Folliculitis in Adults: Condition, Treatments, and Pictures – Overview

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Images of Folliculitis

Overview

Folliculitis is a skin condition caused by an inflammation of one or more hair follicles in a limited area. It typically occurs in areas of irritation, such as sites of shaving, skin friction, or rubbing from clothes. In most cases of folliculitis, the inflamed follicles are infected with bacteria, especially with Staphylococcus organisms, that normally live on the skin.

The most common factors that contribute to the development of folliculitis include:

• Irritation from shaving
• Friction from tight clothing
• A pre-existing skin condition, such as eczema, acne, or another dermatitis (inflammation of the skin)
• Injuries to the skin, such as abrasions
• Extended contact from plastic bandages or adhesive tape

Who’s at risk?

Folliculitis occurs in people of all ethnicities, all ages, and both sexes.

Other risk factors for folliculitis include:

• Diabetes
• Suppressed immune system due to HIV, organ transplantation, or cancer
• An underlying skin condition, such as eczema, acne, or another dermatitis
• Obesity
• Frequent shaving
• Pressure (prolonged sitting on the buttocks)

Signs and Symptoms

The most common locations for folliculitis include:

• Scalp
• Beard area in men
• Underarms, groin, or legs in women
• Buttocks
• Thighs

Individual lesions of folliculitis include pus-filled bumps (pustules) centered on hair follicles. These pus-filled bumps may be pierced by an ingrown hair, can vary in size from 2–5 mm, and are often surrounded by a rim of pink to red, inflamed skin. Occasionally, a folliculitis lesion can erupt to form a scab on the surface of the skin.

Mild and moderate cases of folliculitis are often tender or itchy. More severe cases of folliculitis, which may be deeper and may affect the entire hair follicle, may be painful.

Mild and moderate cases of folliculitis usually clear quickly with treatment and leave no scars. However, more severe cases of folliculitis may lead to complications, such as cellulitis (an infection of the deeper skin tissue), scarring, or permanent hair loss.

Self-Care Guidelines

In order to prevent folliculitis, try the following:

• Shave in the same direction of hair growth.
• Avoid shaving irritated skin.
• Use an electric razor or a new disposable razor each time you shave.
• Consider other methods of hair removal, such as depilatories.
• Avoid tight, constrictive clothing, especially during exercise.
• Wash athletic wear after each use.

The following measures may help to clear up folliculitis if it is mild:

• Use an antibacterial soap.
• Apply hot, moist compresses to the involved area.
• Launder towels, washcloths, and bed linens frequently, and do not share such items with others.
• Wear loose-fitting clothing.

When to Seek Medical Care

Make an appointment to be evaluated by a dermatologist or by another physician if the above self-care measures do not resolve the condition within 2–3 days, if symptoms recur frequently, or if the infection spreads.

Be sure to tell your doctor about any recent exposure to hot tubs, spas, or swimming pools, as a less common form of folliculitis may be caused by contamination from these water sources.

If you are currently being treated for a skin infection that has not improved after 2–3 days of antibiotics, return to your doctor.

Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is a strain of “staph” bacteria resistant to antibiotics in the penicillin family, which have been the cornerstone of antibiotic therapy for staph and skin infections for decades. CA-MRSA previously infected only small segments of the population, such as health care workers and persons using injection drugs. However, CA-MRSA is now becoming a more common cause of skin infections in the general population. While CA-MRSA bacteria are resistant to penicillin and penicillin-related antibiotics, most staph infections with CA-MRSA can be easily treated by health care practitioners using local skin care and commonly available non-penicillin-family antibiotics. Rarely, CA-MRSA can cause serious skin and soft tissue (deeper) infections. Staph infections typically start as small red bumps or pus-filled bumps, which can rapidly turn into deep, painful sores. If you see a red bump or pus-filled bump on the skin that is worsening or showing any signs of infection (ie, the area becomes increasingly painful, red, or swollen), see your doctor right away. Many people believe incorrectly that these bumps are the result of a spider bite when they arrive at the doctor’s office. Your doctor may need to test (culture) infected skin for MRSA before starting antibiotics. If you have a skin problem that resembles a CA-MRSA infection or a culture that is positive for MRSA, your doctor may need to provide local skin care and prescribe oral antibiotics. To prevent spread of infection to others, infected wounds, hands, and other exposed body areas should be kept clean and wounds should be covered during therapy.

