Folliculitis is common and can occur at different ages. It is most frequently seen in young adults and adults of both genders. It is normal to experience one or several episodes of folliculitis However, some patients may have recurrent, widespread, and symptomatic folliculitis.
Folliculitis appears as a pimple-like lesion around the hair follicle, with redness and swelling. Sometimes, folliculitis presents as a red bump with a white pus-filled centre.
Folliculitis can occur as single lesions, small clusters, or spread across large areas of the body. It can occur anywhere with hair, including the scalp, chest, back, buttocks, and legs. Palms of the hands and soles of the feet, where hair is absent, are unaffected by this condition.
Folliculitis usually does not cause significant discomfort, apart from mild tenderness. A deep folliculitis, called a furuncle, can develop into an abscess (pus-filled boil) and cause pain. If multiple furuncles merge and cause systemic symptoms, it is referred to as a carbuncle.
Persistent and inflamed folliculitis can lead to scarring of the hair follicle and surrounding skin. This is particularly problematic on the scalp.
Folliculitis can have various causes. It is important to identify potential contributing factors, as well as aggravating factors. Microbiological diagnostics (bacterial and fungal cultures) may be necessary incases of recurrent skin issues. In rare instances, blood tests and/or biopsies may be performed.
Folliculitis is often caused by superficial and harmless bacterial or fungal infections. Staphylococcus aureus, a type of bacteria, is commonly involved. Risk factors for infectious folliculitis include immunosuppression, obesity, diabetes, prolonged use of prednisolone or antibiotics, and certain medications. A specific type of bacterial folliculitis called pseudomonas folliculitis can be triggered by hot tub exposure.
Other forms of folliculitis are caused by friction against the skin (e.g., shaving), tight clothing (e.g., jeans, workout attire), ingrown hairs, increased sweating, dry skin, and skin irritants. Thick, greasy creams and ointments can also contribute to folliculitis.
Treatment focuses on addressing the underlying cause. As a general rule, it is advised to avoid tight clothing, excessive sweating, and skin dryness. Frequent changing of clothes (especially after exercise and swimming) and towels may also be beneficial.
Infections can often be managed with frequent washing of the affected area with soap and water. Antiseptic hygiene products may be necessary. In some cases, antibiotics or antifungal medications (in cream, liniment and/or tablet form) may be required. For certain types of folliculitis, hair removal can be an effective treatment. Laser hair removal is among the methods used. Other patients may receive advice on proper shaving techniques.
Folliculitis closely resembles acne. However, unlike acne, which originates from sebaceous glands, folliculitis is associated with inflammation of the hair follicles. Therefore, folliculitis has a central hair shaft.
