Folliculitis : Symptoms, Causes and Treatment

What is Folliculitis

Folliculitis is a common skin problem that happens when you get bacteria or a blockage in a tiny pocket in your skin called a hair follicle. A follicle is a small hair cavity from which hair grows. Every single hair on the human body grows from its own follicle. Folliculitis is the name given to a group of skin conditions in which there are inflamed hair follicles. The result is a tender red spot, often with a surface pustule. You can have folliculitis on any part of your body that has hair, but it is most common in the beard area, back, arms, buttocks, and legs.

The condition isn’t life-threatening but it can be itchy, sore, and embarrassing. Severe infections can cause permanent hair loss and scarring.

Types of Folliculitis

Superficial forms include:

• Bacterial folliculitis. A common type of folliculitis is characterized by pus-filled pimples that itch. This type is usually caused by a staph infection, which normally lives on the skin but enters deeper tissues through a wound or other damage to the skin.
• Pseudofolliculitis barbae. Also known as barber’s itch, this type of folliculitis is caused by ingrown hairs. It affects up to 60 percent of black men and others with curly hair. It may also affect people in the genital area.
• Pseudomonas folliculitis. More commonly known as hot tub folliculitis, this is caused by a type of bacteria (pseudomonas) that is found in pools and hot tubs where the chlorine levels and pH balance are not adequately monitored. Symptoms usually appear within 72 hours of exposure and are most prevalent on the areas of the body covered by a swimsuit or on the back of the legs. Minor symptoms can resolve without treatment within 5 days.
• Pittosporum folliculitis. A yeast infection of the skin leads to chronic lesions that are red and itchy. It most commonly affects the face and upper body and is particularly prevalent in young adults and adult men.

Forms of Deep Folliculitis include:

• Sycosis barbae. A deeper form of barber’s itch can cause scarring and permanent hair loss.
• Boils. Staph bacteria deeply infect the follicle and lead to boils (furuncles) that are swollen and filled with pus. They continue to grow larger and become very painful until they rupture and drain. Clusters of boils (known as carbuncles) cause more severe symptoms than single boils. Scarring may result from large boils or carbuncles.
• Gram-negative folliculitis. People with acne who are on long-term antibiotic therapy may experience this deep form of folliculitis, as antibiotics affect the bacterial balance in the skin. The condition usually clears up once a person has finished their antibiotic treatment.
• Eosinophilic folliculitis. People with poorly controlled HIV, late-stage AIDS, or cancer are most likely to experience this form of folliculitis.

What Causes Folliculitis

You may get folliculitis if you have damaged hair follicles. Shaving or wearing clothes that rub the skin can imitate the follicles, which can lead to folliculitis. They also can become blocked or irritated by sweat, machine oils, or makeup. When the follicles are injured, they are more likely to become infected.

You are more likely to get folliculitis if you

• Use a hot tub, whirlpool, or swimming pool that is not properly treated with chlorine
• Wear tight clothes
• Use or work with substances that can imitate or block the follicles. Examples include makeup, cocoa butter, motor oil, tar, and creosote.
• Have an infected cut, scrape, or surgical wound. The bacteria or fungi can spread to nearby hair follicles.
• Have a disease such as diabetes or HIV that lowers your ability to fight this skin infection.

Symptoms of Folliculitis

Folliculitis signs and symptoms include:

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

Some serious symptoms that might indicate a life-threatening condition:

Folliculitis is not a serious condition but left untreated, a staph infection (an infection caused by staphylococcal bacteria aka staphylococcus aureus) can sometimes enter the bloodstream and spread, resulting in a systemic infection called bacteremia or sepsis that should be immediately evaluated in an emergency setting.

•  Change in level of consciousness or alertness, such as passing out or unresponsiveness
• Confusion or loss of consciousness for even a moment High fever (higher than 101 degrees Fahrenheit)
•  Severe difficulty breathing, which may be accompanied by pale or blue lips, rapid heart rate (tachycardia), and anxiety.

Risk Factors

Anyone can develop folliculitis. But certain factors make you more susceptible to the condition, including

•  Having a medical condition that reduces your resistance to infection, such as diabetes, chronic leukemia, and HIV AIDS
• Having acne or dermatitis
•  Taking some medications, such as steroid creams or long-term antibiotic therapy for acne
• Causing damage to hair follicles by shaving, waxing, or wearing tight clothing
• Any medical condition that increases your risk of infection
• Exposure to hot water, especially in hot tubs or heated swimming pools
• Long-term antibiotic skin treatments
•  Obesity

Prevention Tactics

Folliculitis infections largely involve bacteria, germs, and yeast entering the hair follicles. You can prevent and lessen the impact of folliculitis by:

• Keeping the skin clean
• Taking care while shaving
• Checking the chemical disinfectant levels of hot tubs and heated pools before using them.
• Washing off and removing your swimsuit when you get out of a hot tub
•  Bathe or shower daily with a mild soap.
•  Avoid sharing towels, washcloths, or other personal items.
• If you have folliculitis, use a clean washcloth, and towel each time you bathe
•  Do not scratch the bumps.
•  Avoid shaving the bumps. If you must shave, change the razor blade each time.
•  Avoid using oils on your skin. Oils can trap bacteria in the pores of your skin and can cause folliculitis.

