Folliculitis Causes, Symptoms, and Treatment

Folliculitis is a skin disorder that causes inflammation of the hair follicles. Tiny hair grow on the body from small, pouch-like structures within the skin called follicles. When a follicle gets infected by bacteria, it leads to folliculitus. It typically appears as a white or red eruption of the skin that surrounds a hair follicle.

When many hair follicles are infected, white or red rashes can be noted on the skin. It is a very common benign skin disorder which can be found in all age groups and gender. But it is more prone to certain groups of people, including people with diabetes, hepatitis, cancer, HIV/AIDS, people undergoing chemotherapy, etc.

Folliculitis can develop anywhere on the body. The most likely places vulnerable to this condition are arms, armpits, legs, or the scalp. Men who shave can develop face folliculitis. Parts of the body that experience maximum friction with clothes, like the thighs, groin, face, and scalp, develop hair folliculitis.

Most cases of folliculitis can be cured completely, only the time required to heal may differ. Delay in treatment may also affect the recovery time and can leave ugly scars. So, let us find out the symptoms, causes, and treatments for this skin disorder in the following paragraphs.

Every hair grows from a follicle. Even though hair is densest on the scalp, we have hair all over the body, barring the palms and soles. Each follicle is attached to a muscle above which there are sebaceous glands that produce sebum (an oil) to lubricate the skin and hair shaft.

When the follicles get blocked or damaged, they become prone to attacks from bacteria, viruses, and fungus which can lead to infections, such as folliculitis. Folliculitis is caused due to one or more of the following reasons

• Excessive perspiration that blocks the follicles for long periods of time
• Various inflammatory skin conditions, such as acne or dermatitis
• Skin abrasions or wounds
• Excessive friction while shaving (usually if shaving with a blunt blade)
• Friction due to tight clothing that irritates the skin

• Using a hot tub or swimming pool that is not treated with chlorine
• Use of substances or chemicals that irritates the skin and hair follicles, like perfumes, soaps, etc.
• People with diabetes and HIV prone to bacterial infections owing to compromised ability to fight off infections

The symptoms of this condition depend on the type of the infection you are afflicted with - superficial folliculitis or deep folliculitis.

Superficial Folliculitis
Superficial folliculitis consist of the following conditions with their possible symptoms:

▶ Hot Tub Folliculitis/Pseudomonas Folliculitis: Hot tub folliculitis is caused by Pseudomonas aeruginosa that thrives in hot and humid environment. It usually occurs after spending time in a hot tub that has not been cleaned properly. The infected person will develop red, itchy bumps on the legs, hips, buttocks within 12 to 24 hours.

These red bumps will then transform into pus-filled blisters. People who have open cuts or sores, diabetes, or a history of rash infections are more prone to being infected. The symptoms aggravate around the areas that are covered with wet clothing.

▶ Tinea Barbae: Tinea barbae is not caused by bacteria but by a fungus, T. rubrum. Tinea barbae could develop anywhere on the body as pus-filled lumps, having a deep red color and a crusty feel.

▶ Pityrosporum Folliculitis: It is caused by a fungus known as Malassezia furfur. It appears as itchy, red pustules on the chest, back, neck, shoulders, and face.

▶Herpetic Folliculitis: Herpetic folliculitis occurs when a blister caused by the herpes simplex virus is shaved and burst. The virus-filled fluid spreads and infects surrounding hair follicles.

Deep folliculitis occurs deep within the skin and the entire hair follicle is affected. Some of the deep folliculitis conditions and their symptoms include:

▶ Gram-negative Folliculitis: Gram-negative folliculitis develops in people who are on antibiotics for treating acne. The antibiotics usually alter the balance of the bacteria in the nose, causing excess growth of the Gram-negative bacteria. It is when this bacteria spreads to other parts of the face and affects the follicles. This happens rarely, especially when proper hygiene is not maintained.

▶ Barber's Itch: Barber's itch appears on the shaving area of the faces of men. It is also called Sycosis vulgaris or Sycosis barbae. They appear as pus-filled lumps where the skin has been irritated with a blunt blade and infected by the Staphylococcus aureus bacteria. This can also happen to women on their legs or underarms.

▶ Boils and Carbuncles: Boils and carbuncles develop when the follicles are heavily infected with the Staphylococcus aureus bacteria. The boils will usually be big and filled with pus. They usually break and dry up, leaving no mark. Carbuncles are when many boils form. These take more time to heal and could leave slight scars. They might be painful, too.

▶ Eosinophilic Folliculitis: This infection mostly afflicts people with HIV. It is characterized by inflamed, patched, pus-filled sores on the face, upper arms, and back of the body. It may leave a dark patch once it is healed.

The treatment will depend on the type of infection that you have. Following are some of the treatments which you may be prescribed by your dermatologist. Do not try to cure the infection on your own as it can spread and will be difficult to cure later

• Hot tub folliculitis usually will heal by itself, but a topical cream to stop the itching could be prescribed. In severe cases, an oral antibiotic will clear the infection.

• In case of a Barber's itch, the affected area should not be shaved until the infection is totally cured. If the infection takes a long time to cure, oral antibiotics will help to speed up the process.
• Tinea barbae is cured with a prescribed antifungal cream.

• Pityrosporum folliculitis is cured using topical and oral antifungal medication. Since the chances of recurrence are more, you may be asked to use an antifungal cream for some time even though there is no infection.
• Herpetic folliculitis will usually clear by itself. If it does not clear within a week, the physician may prescribe an antiviral medication.

• Gram-negative folliculitis is caused by long-term use of antibiotics and is also cured using prescribed antibiotics.
• Boils and carbuncles will heal by themselves. The doctor could puncture the boil and drain out the fluid to speed up the healing process. In severe cases of carbuncles, antibiotics could be prescribed to heal and prevent spread of infection.

Following precautions will definitely help you to prevent and stop the spread of this skin condition.

• Especially during warm weather, one must avoid wearing clothing that are very tight and irritating to the skin.
• While shaving, make sure that the beard/skin is well-lubricated. Also, always use a sharp blade.

• Those who own hot tubs should maintain them regularly. If using a commercial hot tub, make sure that it is well-maintained and chlorinated.
• Folliculitis can spread from one part of the body to another. Also, avoid bodily contact with someone who has any form of folliculitis.

• Never share your towels and tight-fitting undergarments with an affected person.
• If you have folliculitis, make sure you wash all your clothes separately in warm water as soon as they are removed from your body.
• Do not scratch the bumps.

• Do not use oil on your skin if you are prone to folliculitis as oil traps bacteria and may further cause infections.

Visit your physician as soon as you notice any symptoms of the infection. Folliculitis is never a serious infection, but if it is ignored in its initial stages and allowed to spread, it will not only look really ugly but will take more time to heal and could even leave a permanent scar behind. Maintain proper hygiene and stay healthy!

Disclaimer: This story is for informative purposes only, and should not be used as a replacement for expert medical advice.