Folliculitis

What is folliculitis?

What is folliculitis?

Folliculitis is a pervasive, benign skin disorder that appears as pinpoint red bumps, each one involving a hair follicle, occasionally with a small dot of pus at the top. It affects people of all ages, from babies to seniors.

What is razor burn folliculitis?

Razor burn folliculitis is very common on the male neck and women's legs and is caused by shaving. Repeated passes by the razor produce tiny cuts that allow bacteria to enter the skin and invade the deeper hair follicles. Additionally, excessively close shaving may cause the trapping of small hairs beneath the skin surface (ingrown hairs), causing more inflammation. Occasionally, waxing (which utilizes warm paraffin that, once solidified, is then ripped away, removing encased hairs) can produce folliculitis.

Treatment involves stopping shaving with a razor for a few days to a few weeks and using antibacterial washes and topical antibiotics. Frequently, shaving less vigorously and leaving a small bit of stubble is advisable in the case of ingrown hairs.

What is hot tub folliculitis or Jacuzzi folliculitis?

Hot tub folliculitispurple bumps

The hot tub should be tested and possibly treated by trained pool and spa personnel for bacterial overgrowth. Affected patients may be more prone to recurrences in the future and should be cautious about hot tub use. Although this condition often resolves without treatment, it may be useful to rinse the skin with dilute vinegar.

What is pseudofolliculitis barbae?

Pseudofolliculitis barbae is a very common ingrown hair condition, often referred to as "razor bumps," and is most likely to occur with the use of blade razors. Typically, there are groups of small, red bumps on the beard area that may flare with repeat shaving. This condition may occur on the beard area (lower face and neck) of men but may affect any shaved area, including armpits, limbs, and pubic areas. Pseudofolliculitis tends to be worse with very curly or kinky hair. It can be quite debilitating, especially if one's employment requires a closely shaven appearance. Cutting the hair close to or below the follicular orifice results in hairs that penetrate the follicular wall as they twist and grow. These trapped hairs cause irritation and inflammation in the hair follicles. Alternatively, the hairs may grow into the skin nearby. Bacterial infection may also set in.

Treatment goals include avoiding shaving altogether, corrections to the shaving technique, or a trial of using a "bump-free razor." Correct shaving technique reduces ingrown hairs and includes shaving in the direction of hair growth whenever possible and not stretching the skin taught while shaving to avoid too close a shave. Blade razors should be replaced often to ensure sharpness. Regular exfoliation helps loosen and free trapped hairs. Moisturizers or toners containing antibacterial exfoliating agents such as salicylic acid, benzoyl peroxide, or glycolic acid can also help. If infection is suspected, topical or systemic antibiotics may be prescribed.

Hair removal options that do not cause pseudofolliculitis barbae include professional laser hair removal, electrolysis, electric razors, or a prescription drug called eflornithine (Vaniqa).

What are common types of folliculitis?

The common typesfolliculitis

• Acne vulgaris
  • Acne vulgaris occurs almost universally in teenagers at puberty. Acne vulgaris is usually not considered folliculitis, but it specifically affects the hair follicles of the face, chest, and back.
• Drug-induced folliculitis
  • Systemically administered or topically applied steroids (cortisone-containing medications) are a well-known cause of folliculitis. Certain anti-cancer drugs produce a form of folliculitis.
• Cutting oil folliculitis
  • Machinists exposed to insoluble cutting oils, which are used to decrease friction while machining metal parts, can develop folliculitis on the exposed skin.
• Staphylococcal folliculitis
  • Staphylococci are bacteria that commonly inhabit the skin. One species, S. aureus, is a frequent cause of folliculitis. Occasionally, this organism may be insensitive to several commonly used antibiotics (such as methicillin-resistant Staphylococcus aureus, or MRSA). In this situation, a culture of the organism with sensitivities must be performed so that the ideal antibiotic is selected to treat the infection.
• Fungal folliculitis
  • Folliculitis from a fungus infection can occur on the face and the lower legs. It is often exacerbated by shaving. It can also occur on the trunk (Pityrosporum folliculitis).
• Viral folliculitis
  • Folliculitis from a viral infection often affects the face and is caused by the herpes simplex virus, which affects the lips, leading to a condition commonly known as a cold sore.
• Scarring scalp folliculitis
  • There are a variety of rare, inflammatory, scarring types of folliculitis that can result in permanent hair loss.
• Eosinophilic folliculitis
  • Eosinophilic folliculitis is an uncommon condition that is poorly understood and occurs occasionally as a response to certain drugs, in immunosuppressed patients (AIDS and bone marrow cancers) and infants, affecting the scalp.

SLIDESHOW

What triggers folliculitis?

Folliculitis can be caused by a large number of infectious organisms. However, folliculitis may be sterile and may be induced by irritating chemical substances, drugs, occlusive clothing, and physical irritants like shaving. Differentiating these causes is very important for the physician to be able to treat the condition successfully.

Other possible causes of folliculitis include:

• Improperly maintained hot tubs
• Plucking or waxing skin
• Medication
• Weight gain
• Exposure to insoluble cutting oils
• Herpes simplex virus
• Certain fungal infections

Who is most at risk of folliculitis and where does it develop?

Anyone can develop folliculitis in areas where hair follicles are present on the body. Lesions of folliculitis most frequently involve areas such as the face, scalp, chest, back, buttocks, groin, and thighs. Folliculitis probably affects all humans to some extent at some time during their lives. Folliculitis never involves the palms, soles, or eyelids because these areas are devoid of hair follicles.

Certain groups of people are more prone to develop folliculitis. People with diabetes and those with a compromised immune system (such as from HIV/AIDS, chronic diseases, cancer, systemic chemotherapy, and immune-suppressing drugs) may be more prone to developing folliculitis.

What are folliculitis symptoms?

Folliculitis is an inflammatory condition affecting hair follicles. It appears as a small, red, tender bump occasionally surmounted with a dot of pus surrounding a hair. Older lesions that have lost the pus appear as red bumps surrounding the opening of the follicle, where the hair is absent. One to hundreds of follicles can be affected in any area where hair is present.

Acne vulgaris, the facial rash that teenagers develop, is a type of folliculitis.

Signs of folliculitis include:

• Clusters of red bumps or pimples with hair in the center
• Itchy, burning skin
• Tender skin
• Pimples that break open and crust over
• Deep, swollen masses

What else could folliculitis look like?

There are a large number of exotic skin problems that may involve inflammation of the hair follicles. It takes an expert to distinguish these. If the condition does not resolve spontaneously, it is wise to visit a doctor.

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