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Having bumps on your skin feels really bad. And trying to fix them and having nothing improve, or potentially even having things get worse, is so so frustrating.

The last thing anyone wants to do when they’re struggling with skin issues is spend hours on a science lesson trying to understand why it’s happening.

For most of us, we don’t care why it’s happening! We just want to make it stop.

Understanding skin issues can feel overwhelming. If you’re dealing with red bumps, you might wonder: is it acne or folliculitis? Let’s break it down.

This post will give you an overview of what’s happening and why, then lay out a couple simple tests to see what the issue is. 

What Is Folliculitis?

Folliculitis is the inflammation of hair follicles. It happens when bacteria, fungi, or other factors infect these tiny openings.

If you are interested in the science, here are the most common types include: 

• Bacterial folliculitis: Often caused by staphylococcus aureus.
• Fungal folliculitis: Frequently linked malassezia yeast.
• Hot tub folliculitis: Triggered by pseudomonas aeruginosa.
• Pseudofolliculitis barbae: Also known as razor bumps, common in areas with coarse hair.

Symptoms of folliculitis may include pus-filled bumps, itching, and tenderness. 

How to Tell Whether It’s Folliculitis or Acne

At first glance, folliculitis and acne vulgaris might look similar. Both conditions cause pimple-like bumps, redness, and irritation. At first glance, it’s hard to tell folliculitis vs acne.

Acne cysts and folliculitis cysts may look alike, but they form in entirely different ways.

Acne cyst signs

An acne cyst starts when the sebaceous glands in your skin overproduce oil. This oil, combined with dead skin cells, clogs a pore. 

Once the pore is blocked, bacteria can thrive in this blocked pore, triggering inflammation. That’s why the skin will rise up and get red.

Over time, the inflammation can go deep into the skin, creating a painful, swollen bump filled with pus. 

Acne cysts are typically linked to hormonal changes, oily skin, or genetic factors.

Folliculitis cyst signs

In contrast, a folliculitis cyst begins with the infection or irritation of a hair follicle. 

This can happen when bacteria, fungi, or viruses enter the follicle through minor skin damage or blocked openings. 

(We’ll get back to this bacterial vs fungal folliculitis later!)

The infection triggers inflammation around the follicle, which may progress into a deeper cyst if untreated. Factors like tight clothing, excessive sweating, and hot tubs can increase the risk.

The main difference between acne and folliculitis is the source: 

• acne cysts result from oil and clogged pores
• folliculitis cysts stem from infected or inflamed hair follicles

Identifying the cause is crucial because treatments differ.

 Acne cysts respond well to retinoids or benzoyl peroxide, while folliculitis often needs antibacterial or antifungal treatments.

If you use the wrong treatment, your problem won’t respond. So, if you’ve been using acne treatments for ages and you’re not seeing improvement, it’s worth trying folliculitis treatments. 

Folliculitis Vs Acne Location (and a quick aside about hot tub folliculitis)

It’s worth noting that typically acne appears on the face, chest, or back. If a part of your body can get oily, it is more likely to get acne. 

For folliculitis can affect any area with hair, like the scalp, legs, or upper chest. We’re mammals, so really we do have hair everywhere! 

I also want to just mention hot tub folliculitis here – it’s probably not being confused with acne, but it’s painful enough to be worth mentioning. 

Hot tub folliculitis is from a specific bacteria, and it’s most often passed from person to person in pools or hot tubs. 

We have a backyard hot tub, and after a few years of having it, it was infected with the pseudomonas bacteria from a visitor. (Lots of people just have this living on their skin, so it’s not a sign of being unclean or anything.)

Once the bacteria in, it’s almost impossible to get out! So, even if it feels silly or rude, I wish I had been more diligent about asking people to shower before using the hot tub. As it is, we now have to change the water monthly, be super on top of the chemicals, and basically do a lot more work than before. 

A Cheap and Easy Test to Confirm Folliculitis

I’m assuming that if you have bumps on your body and you’ve tried anything, you’ve tried acne treatments. 

So let’s assume you know it’s not acne, and you want to test and see if it’s folliculitus vs acne. 

Remember I said earlier that there are two types of folliculitus? Fungal and bacterial?

You can do these tests in any order; use what you have in the house. 

Testing for fungal folliculitis

Fungal folliculitis is another name for fungal acne!

This simple test involves using either a topical antifungal cream or a dandruff shampoo. Apply it to a small affected area. If the bumps improve in a few days, you might have fungal folliculitis.

Once you’ve confirmed it’s fungal acne, you can check out this blog post about it! Folliculitis Scout is also a terrific resource for fungal acne sufferers. 

Testing for bacterial folliculitis

If it isn’t fungal, you may still be dealing with folliculitis–it might just be bacteria. 

To test for bacterial folliculitis, try an antibacterial soap with warm water. 

Honestly: this soap is drying, and I wouldn’t recommend you use it for the long term. But if you’re looking to get a sense of whether you’re dealing with bacterial folliculitis….this stuff will let you know. If your skin responds to this, it’s probably bacterial. 

(Plan on a really hydrating routine for the rest of your skincare!) 

So those are the best tests for folliculitis vs acne.

Next Steps for Acne

If it’s acne, follow these steps:

1. Use over-the-counter benzoyl peroxide or salicylic acid products.
2. Avoid oily skin products. Look for “non-comedogenic” labels.
3. Shower after excessive sweating to prevent clogged pores.
4. For severe acne, consult a board-certified dermatologist. They might recommend oral antibiotics or stronger topical treatments.
5. Stick to a consistent skincare routine to manage breakouts.

This will treat a lot of mild acne. If you’re dealing with persistent acne, you might check out some of these posts: Does Endometriosis Cause Acne?, NeoClear Acne Laser Treatment, Best Ingredients for Acne Scars

Next Steps for Folliculitis

For folliculitis, the treatment depends on the cause:

• Bacterial folliculitis: Try topical antibiotics. Start with Neosporin, and go get a prescripton  antibiotic ointment if needed.  More serious cases might require oral antibiotics, but I definitely wouldn’t start there. 
• Fungal folliculitis: Use topical antifungals like selenium sulfide or oral antifungal medications for severe cases. Again, check out the Folliculitis Scout site! 
• Razor bumps (pseudofolliculitis barbae): Avoid tight clothing and try not to shave too closely. Use a soothing cream post-shave.
• Hot tub folliculitis: Cleanse the skin with antibacterial soap (like the Dial linked above). Most cases resolve without treatment.

For chronic or severe folliculitis, you’re best off working with a dermatologist. 

Folliculitis Risk Factors and Prevention Tips

Both conditions share some risk factors, like sweaty clothing and tight clothes. Here’s how to prevent flare-ups:

• Shower regularly, especially after a workout. 
• Avoid excessive sweating when possible.
• Exfoliate gently to remove dead skin cells.
• Use clean razors and avoid sharing towels.

(A lot of these also work for acne too, so they’re good for whatever you’re dealing with, folliculitis vs acne!)