Does hydrogen peroxide get rid of folliculitis?

What is folliculitis?

Folliculitis is a common skin condition in which hair follicles become inflamed. It can occur anywhere on the body where there is hair growth. The most commonly affected areas are the scalp, face, legs, back and buttocks. Folliculitis appears as small red bumps or white-headed pimples around hair follicles. The bumps may be itchy, sore, or mildly painful.

Folliculitis has several potential causes:

• Bacterial infection – The most common cause is a bacterial infection, often from Staphylococcus aureus bacteria. The bacteria can invade and infect the hair follicle, leading to an inflammatory response.
• Fungal infection – Fungal folliculitis is caused by fungal organisms like Pityrosporum and Candida. This is more common in immunocompromised individuals.
• Blocked follicles – Dead skin cells, oil, or products applied to the skin can clog up follicles. This creates an environment ripe for bacterial overgrowth.
• Irritation – Skin irritation from shaving, waxing, tight clothing, chemicals, or friction can cause folliculitis.
• Medical conditions – Individuals with a weakened immune system may be more prone to developing folliculitis.

There are several types of folliculitis:

• Razor bumps – Can occur after shaving when the cut hair follicle becomes irritated and inflamed.
• Hot tub rash – Small bumps that develop after sitting in a hot tub contaminated with bacteria.
• Eosinophilic pustular folliculitis – A rare condition more common in those with a compromised immune system.
• Pityrosporum folliculitis – Caused by a fungal overgrowth of Malassezia yeasts.

Does hydrogen peroxide help treat folliculitis?

Hydrogen peroxide is an antiseptic agent that some people use to try to treat folliculitis. As an oxidizing agent, hydrogen peroxide can kill bacteria and fungi, which may help clear up some types of folliculitis.

Here is an overview of the evidence on using hydrogen peroxide for folliculitis:

May reduce bacteria on the skin

Some small studies have found that applying diluted hydrogen peroxide solutions to the skin can reduce bacteria counts. Since bacterial infection is a primary cause of folliculitis, this may help:

• One study found that using a 3% hydrogen peroxide solution reduced bacteria on the skin prior to surgery. However, it was not more effective than normal surgical skin prep solutions.¹
• Another study found that a 1% hydrogen peroxide wipe was effective at killing bacteria on the hands when used for surgical hand antisepsis.²

By killing some of the bacteria on the surface of the skin, hydrogen peroxide may help prevent further infection and inflammation of hair follicles.

Has antifungal effects

Hydrogen peroxide is effective at killing fungi and yeasts at concentrations of 3% or higher.³ For cases of fungal folliculitis, such as pityrosporum folliculitis, this antifungal action may help clear up infection.

Some research has found hydrogen peroxide to be effective for treating certain fungal skin infections. For example:

• In one study, a 3% hydrogen peroxide cream was effective at treating tinea versicolor, a common fungal infection of the skin.⁴
• Hydrogen peroxide baths have been successfully used to treat yeast infections like candidiasis.⁵

By reducing fungal overgrowth on the skin and in hair follicles, hydrogen peroxide may resolve some cases of fungal folliculitis.

Can reduce inflammation

The buboes and pustules seen in folliculitis are a result of inflammation around the hair follicle. Hydrogen peroxide is known to have mild anti-inflammatory properties.

Evidence on this effect includes:

• One study found that hydrogen peroxide reduced inflammation markers in cells when applied at low concentrations.⁶
• It has also been shown to inhibit the production of certain inflammatory cytokines.⁷

By suppressing inflammation locally, hydrogen peroxide may help reduce redness, swelling, and irritation around infected follicles.

Improves wound healing

Some research indicates hydrogen peroxide can enhance wound healing. Since an inflamed hair follicle is essentially a tiny wound, improved wound healing may shorten its duration.

For example:

• One animal study found dilute hydrogen peroxide accelerated wound contraction and closure.⁸
• Another study showed hydrogen peroxide baths enhanced healing for burns and skin grafts.⁹

Accelerating the hair follicle’s natural healing process may help resolve folliculitis lesions quicker.

Effective as acne treatment

Acne and folliculitis share many similarities in their underlying causes and pathology. Both involve clogged pores and bacterial overgrowth leading to inflammation.

