Folliculitis is an inflammation of the upper part of a hair follicle. The inflammation is caused by an infection. This infection usually leads to the emergence of a pus head at the location of the hair follicle. There is often an itchy or painful skin too. Folliculitis is a common problem and is usually not severe.
Folliculitis is almost always caused by bacteria or fungi. In the vast majority of cases, it is caused by staphylococcal bacteria. This form of folliculitis can occur on the entire body, but the bacterium strikes especially in areas where the skin has been shaven: the face (beard area), armpits, pubic area and legs. Folliculitis that is caused by pseudomonas bacteria is also known as ‘hot tub folliculitis’. The bacteria penetrate the skin and inhabit in the hair follicles. Within a few days they cause an inflammation there. The disease begins six hours to five days after exposure.
Additionally, a skin infection with pityrosporum (a yeast) is common. A yeast is a single-celled fungus. The source of the yeast infection is usually located on the scalp. As a result of the infection, eczema often develops (the famous ‘dandruff'). Also on the back and chest, numerous one to two millimeters large itchy, red bumps with pus heads can appear. Folliculitis on the scalp and in the face (beard area) can sometimes also be caused by dermatophyton fungi. Fungi that can cause folliculitis are usually transferred by pets and other animals.
An infection with the herpes virus may occasionally spread to the hair follicles in the immediate vicinity and cause folliculitis. This usually happens around the mouth. Folliculitis sometimes also occurs with acne, as side effect of certain medications or in case of an autoimmune disease. In the latter case, the immune system sees the healthy cells in the hair follicles as a threat and attacks them. The body reacts with an inflammatory response. Folliculitis is not contagious to other people.
The inflammation can occur anywhere on the body where hair is found. The condition usually occurs on the arms, legs, back, scalp, face and neck. Characteristic for folliculitis are the small pus heads in the opening of the hair follicle. Pus heads can break, causing superficial wounds which can produce yellow exudate. The inflammation may extend deeper into the skin, thus creating red, painful bumps in the skin. These skin disorders can cause a lot of itch.
Although folliculitis may resemble acne (pimples), it is essentially different. Acne is mainly an inflammation of the sebacious glands and not just of the upper part of the hair follicle. Other skin conditions that are similar to folliculitis, but actually are not, are rosacea, perioral dermatitis and pseudofolliculitis.
The doctor can often immediately see which type of folliculitis it (very probably) is. If there is doubt, a culture of the content of the pimples can be made. Since the outcome of the culture often takes some time (days to weeks), the patient will be given, in case of extensive folliculitis, a drug against the most likely cause of the condition.
Folliculitis often cures spontaneously and doesn’t need to be treated. If the condition often recurs and becomes chronic, the doctor may prescribe a treatment.
If bacteria have caused the infection, the skin can be treated by washing daily with an antibacterial soap (iodine or chlorhexidine). If the scalp is also affected, it can be washed with an iodine shampoo. Lubricating a honey-containing ointment can also be useful.
If yeasts are concerned, a cream or shampoo is usually prescribed by the doctor. Any defects on the scalp will also be treated.
If a drug has caused the skin disorder, it must obviously be discontinued.
Folliculitis usually proceeds without complications. Generally, it cures on its own. However, some people may develop folliculitis repeatedly. It’s therefore wise to let this skin condition be treated by the doctor.
- Never squeeze pimples. This increases the risk of self-infection and worsening of the inflammatory response.
- Don’t wear tight clothing.
- Don’t use skin care agents that irritate the skin.
- Don’t use fatty ointments or oils.
- Ensure good general hygiene.