Folliculitis

Folliculitis is a common condition that typically presents as inflammation and little bumps on the skin in the hair follicles – the roots from which the hair on the face and body emerge.

Overview

Folliculitis can either be mild and short-lived, or a severe, chronic (long-term) issue. Due to the variation in severity, it can sometimes lead to the misconception that folliculitis is nothing more than a passing inconvenience, which can be frustrating to those who have a more severe form.

As a result of the chronic, uncomfortable and sometimes unpredictable nature of the more persistent version of the condition, many patients find that it negatively impacts their quality of life and self-confidence. For these reasons, it is common for patients suffering with chronic folliculitis – especially in its more severe forms - to also experience psychological issues, such as depression and anxiety.

For many individuals, living with chronic folliculitis can be upsetting and traumatic, so it may be helpful to seek support from groups or organisations that can provide additional resources. There are also communities on social media, where individuals with chronic folliculitis share their stories to help support others with the condition.

Folliculitis predominantly affects the face, but it can affect any hair-bearing part of the body.

There are different types of the skin condition, including pseudo-folliculitis, which is not in fact folliculitis, but which presents similarly to the condition.

Most cases of folliculitis are mild, and will resolve in 7-10 days, but patients with recurring folliculitis (either short-lived or chronic) can usually be treated by their GP, and most pharmacies will be able to advise about over-the-counter treatments for pseudo-folliculitis. 

While the majority of folliculitis cases are not contagious, if doctors have identified a patient as carrying the S. aureus germ (a bacteria in the nose), it means there is a risk that the infection could be transferred to other people. This risk can be minimised by taking normal hygiene measures, and laundering clothing, bed linens and towels on a hot wash.



It is not advisable for people who have folliculitis or are known to carry the bacteria, to share razors, and they should avoid using hot tubs and jacuzzies.



Symptoms of Folliculitis

Folliculitis can develop anywhere on the skin that can grow hair – so certain areas of the body, such as the palms of the hands or the soles of the feet cannot develop folliculitis.

There is also a condition called pseudo-folliculitis, which is not actually a true subtype of folliculitis, but does look similar, as little lumps form at the bases of hairs, however they do not contain pus. These bumps are also commonly known as ingrown hairs.

Ingrown hairs often irritate the skin and present as a raised, red bump that looks similar to a pimple, and can sometimes be very sore. In men, ingrown hairs often present as a group of bumps on the chin, cheeks, or neck after they've shaved, and in women, they frequently occur on the legs or in the bikini area.

In most cases, an ingrown hair will resolve on its own, but if it doesn't go away, extraction methods such as ‘squeezing’ should be avoided as they can cause more damage, infection or permanent scarring to the skin. Some people find that bathing in warm water helps to resolve ingrown hairs.

There are several types of folliculitis:

This chronic condition presents in the bearded area of the face in men, as well as in some women. Often affecting the upper lip, the condition can be difficult to treat. The skin is sore and crusted, and pustules develop in the hair follicles. Shaving the area can result in burning and itchy sensations, so some men grow a beard to try and minimise it recurring.
The warm, moist conditions of jacuzzies and hot tubs encourage the growth of the bacteria that causes the condition. This type of folliculitis is generally treatable and can be prevented through proper maintenance and chlorination of hot tubs, or by avoiding them altogether. Showering before and after using a hot tub is not seen to reduce the chance of developing folliculitis.
This can occur after acne has been treated with long-term antibiotics, and its name refers to the stain used in conducting laboratory work to identify the various different types of bacteria.

Causes of Folliculitis

Most cases of folliculitis are the result of an infection from the bacteria Staphylococcus aureus. Typically, the bacteria live harmlessly in the noses of many people, without causing any problems, but sometimes they can cause folliculitis.

Folliculitis usually occurs at sites where the hair follicles have been damaged by friction (rubbing), or shaving, or where there the follicle is blocked.

Excessive sweating, also known as hyperhidrosis, can increase the risk of folliculitis. In some people, using a steroid cream on the face can also trigger folliculitis.

The most common area affected by folliculitis is the beard area of men, although women with facial hair can also develop the condition in the same area. Other common sites are the arms, legs, armpits and buttocks.

Other types of folliculitis have different causes, such as:

  • Hot tub folliculitis - This is caused by the bacteria that thrive in warm, moist conditions of jacuzzies and hot tubs. 
  • Gram-negative folliculitis - Different bacteria than staphylococci are involved in this condition. 

Pseudo-folliculitis, or ingrown hairs are hairs that have switched direction when growing, curled around and then grown back into the skin. Anyone can develop them, but they are more common in people who have very curly or coarse hair, as curly hair is more likely to bend back and re-enter the skin.

The risk of ingrown hairs increases after they’ve been shaved or cut, and they may also occur when dead skin cells block the normal hair growth.

Other conditions such as furuncles and carbuncles can also involve the hair follicles, and both are the result of bacteria, typically the S. aureus germ.

A furuncle is a skin infection that involves the hair follicle and its surrounding skin, and when clusters of furuncles join together under the surface of the skin, they form what is known as a carbuncle. Carbuncles and furuncles are typically much bigger and more painful than pustules caused by folliculitis.

Treatment of Folliculitis at Derma

Your appointment will begin with a skin check and medical history, followed by recommended treatment options.

Together with the dermatologist, you will discuss how to care for your skin, the latest and most effective folliculitis treatments, and explain all potential side-effects, enabling you to select the best options.

Mild to moderate forms of folliculitis may be controlled using topical treatments available from chemists, but depending on your condition, prescription creams may be necessary. The dermatologist will let you know whether it is beneficial to continue with any over-the-counter treatment, or if it is advisable to stop.

If folliculitis is more widespread or severe, Derma may be able to offer treatments with antibiotic tablets, which may be prescribed a single time, or periodically.

Depending on the treatment and the severity of your condition, further tests and follow-up appointments may be required to manage your treatment.

Each case of folliculitis is different, but whatever your needs, you can rest assured that Derma will provide the very best care for your skin, with access to the latest research and treatments.

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