Treatments Your Physician May Prescribe

Folliculitis is fairly easy to diagnose in most cases. Your physician may wish to perform a bacterial culture in order to determine the cause of the folliculitis. The procedure involves:

1. Penetrating the pus-filled lesion with a needle, scalpel, or lancet.
2. Rubbing a sterile cotton-tipped applicator across the skin to collect the pus.
3. Sending the specimen away to a laboratory.

Typically, the laboratory will have preliminary results within 48–72 hours if there are many bacteria present. However, the culture may take a full week or more to produce final results. In addition to identifying the strain of bacteria that is causing the folliculitis, the laboratory usually performs antibiotic sensitivity testing in order to determine the medications that will be most effective in killing off the bacteria.

Depending on bacterial culture results, your physician may recommend the following treatments:

• Prescription-strength antibacterial wash, such as chlorhexidine gluconate
• Topical antibiotic lotion or gel, such as erythromycin or clindamycin
• Oral antibiotic pills, such as cephalexin, erythromycin, or doxycycline

Occasionally, the bacteria causing the infection are resistant to treatment with the usual antibiotics (particularly, methicillin-resistant Staphylococcus aureus, MRSA). This can sometimes cause a more severe form of folliculitis. Depending on the circumstances, your doctor may consider more aggressive treatment that includes prescribing:

• A combination of two different oral antibiotics, including trimethoprim-sulfamethoxazole, clindamycin, amoxicillin, linezolid, or a tetracycline
• A topical medication, mupirocin ointment, to apply to the nostrils
• If your doctor prescribes antibiotics, be sure to take the full course of treatment to avoid allowing the bacteria to develop resistance to the antibiotic prescribed.

Trusted Links

MedlinePlus: Hair Diseases and Hair Loss
Clinical Information and Differential Diagnosis of Folliculitis

References

L., ed. Dermatology, pp.211, 241, 553-566. New York: Mosby, 2003.

Freedberg, Irwin M., ed. Fitzpatrick’s Dermatology in General Medicine. 6^th ed, pp.1845, 1250, 1860, 1901. New York: McGraw-Hill, 2003.

Folliculitis, Boils and Carbuncles | Johns Hopkins Medicine

What are folliculitis, boils, and carbuncles?

Folliculitis is the inflammation of hair follicles due to an infection, injury, or irritation. It is characterized by tender, swollen areas that form around hair follicles, often on the neck, breasts, buttocks, and face. Boils (also referred to as furuncles) are pus-filled lesions that are painful and usually firm. Boils happen when infection around the hair follicles spreads deeper. They are usually located in the waist area, groin, buttocks, and under the arm. Carbuncles are clusters of boils that are usually found on the back of the neck or thigh. Staphylococcus aureus is the most common bacteria to cause these infections. 

What are the symptoms of folliculitis, boils, and carbuncles?

The following are the most common symptoms of folliculitis, boils, and carbuncles. However, each person may experience symptoms differently.

Symptoms for folliculitis may include:

Symptoms for boils may include:

• A painful lump in the skin

• Pus in the center of the lump

• Whitish, bloody discharge from the boil

Symptoms for carbuncles (clusters of boils) may include:

• Pus in the center of the boils

• Whitish, bloody discharge from the boils

• Fever

• Fatigue

• Tenderness and pain at the site

The symptoms of folliculitis, boils, and carbuncles may resemble other skin conditions. Always talk with your healthcare provider for a diagnosis.

How are folliculitis, boils, and carbuncles diagnosed?

Diagnosis of folliculitis, boils, and carbuncles are made by your healthcare provider after a thorough medical history and physical exam. After examining the lesions, your healthcare provider may culture the wounds (take a sample of the drainage of the wound, allow it to grow in the lab, and identify specific bacteria). He or she does this to help confirm the diagnosis and to help in selecting the best treatment.

Treatment for folliculitis, boils, and carbuncles

Specific treatment for folliculitis, boils, and carbuncles will be discussed with you by your healthcare provider based on:

• Your age, overall health, and medical history

• Extent of the condition

• Your tolerance for specific medicines, procedures, or therapies

• Expectations for the course of the condition

• Your opinion or preference

Treatment may include:

• Topical antibiotics (for folliculitis)

• For carbuncles and boils, a warm compress may be used to help promote drainage of the lesion

• Surgical incision (making an opening in the skin overlying the infection) and drainage of the pus 

• Oral or intravenous (IV) antibiotics (to treat the infection)

• Cultures may be obtained to identify the bacteria causing the infection

• Acetaminophen or other pain relievers  

Keeping the skin clean helps to prevent these conditions from happening and is essential for healing. Scrub your hands with soap and warm water for at least 20 to 30 seconds after touching a boil. Do not re-use or share washcloths or towels. Change the dressings often and place the dressings in a bag that can be tightly closed and thrown out. 

