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Folliculitis - Definition, Causes, Symptoms and Treatment


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Folliculitis is the name given to a group of skin conditions in which there are inflamed hair follicles. Folliculitis is usually caused by Staphylococcus aureus but occasionally Pseudomonas aeruginosa or other organisms. Hot-tub folliculitis occurs because of inadequate treatment of water with chlorine or bromine. Folliculitis can affect both women and men at any age. It can develop on any part of the body, but is most likely to occur on the scalp, face, or parts of the arms, armpits, or legs not usually covered by clothing. Symptoms are mild pain or irritation. Infected hairs easily fall out or are removed, but new papules tend to develop. Each follicle is attached to a small muscle. When you're cold or frightened, the muscle contracts, raising the hairs above the level of your skin and giving the appearance of goose bumps. Chronic or recurring folliculitis is less likely to clear with just antibiotics. Often this is on the legs of women, but it can occur in any areas of shaving, waxing, hair plucking or friction. These need to be stopped for at least 3 months to allow the hair to grow in healthy.

Deep folliculitis, which affects the entire hair follicle, can cause more severe signs and symptoms, including large, painful, pus-filled pimples that may leave scars when they heal. causes of folliculitis are multiple and include infection, friction, other causes of follicular trauma, excessive perspiration, and occlusion, but many cases remain idiopathic. Patients who have a reduced immune status, prior skin injury, or dermatoses or those who are obese may be more at risk. Mild cases of folliculitis sometimes heal on their own. However, folliculitis may return or get worse. If your folliculitis spreads or returns, see a health professional for proper treatment. Hot-tub folliculitis usually resolves without treatment. However, adequate chlorination of the hot tub is necessary to prevent recurrences and to protect others from infection. Medicated shampoos are available to treat folliculitis on the scalp or beard.

Causes of Folliculitis

Folliculitis starts when hair follicles are damaged by friction from clothing, blockage of the follicle, or shaving. In most cases of folliculitis, the damaged follicles are then infected with the bacteria Staphylococcus. Superficial staphylococcal folliculitis is quite common and is seen in people of all ages. This bacteria is commonly found in contaminated whirlpools, hot tubs, water slides, physiotherapy pools, or even loofah sponges. The condition may occur anywhere on the skin.

Common causes and risk factors of Folliculitis:

  • Long-term antibiotic therapy for acne.
  • Topical corticosteroid therapy.
  • Exposure to coal tar, pitch or creosote.
  • Inflammatory skin conditions.
  • Injuries to your skin such as abrasions or surgical wounds.
  • Trauma to your skin from surgery.

Signs and Symptoms of Folliculitis

The signs and symptoms of folliculitis vary, depending on the type of infection. In superficial forms of the disorder, small pimples develop around one or more hair follicles. It turns into a small, raised area of skin that contains pus and often itches or burns. Many small pustules appear on your torso and sometimes your arms and legs. You may have a mild fever and feel ill.

Sign and symptoms may include the following :

  • A rash.
  • Itching, and pimples.
  • Pustules near a hair follicle in the neck, groin, or genital area.
  • Reddened skin area.
  • The pimples may crust over.

Treatment for Folliculitis

Hot moist compresses may promote drainage of extensive folliculitis. Oral treatments are the most effective. If you have folliculitis, do not share a razor, towel, or washcloth with anyone because the condition is contagious. If the infected hair follicles are in an area that you shave, you may need to take a break from shaving until the condition has cleared up. You can help prevent scalp folliculitis by shampooing your hair regularly.

Treatment may include:

  • Topical antiseptic treatment is adequate for most cases.
  • Hot moist compresses may promote drainage of extensive folliculitis.
  • Oral treatments are the most effective. The two used are Nizoral and Sporonox.
  • Some patients may benefit from systemic flucloxacillin.
  • Topical antibiotics such as mupirocin ointment.