Folliculitis: Causes, Symptoms and Treatment

Folliculitis is a skin disorder that causes inflammation of the hair follicles. Tiny hair grows on the body from a small pouch like structure within the skin called a follicle. When this follicle gets infected by bacteria, it leads to folliculitus. Folliculitis typically appears as a white or red eruption of the skin that surrounds a hair follicle. When many of the hair follicles are infected it appears as a white or red rash of the skin. Let us go into the details of the folliculitis causes, symptoms and treatment in this Buzzle article.

Where Can Folliculitis Develop
Folliculitis can develop anywhere on the body. This means any part of the body where follicles appear, is prone to developing hair folliculitis. The only exception being the palms and soles that are not covered by hair. The most likely places for folliculitis to appear are the arms, armpits, legs, or the scalp. Men who shave could develop face folliculitis. Parts of body that are rubbed on by clothes like the thighs, groin, face and scalp develop hair folliculitis.

Causes of Folliculitis
Every hair in our bodies grows from a follicle. Even though they are most dense on the scalp, they are spread across the entire body except the palms and soles. Each follicle is attached to a muscle above which are sebaceous glands that produce sebum (an oil) to lubricate the skin and hair shaft.

It is when the follicles get blocked or damaged that they are prone to attacks from bacteria, viruses and fungus which can lead to infections such as folliculitis. Folliculitis causes could be due to one or more of the following:

• Excess perspiration that blocks the follicles for long periods of time
• Various inflammatory skin conditions such as acne or dermatitis
• Abrasions or wounds to the skin
• Excess friction while shaving (usually if shaving with a blunt blade)
• Friction from tight clothing that irritate the skin
• Using a hot tub or swimming pool that is not treated with chlorine
• Use of substances or chemicals that irritates the skin and hair follicles like perfumes, soaps, etc.
• People with diabetes and HIV are more prone to bacterial infections as their ability to fight off infections is compromised.

Symptoms of Folliculitis
Folliculitis symptoms depend upon the type and intensity of the infection. They are usually categorized as superficial folliculitis and deep folliculitis. Superficial folliculitis consist of the following condiitons:

• Hot tub folliculitis / Pseudomonas folliculitis
• Barber's itch
• Tinea barbae
• Pityrosporum folliculitis
• Herpetic folliculitis

Hot tub folliculitis is caused by Pseudomonas aeruginosa that thrives in hot and humid environment. It is usually occurs after spending time in a hot tub that has not been cleaned properly.. The infected person will develop red itchy bumps on the legs, hips, buttocks with 12 to 24 hours. These red bumps will form into pus-filled blisters. Persons who have open cuts or sores, those who have diabetes or a history of rash infections are more prone to being infected. The symptoms aggravate around the areas that are covered with wet clothing.

Barber's itch appears on the shaving area of the faces of men. It is also called Sycosis vulgaris or Sycosis barbae. They appear as pus-filled lumps where the skin has been irritated with a blunt blade and infected by the Staphylococcus aureus bacteria. This can also happen to women on their legs or underarms.

Tinea barbae is not caused by bacteria, but by a fungus, T. rubrum. It could develop anywhere on the body as pus-filled lumps having a deep red color and a crusty feel. Pityrosporum folliculitis is caused by a fungus known as Malassezia furfur. It appears as itchy red pustules on the chest, back, neck, shoulders and face. Herpetic folliculitis occurs when a blister caused by the herpes simplex virus is shaved and thus, burst. The virus-filled fluid spreads and infects surrounding hair follicles.

Deep folliculitis occurs deep within the skin and the entire hair follicle is affected. Some of the deep folliculitis symptoms include:

• Gram-negative folliculitis
• Boils and carbuncles
• Pus-filled blisters
• Pain
• Scarring of the infected area

Gram-negative folliculitis develops in persons who are on antibiotics for treating acne. The antibiotics usually alter the balance of the bacteria in the nose, causing excess growth of the Gram-negative bacteria. It is when this bacteria spreads to other parts of the face and affects the follicles that the infection occurs. This happens rarely when proper hygiene is not maintained.

Boils and carbuncles develop when the follicles are heavily infected with the Staphylococcus aureus bacteria. The boils will usually be big and filled with pus. They usually break and dry-up leaving no mark. Carbuncles are when many boils form. These take more time to heal and could leave slight scars.

Treatment of Folliculitis
Folliculitis treatment will depend on the type of infection that you have. Hot tub folliculitis usually will heal by itself, but a topical cream to stop the itching could be prescribed. In severe cases an oral antibiotic will clear the infection. Barber's itch requires that the affected area not be shaved until the infection is totally cured. If the infection takes a long time to cure, oral antibiotics will speed up the process.

Tinea barbae is cured with a prescribed antifungal cream. Pityrosporum folliculitis is cured using topical and oral antifungal medication. Since the chances of recurrence are more, you may be asked to use an antifungal cream for some time even though there is no infection.

Herpetic folliculitis will usually clear by itself. If it does not clear within a week the physician may prescribe an antiviral medication. Gram-negative folliculitis is caused by long-term use of antibiotics and is also cured using prescribed antibiotics. Boils and carbuncles will heal by themselves. The doctor could puncture the boil and drain out the fluid to speed up the healing process. In severe cases of carbuncles antibiotics could be prescribed to heal and prevent the spread of infection.

Especially during warm weather, one must avoid wearing clothing that are very tight and irritating to the skin. While shaving makes sure that the beard/skin is well lubricated and always use a sharp blade. Those who own hot tubs should maintain them regularly. If using a commercial hot tub, make sure that it is well maintained and chlorinated. If you are wondering 'can folliculitis spread', then the answer is yes. It can spread from one part of the body to other. Also, avoid bodily contact with someone who has any form of folliculitis. Never share your towels and tight-fitting undergarments with anyone. If you have folliculitis make sure that you wash all your clothes separately in warm water as soon as they are removed from your body.

Visit your physician as soon as you notice any symptoms of the infection. Folliculitis is never a serious infection, but if it is ignored in its initial stages and allowed to spread, it will not only look really ugly, but will take more time to heal and could even leave a permanent scar behind.