Folliculitis Pictures | Healthhype.com

What is Folliculitis?

Folliculitis is an inflammation of the hair follicles, the tiny tunnels in the skin from which hair grows. It occurs when the hair follicles become irritated and an infection then sets in. This may be seen with damage to the follicle as a result of shaving, friction with clothing, scratching, or an obstruction of a pore.

An infected hair follicle appears as a red bump or white pustule which may crust over at a later stage (Picture 1). Infectious folliculitis which arises with a Staphylococcus aureus (bacteria) infection is discussed in detail within this article. Read about other types of folliculitis.

Folliculitis Pictures

Picture of staphylococcal folliculitis on the thigh with red bumps and pus-filled white centers. (Source: Samuel Freire da Silva, M.D., atlasdermatologico.com.br)

Picture of staphylococcal folliculitis on the chest. (Source: Dermnet)

Folliculitis and Acne

Folliculitis and acne are two different skin conditions although gram-negative folliculitis may be seen in certain cases of severe acne. Acne primarily involves the oil-producing glands (sebaceous glands) of the skin which are clogged with excess oil (sebum) and shed skin cells. It may lead to localized inflammatio which may then develop into folliculitis (Picture 5).

Due to the similarity of the lesions, it may sometimes difficult to differentiate between acne and folliculitis only by visual examination. Some key points to bear in mind though is that acne occurs mainly on the face, neck and upper trunk, more often in teenagers, and may last for months or years. Folliculitis on the other hand may occur anywhere on the body, can affect at any age group, and it usually lasts only for a few days or weeks.

Picture of infected acne. (Source: Dermnet)

Symptoms of Staphylococcal Folliculitis

Staphylococcal folliculitis usually appears as clusters of red bumps surrounding hair follicles (with or without the hair). It varies between 2 to 5 millimeters in diameter, often with a white blister in the center (Pictures 1-3). Inflamed follicles may burst, release pus and crust over. The skin in superficial folliculitis is itchy and tender while in  deep folliculitis it may be painful.

Folliculitis most commonly occurs on the :

• Beard area in men
• Scalp
• Upper trunk (chest, under breasts, in armpits)
• Buttocks
• Thighs
• Groin

Folliculitis never appears in areas without hair follicles such as the palms, soles, or mucous membranes. Superficial folliculitis affects only upper parts of a hair follicle, while deep folliculitis affects the whole hair follicle.

Folliculitis Barbae

Folliculitis barbae is a superficial folliculitis of the bearded area in men, caused by Staphylococcus aureus (staph) bacteria. It often appears on the skin around the nose or mouth when hair follicles that are damaged during shaving become infected, especially in those who are nasal staph carriers.

Picture of folliculitis barbae.

Pseudofolliculitis Barbae (Ingrown Hair)

An ingrown hair is a curly hair that curves or twists on the surface and then re-enters the hair follicle opening again. This causes inflammation of the follicle (folliculitis). It may resemble bacterial folliculitis but pseudofolliculitis barbae this is not an infection and tends to occur in those who shave with a razor blade. The use of an electric razor may be one of the preventative measures that may be employed, along with shaving every second day or resorting to not shaving and letting the beard grow (3).

Pictures of Pseudofolliculitis Barbae (Shaving Bumps)

Sycosis Barbae

Sycosis barbae is deep folliculitis of the bearded area in men and involves the deeper parts of hair follicles. Sycosis barbae may leave scars.

Picture of Sycosis Barbae

Stye

A stye is an inflammation or infection of a hair follicle on the eyelid.

Picture of a stye (staphylococcal folliculitis) on the lower eyelid. (Source: Dermnet)

Risk Factors for Folliculitis

Folliculitis is more likely to occur in:

• Nasal staph carriers
• Diabetes mellitus
• Dermatitis
• Obesity
• Topical steroid treatment
• Lowered immunity (leukemia, AIDS)
• Acne treatment with tetracycline
• Infants with tight clothes
• Athletes
• Hot humid climates

Folliculitis Diagnosis

Folliculitis may be diagnosed by a medical doctor without any further tests. However, if there is doubt about the diagnosis, then swabs or biopsies of the skin lesions are collected and sent for laboratory testing.  In recurrent folliculitis, diabetes and HIV tests should be considered.

