Folliculitis is a common skin condition in which hair follicles become inflamed. This condition is usually caused by fungal or bacterial infection. At first, it can look like white – headed pimples or red bumps around hair follicles. Hair follicles are tiny pockets from which each hair grows. This infection can spread and it can turn into non-healing and crusty sores. This condition is not life – threatening but it can be embarrassing, sore and itchy. When there are severe infections, then they can cause scarring and permanent hair loss [1]. If you have a mild case, then this condition can clear in a few days with basic self – care measure.
Symptoms of Folliculitis
Here are the signs and symptoms:
- A large swollen bump or mass
- Tenderness or pain
- Itchy or burning skin
- Red and inflamed skin
- Pus – filled blisters that break open and crust over
- Clusters of small red bumps or white – headed pimples that develop around hair follicles
You should visit your doctor if you have noticed that this condition is widespread. Also you should talk with your doctor if the signs and symptoms do not go away after a few days. Your doctor will give you antifungal or antibiotic medication to help control the problem.
Causes of Folliculitis
This skin condition is caused by infection of hair follicles which is usually happening from the bacteria Staphylococcus aureus. But also this condition can be caused by fungi, viruses and even an inflammation from ingrown hairs. It is classified as either deep or superficial, based on how much of the hair follicle it involves. The more severe is the deep folliculitis. Follicles are denset on our scalp and they can happen everywhere on our bodies, except our mucous membranes, lips, soles and palms. Damaged follicles have a risk of infection. The most common causes for follicle damage are:
- Covering on your skin, such as plastic dressings or adhesive tape
- Injuries to your skin, such as from scrapes or surgical wounds
- Certain skin conditions, such as acne and dermatitis
- Heat and sweat, such as that caused by wearing rubber gloves or waders
- Friction from shaving or tight clothing
The most common causes of folliculitis [2] are:
- Excessive sweating
- Bacterial infection
- Ingrown hairs
- Waxing
- Plucking
- Shaving
Less common causes are:
- Hirsutism: may be a complication of excess hair growth in women [3]
- Steroid creams: may sometimes trigger a bout of folliculitis [4]
- A weak immune system: for example, people with HIV are more susceptible [5]
- Mite infection: caused by parasites that lice in hair follicles
- Viral or fungal infection: such as herpes viruses or yeasts
Types of superficial folliculitis:
- Pityrosporum folliculitis
- Barber’s itch
- Hot tub folliculitis
- Bacterial folliculitis
Types of deep folliculitis:
- Eosinophilic folliculitis
- Boils (furunles) and carbuncles
- Gram – negative folliculitis
- Sycosis barbae
Risk factors: Every single person can develop folliculitis but there are some factors which can make you more susceptible to this condition such as
- Shaving [6]
- Soaking in a hot tub that is not maintained well
- Regularly wearing clothing that traps heat and sweat such as high boots or rubber gloves
- Being overweight [7]
- Taking some medications, such as steroid creams or long – term antibiotic therapy for acne [4]
- Past damage to your skin, as from injury or surgery
- Having acne or dermatitis
- Having a medical condition that reduces your resistance to infection, such as HIV/AIDS, chronic leukemia and diabetes
Complications: Here are possible complications of folliculitis:
- Destruction of hair follicles and permanent hair loss
- Permanent skin damage, such as scarring or dark spots
- Boils under the skin (furunculosis)
- Large, itchy patches of infected skin (plaques)
- Recurrent or spreading infection
If you have recurring or more serious folliculitis, then you need to see your doctor. There are certain types of folliculitis which are known as barber’s itch, razor bumps and hot tub rash.
References:
[1] Novak MA, Meyer JS. Alopecia: Possible causes and treatments, Particularly in captive nonhuman primates. Comparative Medicine. 2009;59(1):18–26.
[2] Rubenstein RM, Malerich SA. Malassezia (pityrosporum) folliculitis. The Journal of Clinic and Aesthetic Dermatology. 2014;7(3):37–41.
[3] Sachdeva S. Hirsutism: Evaluation and treatment. Indian Journal of Dermatology. 2010;55(1):3–7.
[4] Rathi SK, D’Souza P. Rational and ethical use of topical corticosteroids based on safety and efficacy. Indian Journal of Dermatology. 2012;57(4):251–9.
[5] National Center for Advancing Translational Sciences. Eosinophilic pustular folliculitis. Retrieved from rarediseases.info.nih.gov/diseases/8534/eosinophilic-pustular-folliculitis/cases/59674
[6] Ogunbiyi A. Pseudofolliculitis barbae; current treatment options. Clinical, Cosmetic and Investigational Dermatology. 2019;12:241–7.
[7] Mohammad NE, Elshimi E, Galal SA. Skin complications of obesity: Controlled prospective study. Clinical Dermatology Research Journal. 2017;2(2).
