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What is folliculitis ?

Infection of the hair follicles, with staphylococcus or other bacteria is known as folliculitis. Certain varieties of folliculitis are known by the name of barber’ itch or hot tub folliculitis. Severe bacterial or fungal infections of this type can cause permanent hair loss.

Normally infections appear as small pimple like, white heads around hair follicles. Most of them are shallow and fade off within few days. But the deep and recurring folliculitis needs medication.

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Is folliculitis contagious ?

Folliculitis normally is not contagious. But certain types like  Staphylococcal Folliculitis can be very contagious. In the contagious cases, the infection can be spread through bacteria in the form of contact with the skin of the infected  person, sharing towels, clothes, under clothing, razors etc.

Symptoms of folliculitis

Depending on type of infection, the symptoms of folliculitis vary.

Superficial folliculitis which occur on upper part of hair, cause:

  • Cluster of pus-filled bumps around hair follicles.
  • Skin inflammation
  • Pus filled blisters
  • Tenderness and itching

Deep folliculitis develops deeper in skin around hair follicles and their symptoms are:

  • Large swollen bump
  • Pain
  • Pus filled blisters

Complications of mild infections are:

  • Spreading of infection and recurrence
  • Itchy patches of staph infection.

Folliculitis of severe nature includes the following complications:

  • Scarring: It leaves dark patches of thick skin and scars.
  • Furunculosis: More number of painful pus filled boils develop.
  • Destruction of hair follicle: Results in permanent hair loss.

Types of folliculitis

Types of superficial form of folliculitis are:

  • Staphylococcal folliculitis: They are itchy, pus filled bumps which can occur throughout the body where hair follicles are present. The staphylococcus aureus bacteria which enter the body through cuts and wounds, and when it affects the beard area, it is called as barber’s itch.
  • Pseudofolliculitis barbae: It is an inflammation of skin in beard area, when a shaved hair curves back into the skin and sometime causes scars
  • Pseudomonas folliculitis: A continuous exposure for eight hours to 5 days, to Pseudomonas bacteria, which spread through contaminated water, causes red rash, itchy bumps. Later they develop into pus filled pustules.
  • Pitrosporum folliculitis: It is caused by yeast that develop chronic, red, itchy pustules on chest, back and other parts of the body.

Types of deep folliculitis are:

  • Sycosis barbae: It is an inflammation of whole hair follicle for men who have begun shaving. Small blisters appear on upper lip, chin and jaw and continue to prevail with shaving. A severe case can cause scars.
  • Boils and carbuncles: It is a deep infection of follicles by staph bacteria and appear suddenly as a painful red bump. The pus filled painful bump grows bigger and finally ruptures and drains and leaves scare. A cluster of boils that occur on back of neck, shoulders, back and thighs are called as carbuncles which causes deeper and severe infection. They heal slowly and leave scars.
  • Gram-negative folliculitis: Long term use of antibiotics for acne, which alter the balance of nasal bacteria cause this type of folliculitis. In most cases, it does not cause problems, once the antibiotics have stopped. In few cases, the spread of this bacteria cause severe acne lesions.
  • Eosinophilic folliculitis: The exact cause of Eosinophilic folliculitis is not known. However it is believed that the yeast-like fungus responsible for pityrosporum folliculitis may be a possible cause. Primarily it is seen with HIV infected persons, with recurring patches of inflamed, pus filled sores, mostly on face, sometimes on back and upper arms.

Causes of folliculitis

The most common causes of follicle damage are:

  • Friction caused by shaving or tight clothing
  • Inflammatory skin conditions
  • Excessive perspiration
  • Plastic dressings or adhesive tape cover
  • Injuries, abrasions and surgical wounds.

Factors that aggravate the conditions are:

  • Lesser resistance power to infection due to the presence of organ transplantation, diabetes, HIV/AIDS and chronic leukemia
  • Surgery or skin injury
  • Long- term antibiotic therapy for acne.
  • Skin condition  such as dermatitis or acne
  • Excessive weight or obesity
  • Topical corticosteroid therapy
  • Heat-trap clothing, wearing high boots or waders.
  • Exposure to hot water tub, or heated swimming pool

Folliculitis treatment

The medications for folliculitis depend on the type and severity of infection.

  • Staphylococcal folliculitis: Oral and topical antibiotic medicines are prescribed. Avoid shaving till the infection is healed or use an electric shaver or a new blade for every new shave.
  • Pseudofolliculitis barbae: Self care methods like shaving by using electric razor, or a new blade after applying gel instead of shaving cream on the beard, shaving only in the direction of hair growth and apply moisturizing after shave, after rinsing the face.
  • Pseudomonas folliculitis: To control itching oral or topical medicines may be prescribed. More serious cases may need an oral antibiotic.
  • Pityrosporum folliculitis: Topical and antifungal medicines are prescribed. Indefinite use of topical ointments is advised as there are greater chances of the condition, recurring. Antibiotics are not recommended as it tends to upset the balance of bacteria on skin.
  • Gram-negative folliculitis: As it is caused by long term antibiotics therapy, it is treated with some topical or oral antibiotics.
  • Sycosis barbae: Doctor may advice warm saline compresses and topical antibiotics. If infection is severe, he may advice an oral antibiotic.
  • Eosinophilic folliculitis: Topical corticosteroids are the choicest treatment, but it should be for a short period as it has serious side effects. For persons with HIV/AIDS, topical steroids may be prescribed with oral antihistamines.
  • Boils and carbuncles: The deep infection pus is removed by doctor by making a small incision and may prescribe antibiotics for healing and to prevent recurrence.

Folliculitis pictures

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