Compare Pictures of Folliculitis with Other Types of Rash

Folliculitis Treatment

• Superficial folliculitis may heal on its own within 1 to 2 weeks.
• Applying over the counter (OTC) antibiotic ointments like Bacitracin, Mycitracin (bacitracin + neomycin + polymyxin B), or Bactrobam (mupirocin), or washing with antibacterial soaps may help in more resistant cases (2).
• In a deep folliculitis and recurrent cases, oral antibiotics (dicloxacillin, cephalosporins) may be needed.
• Folliculitis caused by MRSA requires treatment by antibiotics chosen on the basis of antibiotic sensitivity test (1).

During acute stages, electric razors should be used or shaving should be temporarily avoided in this time. S. aureus carriers may be treated with mupirocin ointment in the nasal vestibule twice a day for 5 days (1). Family members may be also treated by mupirocin to eliminate the carrier state and prevent re-infection.

Is Folliculitis Contagious?

Staphylococcal folliculitis is very contagious. It spreads by direct skin-to-skin contact, or by sharing razors, towels, clothes or other personal items.

Prevention of Folliculitis

The following measures may help to prevent folliculitis :

• Wear comfortable airy clothes.
• Wash and dry swimming suits and sport apparel after each use.
• Eradicate nasal staphylococci.
• Laser depilation for hair removal.
• Disinfect of a sport equipment and hot tubs.
• Do not share razors and towels.
• Apply a disinfectant on any break in the skin with shaving.

Folliculitis Complications

Folliculitis may result in :

• Furuncles
• Cellulitis – inflammation of deeper layers of the skin
• Scars or hyper-pigmentation
• Permanent hair loss (alopecia)

Pictures of Other Types of Folliculitis

Several other types of folliculitis beside staphylococcal folliculitis are known:

Related Articles:

References:

1. Antibiotics for staphylococcal folliculitis (emedicine. com)
2. Antibiotic ointments for folliculitis (bestincosmetics.com)
3. Ingrown hair – shaving bumps (aocd.org)

Hot Tub Folliculitis – American Osteopathic College of Dermatology (AOCD)

Hot tub folliculitis is a skin infection of the hair follicles that appears after coming into contact with bacteria contaminated water. The infection is caused by the bacteria Pseudomonas aeruginosa which lives in wet, warm areas including hot tubs, whirlpools, and waterslides. Children tend to be affected more often than adults.

The infection can begin a few hours to days after being exposed to contaminated water. It begins as an eruption of itchy, red bumps that are seen primarily on the trunk. The bumps often develop into more tender nodules and can sometimes fill with pus. In areas occluded by bathing suits, the rash can be more severe, and women who wear one-piece suits are more susceptible to infection. Systemic symptoms rarely occur but can include fever, malaise and fatigue.

Hot tub folliculitis typically resolves without any treatment within 5-10 days. Topical treatments that can be helpful include silver sulfadiazine cream twice a day or white vinegar applied to the rash for 20 minutes two to four times per day. Oral antibiotics can be used for 5-10 days if the rash is severe or resistant to topical treatment. It is important to note that although the rash may resolve within 5-10 days, it can leave behind reddish-brown, hyperpigmented areas that can take a few months to completely disappear.

Inadequate care of water, prolonged water exposure and an excess number of people in the pool can all predispose one to infection. Continuous water filtration, adequate chlorine levels, and changing the water frequently can all decrease the risk of infection. Unfortunately, showering after being exposed to contaminated water does not decrease the rate of infection so it is best to avoid exposure.

Back to Index

The medical information provided in this site is for educational purposes only and is the property of the American Osteopathic College of Dermatology. It is not intended nor implied to be a substitute for professional medical advice and shall not create a physician – patient relationship. If you have a specific question or concern about a skin lesion or disease, please consult a dermatologist. Any use, re-creation, dissemination, forwarding or copying of this information is strictly prohibited unless expressed written permission is given by the American Osteopathic College of Dermatology. 

What Is Pityrosporum Folliculitis and How to…

Most likely you will develop a variety of common rashes in your lifetime, from skin irritation, allergic reaction, acne or infection. Folliculitis is one type of skin rash, caused by the irritation of your hair follicles. Find out the causes, diagnosis and treatment of pityrosporum folliculitis.