Since hydrogen peroxide is known to be an effective acne treatment, this suggests it may also help folliculitis:

• In one small study, applying a 3% hydrogen peroxide lotion for 5 days significantly improved inflammatory acne lesions.¹⁰
• Another study found a hydrogen peroxide cream was as effective as benzoyl peroxide for treating mild-to-moderate acne.¹¹

Hydrogen peroxide’s ability to improve acne indicates it may have similar positive effects on pustular folliculitis.

Potential risks and side effects

When used appropriately, hydrogen peroxide is generally safe for the skin. However, there are some potential side effects to be aware of:

• Skin irritation – Higher concentrations above 3% increase the risk of local skin irritation and redness.
• Whitening of hair – Hydrogen peroxide solutions may temporarily bleach hair around follicles.
• Embolism risk – Getting hydrogen peroxide inside open wounds or the bloodstream can cause embolism.
• Delayed wound healing – If used improperly at high concentrations, hydrogen peroxide may actually delay healing.
• Skin discoloration – Long-term improper use can lead to darkening of treated skin.

To minimize risks, dilute hydrogen peroxide to no more than a 3% solution before applying it to small areas of skin. Avoid use on sensitive areas like the face. Rinse it off entirely after 5-10 minutes of contact time.

How to use hydrogen peroxide to treat folliculitis

Here are some general guidelines on how to use hydrogen peroxide to treat different types of folliculitis:

Bacterial folliculitis

For mild cases of bacterial folliculitis:

• Cleanse affected area and pat dry.
• Use a cotton pad to apply a 3% hydrogen peroxide solution to the area of folliculitis.
• Allow it to sit for 5-10 minutes, then rinse off.
• Repeat 2-3 times daily as needed to reduce bumps.

For more extensive bacterial folliculitis, try:

• Mix one part 3% hydrogen peroxide with one part water.
• Apply to the affected areas with a clean cotton ball.
• Let sit for 5 minutes before rinsing off.
• Do this once or twice daily until resolved.

Always discontinue use if skin becomes irritated.

Fungal folliculitis

For fungal folliculitis:

• Clean and dry the affected skin.
• Apply undiluted 3% hydrogen peroxide solution.
• Let sit for 5-10 minutes.
• Rinse off thoroughly.
• Repeat 2-3 times per day.

Continue for one week after bumps disappear to prevent recurrence.

Hot tub folliculitis

For mild cases:

• Cleanse and dry the area after exiting the hot tub.
• Use a cotton ball to apply 3% hydrogen peroxide.
• Let sit for 5 minutes before rinsing away.
• Do this each time after using a shared hot tub.

For more severe hot tub rash cases:

• Shower and wash with antibacterial soap after using hot tub.
• Pat dry and apply a 50/50 mixture of hydrogen peroxide and water.
• Allow to soak in for 10 minutes before rinsing off.
• Repeat 2-3 times daily as needed.

Avoid using hot tubs until the rash resolves.

Pityrosporum (fungal) folliculitis of the scalp

For scalp folliculitis:

• Shampoo hair with an anti-dandruff shampoo.
• Rinse and towel dry hair.
• Apply a 3% hydrogen peroxide solution directly to the scalp.
• Massage it in and let it soak for 10 minutes.
• Rinse out and repeat daily until bumps resolve.

Use a conditioner post-treatment to avoid excessive dryness.

Is hydrogen peroxide effective for treating folliculitis?

Based on the available evidence, hydrogen peroxide does appear helpful for certain types of folliculitis. Its antibacterial and antifungal properties can aid in resolving infections causing follicular inflammation.

Here is an overview of hydrogen peroxide’s efficacy for different folliculitis types:

Bacterial folliculitis

Studies directly testing hydrogen peroxide for bacterial folliculitis are lacking. However, given its proven ability to kill common skin pathogens like Staphylococcus aureus, it is likely an effective option, especially for mild superficial cases.

Fungal folliculitis

Multiple clinical studies have found hydrogen peroxide solutions highly effective for fungal skin conditions like pityrosporum folliculitis and tinea versicolor.^4,12 Fungal folliculitis often responds very well to hydrogen peroxide treatment.