Diagnosis of Folliculitis

The diagnosis of folliculitis is generally based on the appearance of the skin. In some situations. microbial culture of pus from the pustule will help to detect an infection. It may be necessary to pull out some of the affected hairs and examine these microscopically using potassium hydroxide to detect fungal infections or other infectious organisms. Occasionally, a small skin biopsy may be used to help the doctor confirm the diagnosis. Infectious causes include bacteria, fungi. viruses, and parasites. Usually. no specific blood tests are needed in the diagnosis of common folliculitis.

Treatment

Treatments for folliculitis depend on the type and severity of your condition, what self-care measures you’ve already tried, and your preferences. Options include medications and interventions such as laser hair removal. Even if the treatment helps, the infection may come back. Medications

• Creams or pills to control infection. For mild infections, your doctor may prescribe an antibiotic cream, lotion, or gel. Doctors don’t recommend oral antibiotics for folliculitis. But for a severe or recurrent infection, your doctor may prescribe them.
• Creams, shampoos, or pills to fight fungal infections. Antifungals are for infections caused by yeast rather than bacteria. Antibiotics don’t help treat this type
• Creams or pills to reduce inflammation. If you have mild eosinophilic folliculitis, your doctor may suggest you try a steroid cream to ease the itching If you have HIV AIDS, you may see improvement in your eosinophilic folliculitis symptoms after antiretroviral therapy.

Lifestyle and Home Remedies

Mild cases of folliculitis often improve with home care. The following approaches may help relieve discomfort, speed healing, and prevent an infection from spreading

• Apply a warm, moist washcloth or compress. Do this several times a day to relieve discomfort and help the area drain, if needed Moisten the compress with a saltwater solution (1 teaspoon of table salt in 2 cups of water)
• Clean the affected skin. Gently wash the infected skin twice a day with antibacterial soap Use a clean washcloth and towel each time and don’t share your towels or washcloths. Use hot, soapy water to wash these items. And wash clothing that has touched the affected area.
• Protect the skin. If possible, stop shaving, as most cases of barber’s itch clear up a few weeks after you stop shaving.
• Apply over-the-counter antibiotics. Try various nonprescription infection-fighting gels, creams, and washes.
• Apply soothing lotions. Try relieving itchy skin with a soothing lotion or an over-the-counter hydrocortisone cream.

Home Remedies for Folliculitis

1.Tea Tree Oil

It is known for its ability to fight bacteria and fungi; you can easily add tea tree oil to your favorite shampoo and body wash. This is particularly helpful for recurrent folliculitis as it is shown to be effective against bacteria that occur on the skin, including staph and most gram-negative bacteria. Moreover, it demonstrates great antifungal properties. Before using, do a small test patch in an inconspicuous area as tea tree oil can cause an adverse reaction for some people. Hence, if you don’t react to the test, mix 4 to 5 drops of tea tree oil with your favorite shampoo or body wash for each shower. Massage in well, allow to sit on your skin or hair for five minutes or so and rinse well.

2.Witch Hazel

Used for generations for skin ailments, witch hazel is safe and effective for a myriad of hair and skin conditions, including folliculitis. Witch hazel fights bacteria while soothing irritation, including itching and inflammation, Apply witch hazel with a sterile cotton pad on and around the bumps and pimples. For the scalp, mix several drops of witch hazel into your shampoo and your conditioner, and then wash, condition and style normally.

3.Neem oil

Because of its powerful antiseptic and antifungal properties, neem oil may rid the skin of bacteria and certain fungal infections, including Candida albicans, while reducing redness and inflammation. To relieve a bacterial or fungal infection on the skin or scalp, mix 3 drops of neem oil to I tablespoon of coconut oil or almond oil. Apply to affected areas and massage gently into surrounding areas to help kill any surface-level infection. Leave overnight, if possible, or at least six to eight hours.

4.Turmeric

Known for its anti-inflammatory, antimicrobial, and antioxidant properties, it has shown significant improvement in skin disease severity with turmeric/curcumin treatment. When fighting a folliculitis outbreak, take 600 milligrams three times a day of a high-quality turmeric supplement.

Moreover, make sure you select one that contains black pepper as it increases turmeric’s absorption. Topically, a turmeric paste may help fight infection. But – beware – the bright yellow tone of the turmeric may stain your skin.

To learn more about the other skin problems, you can check our other blog posts on blisters as well as dermatitis.