Follicular eczema, also called follicular dermatitis, is a skin condition in which there is inflammation of the hair follicles—the structures that attach your hair to your skin. This condition is more common in people with darker skin.

Learn more about the symptoms, causes, diagnosis, treatment, and how to cope with follicular eczema in this article.

Types of Follicular Eczema

Follicular eczema can be part of two main types of dermatitis—atopic and contact.

Atopic dermatitis causes “whole-body” skin inflammation when your immune system overreacts to a substance it views as foreign to your body. This type of eczema often runs in families and affects people who have other allergies such as hay fever or medical conditions such as asthma.

Contact dermatitis occurs when your skin comes into contact with a substance that causes an allergic reaction. Although your immune system reacts, your symptoms will only appear in the area exposed to the substance.

Follicular Eczema Symptoms

Follicular eczema causes symptoms similar to other types of eczema or dermatitis. However, its location is what sets it apart. Skin irritation occurs in hairy areas of the body, such as the chest, abdomen, back, upper arms, groin, and thighs.

Symptoms can include:

  • Redness in a “dotted” patternHair sticking up straightItchy skinPainDry or cracked skinWeeping fluid or crusted skin

Causes

Follicular eczema from atopic dermatitis is caused by an overactive immune system. Certain skin defects have also been identified in people with this condition. These defects are inherited, which is why this type of eczema often runs in families.

Atopic dermatitis can develop if your skin doesn’t make enough of a protein called filaggrin. This protein is important for making a strong barrier to keep unwanted substances from entering your skin. This condition can also be caused by defects in certain immune system cells and the proteins they produce or are activated by.

Contact dermatitis occurs when your skin comes into contact with either an irritant or an allergen. Some substances can be both an irritant and an allergen.

Irritant dermatitis develops when a substance damages the skin cells that it has touched. Skin irritation shows up quickly.

Common irritants include:

  • SolventsDetergentsBleachSoapsPersonal hygiene productsMake-upHair dyeFragrancesPreservativesIrritating materials such as woolAcidPetroleumGreases and oils

Allergic dermatitis causes an allergic reaction within a day or two of exposure. You might even notice that your irritated hair follicles and skin resemble the shape of the allergen (such as a piece of jewelry).

Common allergens include:

  • A variety of metals (especially nickel)Environmental chemicalsFragrancesPoison ivyMake-upPreservativesDanderRubberLatexDyesFormaldehydeSunscreen

Changes in the weather can also cause flare-ups of follicular eczema. Cooler weather and lower humidity in the fall and winter often make skin conditions worse during this time of year.

Diet and Eczema

People who have eczema are more likely to have allergies to food as well. Your diet might also play a part in your eczema flare-ups. Research has shown that allergies to eggs, dairy, gluten, and soy can make eczema symptoms worse. If you suspect food is contributing to your symptoms, consult your doctor for dietary recommendations.

High levels of stress can also make a flare-up more likely.

Diagnosis

Follicular eczema is diagnosed by your doctor during a physical exam. This condition is distinct-looking because it specifically affects individual hairs. However, you’ll likely need some testing to determine what caused your symptoms in the first place.

You might be able to determine the cause of irritant contact dermatitis based on what you were exposed to when your symptoms developed. Allergen contact dermatitis can be a bit more tricky because symptoms can show up days after you’ve been exposed to the allergen.

A patch test is commonly used to determine contact allergies. A variety of suspected allergens are placed on small patches that your doctor (an allergist or dermatologist) sticks on your back. After 48 hours, the patches are removed to look for skin reactions. The doctor will re-check your skin a few days later to look for delayed reactions.

Allergy testing is also performed with a prick or scratch test, where a small amount of a specific allergen is placed into your skin. This typically causes a reaction within 30 minutes if you have an allergy.

Treatment

The first goal in the treatment of follicular eczema is removing the allergen that is causing your symptoms. In some cases, this is enough to allow your skin to heal spontaneously, without formal treatment. However, with some allergens, this won’t always be possible.

Follicular eczema symptoms are often treated with a topical (placed on the skin) medication called corticosteroids. This is applied directly to your skin to decrease inflammation. In severe cases, your doctor might prescribe an oral steroid medication as well.

You can also treat your follicular eczema symptoms and help prevent future flare-ups with home remedies. These include:

  • Repurpose your oatmeal: This grain isn’t only for breakfast. Soak in an oatmeal bath to help ease inflammation and gently remove dead skin cells.
  • Don’t scratch the itch: To help decrease itching, soak a washcloth in cool water. Squeeze out excess water and lay the cloth over your irritated skin.
  • Hydrate your skin: Apply oil-based moisturizer to your skin within a few minutes of bathing before the water on your skin can evaporate. Apply a thick layer and avoid products with high water content, such as most lotions. Choose products that are free of common allergens, such as fragrances, dyes, or preservatives.
  • Dress appropriately: Wear loose-fitting, 100% cotton or silk clothing over the affected area. Tight clothing can cause more irritation to your hair follicles. In addition, some fabrics such as wool can make your flare-up worse.
  • Adjust your grooming routine: Avoid shaving or other hair-removal techniques until your skin has fully healed. If you cut your already-irritated skin, you increase the risk of developing an infection.

Prognosis and Coping

Prognosis for follicular eczema depends on the underlying cause. If your symptoms come from exposure to a specific irritant, you might be able to avoid it and never have another flare-up. However, follicular eczema caused by allergies can be chronic. Maintaining a consistent skincare routine can help.

Summary

Follicular eczema is inflammation of the hair follicles, often resulting in a dotted red rash. It can be caused by irritants or allergens. A healthcare professional can diagnose it based on physical exam and may do testing to see what is triggering the condition. Treatment is with corticosteroid cream.

A Word From Verywell

Follicular eczema can make life more difficult, but high levels of stress can make your condition worse. Talk to your doctor about the best treatment options for your condition. Look for a support group or find online resources to help improve your quality of life.

Frequently Asked Questions

  • How do you treat follicular eczema?
  • Follicular eczema is treated with topical medications and a good skincare routine.
  • Is follicular eczema contagious?
  • Follicular eczema is not a contagious condition.
  • Will eczema go away?
  • Eczema can be a chronic condition, especially if you have allergies, but symptoms can come and go.
  • What is the difference between follicular eczema and papular eczema?
  • Both follicular and papular eczema cause rashes, but follicular eczema specifically affects the hair follicle.

Follicular eczema is treated with topical medications and a good skincare routine.

Follicular eczema is not a contagious condition.

Eczema can be a chronic condition, especially if you have allergies, but symptoms can come and go.

Both follicular and papular eczema cause rashes, but follicular eczema specifically affects the hair follicle.