What Is Folliculitis?

Folliculitis describes a family of skin rashes caused by the inflammation of the hair follicles, the microscopic tubes in the skin that surround each hair strand. The irritation causes small red bumps that may have whiteheads on them. Folliculitis often looks like an acne breakout, but offers different symptoms. Your skin may be itchy or sting where the bumps are clustered, which isn’t typical of acne. Deeper types of folliculitis can cause large, painful boils. Folliculitis is caused by ingrown hairs from shaving, is a bacterial infection, or can be a fungal infection.

What Causes Pityrosporum Folliculitis?

Pityrosporum folliculitis is caused by a yeast infection on your skin, and usually affects teenagers and young adults. Also called “Malassezia folliculitis”, this kind of folliculitis occurs when yeast molecules of the genus Malassezia get into your hair follicles and multiply, creating an acne-like rash on your skin. Malassezia is a naturally occuring yeast on your skin and normally doesn’t cause problems, but certain factors can cause an overabundance of the yeast, which leads to the infection. The same yeast is also associated with a kind of severe dandruff, called “seborrheic dermatitis”. Some of the factors that seem to play a role in the overgrowth of the Malassezia yeast on your skin are the use of oral or topical antibiotics; stress and fatigue; oily skin, the yeast feeds on the oil, wearing of tight, synthetic clothing while sweating, yeast tends to grown in warm, humid environments; diabetes; decreased immunity; being overweight, which leads to increased sweating; use of oral contraceptives or oral steroids, like prednisone.

How Is It Diagnosed?

Pityrosporum folliculitis can be difficult to diagnose because it is so much like an acne eruption. It tends to be in the same oilier areas of your body that acne shows up on, such as the shoulders, chest, and upper back. In order to get a proper diagnosis, your doctor will have to take a look at your skin and verify that your symptoms are not those of acne, but rather pityrosporum folliculitis. As mentioned before, you will not have whiteheads, blackheads, or itching if it us acne. Pityrosporum folliculitis is usually an itchy rash that doesn’t come to a head. The small bumps of pityrosporum folliculitis are pin-head size and uniform in size and shape. Acne eruptions can be varied in size. However, it is not uncommon for an individual to have both acne and pityrosporum folliculitis in the same area, making it trickier to self-diagnose the cause of the bumps. The best approach for diagnosis is to seek the care of a dermatologist. A dermatologist will get a skin sample by gently scraping your skin and then examine the sample with a microscope to determine if there is yeast present. Your dermatologist may also take a small skin biopsy to confirm the presence of the Malassezia yeast.

Treatment

If your dermatologist determines that you have pityrosporum folliculitis, you will be prescribed an oral and/or a topical medication. They may suggest you continue take antifungal oral medication regularly for maintenance, as you will probably remain susceptible to re-infection. The topical medications include both creams and medicated shampoos. You can continue to wash your body with antifungal soaps and shampoos to prevent recurrence. You should also remove sweaty clothing as soon as possible, manage your stress well to increase your immunity and discontinue use of oral antibiotics and corticosteroids when they are not necessary.

Call Vanguard Today

Contact Vanguard Dermatology, located in the greater New York City area. The board-certified dermatologists at Vanguard can diagnose, treat and help you manage your skin conditions as well as offer a variety of cosmetic dermatology services.

Folliculitis – wikidoc

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jesus Rosario Hernandez, M.D. [2]Rekha, M.D.

Overview

Folliculitis is the inflammation of one or more hair follicles. The condition may occur anywhere on the skin.

Classification

• Folliculitis can be classified in a variety of ways based on the:
  • Depth of the involvement(superficial vs deep)
  • Underlying etiological agent(infectious vs non infectious)
  • chronicity of the condition( acute vs chronic/recurrent)

Pathophysiology

• The pathogenesis of folliculitis depends upon the etiological agent.It can be caused by an infection (bacterial, viral, fungal, or parasitic) or have a noninfectious etiology, as the result of follicular trauma, inflammation, occlusion,scratch around the hair follicle or topical application of steroids may induce the infection and subsequently inflammation of the hair follicle.
• Although the cause of Esinophilic Folliculitis is unknown. A variety of microorganisms have been implicated, including the mite Demodex, the yeast Pityrosporum, and bacteria. An autoimmune process has also been investigated.
• On microscopic pathology, superficial folliculitis characterized by neutrophic infiltration confined to the infundibulum of the hair follicle, however in deep folliculitis it extend to the deeper portion of the follicle and dermis.Infiltrate initially consists of neutrophils, later becomes mixed with lymphocytes and macrophages.Chronic cases shows granulomatous inflammation with giant cells containing keratin and fragmented hair. Suppurative folliculitiis often heals spontaneously, some longstanding cases may progress to the formation of granulomas or fibrosis with evident clinical scarring.

