FOLLICULITIS – Causes, Risk Factors, Types, Clinical Manifestations, Treatment

Folliculitis means an inflammation or infection of the hair follicles of the skin. It is a common problem that is not usually serious. Tiny pus-filled spots (pustules) develop at the base of a hair where friction, moisture, rubbing or oil is more, often in crops.

CAUSES

Folliculitis usually occurs at sites where hair follicles are damaged by friction or shaving or where there is blockage of the follicle. Excessive sweating due to over-activity of the sweat glands can be another cause. Sometimes, using a steroid cream on the face can trigger about of folliculitis. Other common sites for folliculitis are the beard, arms, legs, armpits and buttocks.

Bacterial folliculitis is commonly due to Staphylococcus aureus
Spa pool folliculitis is due to infection with Pseudomonas aeruginosa
Malassezia folliculitis is due to yeast is Pityrosporum ovale, also known as Malassezia.

 

RISK FACTORS

  • Overuse of topical steroids
  • Long-term antibiotic therapy for acne
  • Ringworm of the scalp (tinea capitis)
  • Poor hygiene
  • Poor nutrition
  • Prolonged skin moisture from excessive perspiration
  • Friction from shaving or tight clothing
  • Inflammatory skin conditions, including dermatitis and acne
  • Injuries to skin, such as abrasions or surgical wounds
  • Coverings on skin, such as plastic dressings or adhesive tape
  • Exposure to hot water, such as a hot tub or a heated swimming pool


 

TYPES OF FOLLICULITIS

Folliculitis can occur anywhere on hair-bearing skin. There are a few specific types of folliculitis that deserve a mention:

 

  1. Sycosis Barbae: This is the medical name for a chronic folliculitis in the beard area of the face in men. It often affects the upper lip and it can be difficult to treat. The skin is painful and crusted, with burning and itching on shaving.
  2. Hot Tub Folliculitis: as the name suggests, this tends to affect people who use hot tubs a lot. The hot water encourages germs bacteria called pseudomonas species to grow. This type of folliculitis is generally harmless and is prevented by proper maintenance of hot tubs
  3. Gram-Negative Folliculitis: this is a type of folliculitis that may occur after acne has been treated with long-term antibiotics. Gram-negative refers to a type of stain that is used in a laboratory to identify different types of bacteria.
  4. Pseudo-Folliculitis: This is not really a true folliculitis. It does look similar, as little lumps form at the bases of hairs. These lumps do not contain pus. They are actually due to in growing hairs. Sometimes this problem causes scarring.


 

CLINCIAL MANIFESTATIONS

1. Superficial folliculitis, which affects the upper part of the hair follicule, may cause:

  • Clusters of small red or pus-filled bumps that develop around hair follicles
  • Pus-filled blisters that break open and crust over
  • Red and inflamed skin
  • Itchiness or tenderness


 

2. Deep folliculitis starts deeper in the skin surrounding the hair follicle and affects the entire hair follicle. Signs and symptoms include:

  • A large swollen bump or mass
  • Pus-filled blisters that break open and crust over
  • Pain
  • Possible scars once the infection clears


 

TREATMENT

  1. Mild folliculitis usually heals on its own in about 2 weeks
  2. Warm compresses made with white vinegar or Burow’s solution ease itching and helps healing
  3. Medicated shampoo can be used to treat folliculitis on the scalp or beard
  4. Antibiotics applied to the skin (mupirocin) or taken by mouth (dicloxacillin)
  5. Antifungal medications to control the infection
  6. Apply a warm, moist wash cloth or compress to the affected area several times a day to relieve discomfort and help the area drain, if needed
  7. Try an oatmeal lotion or over-the-counter hydrocortisone cream to help soothe itchy skin
  8. Gently wash the infected skin twice a day with antibacterial soap or apply an over-the-counter antibiotic ointment. Use a clean washcloth and towel to dry off each time wash
  9. Avoid shaving irritated skin. If must shave, use an electric razor rather than a blade and apply a soothing aftershave lotion when finished. Also, shave in the direction of hair growth rather than against it
  10. Don’t share towels or washcloths, and launder them in plenty of hot, soapy water after every use. Wash clothes that cover the affected areas after each wearing​  

FOLLICULITIS – Causes, Risk Factors, Types, Clinical Manifestations, Treatment 

FOLLICULITIS – Causes, Risk Factors, Types, Clinical Manifestations, Treatment
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