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Bacterial folliculitis, Razor bumps (pseudofolliculitis barbae), Hot tub folliculitis, (pseudomonas folliculitis), Gram-negative folliculitis, Sycosis barbae, Eosinophilic folliculitis, Pityrosporum folliculitis, Boils (furuncles) and carbuncles

Scalp Folliculitis

Causes, symptoms and treatment

Folliculitis is one of the most prevalent common skin conditions in which hair follicles become infected and inflamed. It is usually caused by a fungi or bacteria and rarely by viruses. At first, it may look like small white-headed pimples or red bumps around hair follicles. The infection can spread from the initial site and turn into non-healing, crusty sores.

The condition is not life-threatening (with exceptions like folliculitis of the inner nose), but it can be sore, itchy and embarrassing. Severe follicle infections can cause permanent scarring and hair loss. 

Types of folliculitis

  • Bacterial folliculitis.
  • Razor bumps (pseudofolliculitis barbae)
  • Hot tub folliculitis (pseudomonas folliculitis)
  • Gram-negative folliculitis
  • Sycosis barbae
  • Eosinophilic folliculitis
  • Pityrosporum folliculitis
  • Boils (furuncles) and carbuncles

Symptoms

Signs and symptoms of folliculitis include:

  • Clusters of small white-headed pimples or red bumps that develop around hair follicles
  • Itchy, burning skin
  • A large swollen bump or mass
  • Pus-filled blisters
  • Painful, tender skin

 Causes

You are more likely to get a follicular infection if you:

  • Use a hot tub, swimming pool or whirlpool that is not adequately treated with chlorine.
  • Use or work with chemicals that can irritate the follicles. Examples include cocoa butter, motor oil, make up, creosote (Wood preservatives) and tar.
  • Wear tight clothes that can irritate the skin.
  • Have an infected surgical wound, cut or scrape. The causative bacteria or fungi can spread to adjacent hair follicles.
  • Have a systemic disease such as HIV or diabetes that suppresses your immune system.

Treatment

Treatments for folliculitis depend primarily on the type and severity of infection, what self-care measures you have already tried and your medico-surgical preferences. Options include medications and surgical interventions such as laser therapy.

 Medications

Topical creams, ointments or pills to control infection. For mild folliculitis, your physician may prescribe an antibiotic cream or gel. Oral antibiotics are not routinely used for follicular infection. But for severe or recurrent infection, your physician may prescribe them.

Shampoos, antifungal creams or pills to fight fungal infections. Antifungal medicines are for infections caused by fungi rather than bacteria. Antibiotics are not helpful in treating this type.

Anti-inflammatory creams or drugs to reduce inflammation. If you have eosinophilic folliculitis, your physician may suggest you a steroid cream to reduce swelling and ease the itching. If you have AIDS or another immuno-suppressant disease like diabetes, you may see improvement in your symptoms after anti-inflammatory therapy. 

Other interventions

Minor surgery – If you have a carbuncle or large boil, your physician may give a small incision in it to drain the dead hair cells (pus). This may relieve pain, lessen scarring and speed recovery. In case pus continues to drain, your physician may then cover the infected area with sterile gauze.

Laser hair removal – If other treatments fail, long-term laser therapy that removes the infected hair may clear up the infection. Laser therapy is expensive and often requires multiple treatments. Its commonest side effect is the permanent removal of hair follicles, thus decreasing the density of the hair. It may also cause scarring, blistering and discoloured skin.

 

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