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What is Folliculitis?

Folliculitis is a common skin condition that involves the hair follicles of your skin. It refers to the inflammation or infection of these follicles and as a result, small red bumps appear on your skin. It can also present as acne or white-headed pimple around the affected hair follicles, which can eventually spread and form nonhealing crusty lesions. Furthermore, the skin might become itchy and red.

While our skin is made up of 20 different cell types, each one of these plays a role in providing protection and support to different structures. Hair follicles are pocket-like tiny holes in our skin, through which our hair grows. Hair growth is controlled by multiple factors, such as hormones or immune cells, resulting in a range of hair types.

Although folliculitis is harmless, it can be irritating with skin becoming itchy and sore over time. Though the urge to scratch is strong, you should avoid scratching as it might worsen the infection. Pus-filled blisters might develop under your skin, which eventually burst to crust over.

You might develop folliculitis for multiple reasons. Diabetic patients are prone to develop folliculitis as well as those who are obese. Not keeping your skin clean and dry right after excessive sweating might increase your risk of developing folliculitis. Moreover, some specific types of folliculitis are associated with shaving or long-term antibiotic use.

Types of Folliculitis

There are two major types of folliculitis, superficial and deep folliculitis. The former involves some part of the hair follicle while the other is more severe, involving the entire follicle as well as the dermis around the affected follicle.

Superficial Folliculitis

Bacterial Folliculitis

As the name suggests, this type occurs when one’s hair follicles are infected by bacteria, mostly Staphylococcus aureus. This bacterium is naturally present on your skin, but once it enters your body either through a wound or a cut, it can infect your hair follicles. Infected hair follicles appear inflamed pus-filled and itchy.

Hot Tub Folliculitis

Otherwise known as pseudomonas folliculitis, is a type of superficial folliculitis in which one might develop a red rash with itchy bumps a few days after exposure to the organism. The bacteria, Pseudomonas aeruginosa, is mostly found in hot tubs with unregulated pH levels.

Razor Bumps

A skin condition due to ingrowth of hair, affecting men with curly hair who shave too close to the skin, or people who get bikini waxes and develop a similar itch near the groin (barber’s itch). Continuous and aggressive scratching might result in dark raised scars.

Deep Folliculitis

It can appear as furuncles or carbuncles. Furuncle (boil) is like folliculitis, deeply infected and involving one hair follicle, while a carbuncle is a deeply infected skin lesion, involving multiple follicles. The most common organism causing these lesions is Staphylococcus aureus. Infection presents in the form of a painful red bump. Furthermore, there are other types of deep folliculitis, some of which are, Eosinophilic folliculitis and Sycosis barbae.

Eosinophilic Folliculitis

This type of folliculitis is seen most in immunocompromised (not fully functioning immune system) individuals, such as those with HIV/AIDS. People most commonly suffer from recurrent itchy bumps and pimples near their facial hair or upper body hair.

Sycosis Barbae

Potentially scarring this type commonly affects men who have recently started shaving. Infection results in a large red pustule mostly on your beard area.

Treatment of Folliculitis

While severity decides the course of treatment, milder forms require less care than severe ones that might require medications or other interventions.

Medical treatment involves using medicated creams, shampoos, or pills to control the infection. Antibiotic creams, ointments, or gels are commonly prescribed by doctors for bacterial folliculitis, rather than oral antibiotics. Oral antibiotics are given only in cases of systemic infections and in severe cases.

For fungal forms, which cannot be treated by antibiotics, a doctor may prescribe you medicated shampoos and creams. Furthermore, you might be prescribed medications to reduce inflammation and itching.

Other interventions include a minor surgery requiring an incision to drain the pus from a large boil or carbuncle. This aids recovery relieves pain and reduces scarring. Laser hair removal for long-term hair removal might be a bit expensive but is a definitive treatment as it aims to permanently damage the hair follicles preventing further hair growth, reducing the chances of re-infection while clearing up the existing one.