Medical Care

P aeruginosa is usually a self-limited infection, clearing in 2-10 days. Despite the discomfort caused by the Pseudomonas folliculitis rash, no treatment is necessary. Systemic spread is typically not observed. P aeruginosa is resistant to nearly all common topical and oral antibiotics, and no indication exists that the course of the skin condition is altered with treatment.

Symptomatic relief of Pseudomonas folliculitis may be achieved through the use of acetic acid 5% compresses for 20 minutes twice a day to 4 times a day.

In Pseudomonas folliculitis patients with associated mastitis, in those with persistent infections, or in those who are immunosuppressed, a course of ciprofloxacin (500 or 750 mg PO bid) is advised.

Prevention

Proper maintenance and chlorination of pools, hot tubs, whirlpools, and spas are essential to decrease the population of Pseudomonas species. The Centers for Disease Control and Prevention recommend a free chlorine concentration of 1-3 mg/L and a pH of 7.2-7.8.^[32]However, P aeruginosa has been recovered from adequately chlorinated water containing 2 mg/L of free chlorine. Bromine is considered an acceptable alternative to chlorine and is considered more effective in hot water, with a longer period of activation.

Complete drying of sponges between uses is essential because P aeruginosa does not survive drying.

Showering after exposure to contaminated water does not seem to prevent Pseudomonas folliculitis.

Medication

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Media Gallery

Erythematous papulopustules of pseudomonas folliculitis. Courtesy of Mark Welch, MD.
Erythematous papulopustules of pseudomonas folliculitis, with significant perilesional flare. Courtesy of Andy Montemarano, MD.
Pseudomonas folliculitis. Courtesy of Hon Pak, MD.

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Author

Charles B Toner, MD Assistant Professor, Department of Dermatology, Uniformed Services University of the Health Sciences, F Edward Hebert School of Medicine; Mohs Surgeon, Skin Cancer Surgery Center; Mohs Surgeon, Charles County Dermatology; Mohs Surgeon, Georgia Dermatology and Skin Cancer Center

Charles B Toner, MD is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Surgery, Association of Military Surgeons of the US, Association of Military Dermatologists, American Medical Association, American Society for Dermatologic Surgery

Disclosure: Nothing to disclose.

Coauthor(s)

Stephen J Krivda, MD Assistant Professor of Dermatology, Uniformed Services University of the Health Sciences; Chief of the Integrated Department of Dermatology, Chief of Dermatology Service, Director of Dermatopathology, Staff Dermatopathologist, Walter Reed Army Medical Center; Head, Department of Dermatology, Staff Dermatologist and Dermatopathologist, National Naval Medical Center

Stephen J Krivda, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, American Society of Dermatopathology, Phi Beta Kappa

Disclosure: Nothing to disclose.

Specialty Editor Board

Michael J Wells, MD, FAAD Dermatologic/Mohs Surgeon, The Surgery Center at Plano Dermatology

Michael J Wells, MD, FAAD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

Lester F Libow, MD Dermatopathologist, South Texas Dermatopathology Laboratory

Lester F Libow, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, Texas Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Leonard Sperling, MD Chair, Professor, Department of Dermatology, Uniformed Services University of the Health Sciences

Leonard Sperling, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Pseudomonas Folliculitis Treatment & Management

Medical Care

Prevention

References

Tables

Contributor Information and Disclosures

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