Folliculitis

Folliculitis is the inflammation of hair follicles which are small cavities that surround the roots of the hair. This condition occurs anywhere on the body, wherever hair growth is seen. Areas such as armpits, thighs, or neck where friction is common are more likely to develop folliculitis. The condition can be acute or chronic.

Folliculitis is classified into superficial and deep based on the involvement of hair follicle. The deep folliculitis is considered as severe. Folliculitis is more commonly seen on the scalp where hair follicles are dense (scalp folliculitis). Eosinophilic folliculitis is a type of folliculitis developed in patients infected with HIV or those who have cancer.

Symptoms

Folliculitis is characterized by small bumps, rashes, or scars on skin that may be in yellow, red, or white in color. You may also develop tenderness, itching, and swelling. Other symptoms include soreness and formation of pus.

Causes and risk factors

Staphylococci bacteria are the most common cause for folliculitis. Some viruses and fungi may also cause folliculitis. Due to repeated friction by shaving or wearing tight clothing, prolonged sweating or exposure to heat, conditions such as dermatitis and injuries to the skin can cause folliculitis.

Use of contaminated towels or soaps and swimming in uncleaned pools increases the risk of infection. Immune compromised conditions such as HIV, history of diabetes, obesity, and long-term use of steroid creams and antibiotics increases the risk of folliculitis.

Complications

Folliculitis is self-limited condition and complications are uncommon. Formation of abscess or cysts that require minor surgery, boils under the skin, permanent scarring (due to aggressive scrubbing or deep inflammation), damage to hair follicles or hair follicle infection or permanent hair loss, and recurrent infection are some of the complications of folliculitis.

When to seek medical advice?

If you have skin irritation associated with fever, if there is a spread of rash to other parts, and if there is pus formation in the bumps, consult your doctor immediately.

Diagnosis

Your doctor performs a skin examination and may ask questions about your general health and daily activities to identify the underlying cause. Your doctor also may also ask questions about the onset of symptoms, duration of infection, and also other symptoms you are experiencing.

Diagnostic tests are performed to rule out other conditions such as impetigo or heat rash that have similar symptoms.

Your doctor uses a swab to take the sample from the infected skin. This sample is sent to a laboratory for examination, and to determine the cause of infection. A skin biopsy is also performed in few cases.

Treatment

Folliculitis is self-limited and doesn’t require treatment. The folliculitis treatment depends on the type and severity of the infection.

Antibiotic creams such as mupirocin or pills are given to control the infection. Topical or oral corticosteroids are given to reduce inflammation. Corticosteroids are given in topical form in case of mild infection, and oral forms are prescribed in case of severe infection.

If the follicle has turned into a boil, your doctor may prefer minor surgery. The procedure involves making a small incision and draining the pus.

If the other treatments don’t work, your doctor may recommend photodynamic therapy or laser therapy to remove the infection.

During treatment, don’t shave, pluck, or wax hair as hair growth can help you to heal. Use a warm compress to relieve pain and irritation. Wash your towel or any other wash clothes every day until the symptoms subside. You can use medicated shampoo for cleaning scalp or beard.

Self-management

The infection may recur even after the treatment. So, it is necessary to maintain few precautions to prevent new or recurrent infection.

  • Don’t wear tight-fitting clothing
  • Apply soothing lotions that don’t block your skin pores
  • Avoid using oils as oil can clog the skin pores
  • Avoid sharing razors, soaps, or towels
  • Use cleaned hot tubs or in case of pools add chlorine as recommended