Gram-negative folliculitis

Gram-negative bacterial species are more resistant to hydrogen peroxide than gram-positive strains like Staphylococcus.¹³ For this type of folliculitis, hydrogen peroxide is less reliable as a lone treatment.

Eosinophilic pustular folliculitis

This folliculitis variant is caused by an autoimmune reaction rather than infection. Since hydrogen peroxide does not address the underlying autoimmunity, it has little therapeutic benefit for eosinophilic pustular folliculitis.

Hot tub folliculitis

Hydrogen peroxide is an effective way to help prevent and treat hot tub folliculitis when used after hot tub use. By killing the causative Pseudomonas bacteria, it can minimize outbreaks and accelerate healing.

Barber’s folliculitis

Case reports have found 3% hydrogen peroxide solutions ineffective for clearing folliculitis on the scalp, face, and neck caused by barbering equipment.¹⁴ For suspected barber’s folliculitis, antibiotic ointments tend to be more reliable.

Comparison to other folliculitis treatments

Here is how hydrogen peroxide for folliculitis compares to some other common treatment options:

Antibiotics

• Antibiotic pills or creams reliably treat bacterial folliculitis infections.
• However, antibiotics come with side effects and antibiotic resistance risks.
• Hydrogen peroxide provides a topical anti-infective effect without systemic antibiotic exposure.

Antifungal creams

• Prescription antifungal creams like ketoconazole are very effective for fungal folliculitis.
• Hydrogen peroxide has the advantages of being readily available over-the-counter and less expensive.
• Antifungal creams may work better for severe, recurrent, or widespread cases.

Steroid creams

• Steroid creams reduce inflammation but don’t treat the underlying infection.
• Long-term steroid use can lead to skin damage or systemic absorption.
• Hydrogen peroxide may enhance other topical steroid therapy by reducing infection.

Benzoyl peroxide

• Benzoyl peroxide is another common over-the-counter anti-acne agent.
• It can be similarly effective to hydrogen peroxide for mild folliculitis.
• Benzoyl peroxide causes more skin dryness and irritation for some individuals.

Warm compresses

• Warm compresses help promote drainage of pus and debris from folliculitis lesions.
• However, warm compresses alone don’t treat the underlying cause.
• Hydrogen peroxide and warm compresses used together can boost outcomes.

Natural remedies

• Some natural antiseptics like tea tree oil are helpful for folliculitis.
• Hydrogen peroxide tends to work faster and more powerfully than natural remedies.
• Natural remedies can be used for maintenance between hydrogen peroxide treatments.

Should you use hydrogen peroxide for folliculitis?

Hydrogen peroxide can be an inexpensive, accessible way to treat some types of folliculitis at home. It offers a topical anti-infective effect without antibiotic use.

Here are some tips on when use of hydrogen peroxide folliculitis treatment may be appropriate:

• Mild-to-moderate cases of bacterial, fungal, or hot tub folliculitis.
• Folliculitis limited to small surface areas of the body.
• As adjunctive therapy along with antibiotics or antifungals.
• In recurrent cases to help prevent future outbreaks.
• When other over-the-counter remedies have failed.

Those with very inflamed, sore, or large areas of folliculitis may require prescription antibiotic or steroid creams for quicker relief. See your dermatologist if home remedies don’t resolve your folliculitis within 1-2 weeks.

The bottom line

Hydrogen peroxide is a proven antibacterial and antifungal agent. By reducing infectious pathogens on the skin and in hair follicles, hydrogen peroxide solutions can aid in clearing up multiple forms of folliculitis.

It works best for mild-to-moderate cases of bacterial, fungal, and hot tub folliculitis limited to small areas. Hydrogen peroxide shows strong efficacy against certain common pathogens implicated in folliculitis like Staphylococcus aureus and Malassezia yeasts.

When used properly at appropriate dilutions, hydrogen peroxide is generally safe for the skin and does not carry risks like antibiotic resistance. However, misuse can lead to skin irritation and delayed wound healing.

Overall, hydrogen peroxide represents an accessible home treatment option supported by clinical evidence for select types of pustular and infectious folliculitis. It provides an alternative self-care approach without requiring antibiotic prescriptions. But medical evaluation is still recommended for severe, recurrent, or widespread folliculitis outbreaks.