimethoprim-sulfamethoxazole, clindamycin, or tetracycline.
• A topical medication, mupirocin ointment, to apply to the nostrils.

If your doctor prescribes antibiotics, be sure to take the full course of treatment.