Differentiating Folliculitis from other Diseases

• Folliculitis must be differentiated from following diseases:

Epidemiology and Demographics

• Superficial folliculitis is although commonly seen but the exact incidence is not known.It is difficult to determine the incidence of the folliculitis as majority of the people affected with it never seek medical attention.

Age

• Patients of all age groups may develop folliculitis.
• Superficial folliculitis and Hot tub folliculitis is more commonly observed among adults than children.
• Demodex folliculitis is more commonly seen in adults however it also has been implicated in facial pustules and papules in children.^[1]

Gender

• Superficial folliculitis affects men and women equally.

• Males are more commonly affected with Herpes folliculitis and Pityrosporum folliculitis^[2] than females.
• Eosinophilic folliculitis has been seen in HIV-infected men, women, and children. ^[3][4][5]

Race

• There is no racial predilection for folliculitis however Pseudofolliculitis barbae usually affects individuals of the African descent.

Causes

Most carbuncles and furuncles and other cases of folliculitis develop from Staphylococcus aureus.

Folliculitis starts when hair follicles are damaged by friction from clothing, blockage of the follicle, or shaving. In most cases of folliculitis, the damaged follicles are then infected with the bacteria Staphylococcus (staph).^[6]

Iron deficiency anemia is sometimes associated with chronic cases

• Sycosis barbae or barber’s itch is a staph infection of the hair follicles in the bearded area of the face, usually the upper lip. Shaving aggravates the condition.

• Pseudofolliculitis barbae is a disorder occurring primarily in men of African descent. If curly beard hairs are cut too short, they may curve back into the skin and cause inflammation.

• Hot tub folliculitis is caused by the bacteria Pseudomonas aeruginosa often found in new hot tubs. The folliculitis usually occurs after sitting in a hot tub that was not properly cleaned before use. Symptoms are found around the body parts that sit in the hot tub — typically the legs, hips and buttocks and surrounding areas. Symptoms are typically amplified around regions that were covered by wet clothing, such as bathing suits.

Risk Factors

• Common risk factors in the development of folliculitis are:
  • Frequent shaving against the direction of the hair growth
  • Immunosuppresion
  • Presence of dermatosis
  • Long term oral antibiotic use
  • Hot tub bath
  • tight clothing
  • exposure of certain solvents
  • poor hygiene
  • friction
  • obesity
  • Diabetes
  • HIV,late stage esp with low CD4 cell count
  • Prolonged used of topical steriods
  • Exposure to the hot humid temperature
  • Patients treated with EGFR inhibitors^[7]
  • post vaccination esp after the small pox and anthrax vaccine^[8][9]

Natural History, Complications and Prognosis

• The majority of patients with folliculitis remain asymptomatic however sometimes it presents with pruritic or painful erythematous papule or pustule that is a self limiting entitiy.
• If left untreated,occasionally folliculitis may progress to develop furuncle. Multiple furuncles can coalesce to form carbuncles that become painful and fluctuant after several days.Sometimes rupture do occur with the discharge of pus and necrotic material.
• Common complications of folliculitis include cellulitis, furunculosis, scarring, sinus tract formation, permanent hair loss and recurrence in some cases.
• Sometimes,in dark skin people, folliculitis often resolve with post-inflammatory hyperpigmentation, which can take months to years to fade completely.
• Prognosis is generally excellent if the causative agent is accurately identified and treated.

Diagnosis

Folliculitis is a clinical diagnosis so diagnosis is usually based on history and physical examination.

Symptoms

• Folliculitis is usually asymptomatic, benign and self limiting condition.
• Symptoms of folliculitis may include the following:
  • • Clusters of small red bumps or white-headed pimples present around hair follicle
    • Itchy, burning and painful skin lesions.
    • Pus-filled blisters that may break open and crust over

Physical Examination

• Patients with folliculitis usually appear generally well.
• Physical examination may be remarkable for:

• multiple erythematous, folliculocentric papules and pustules in the hair-bearing regions,usually less than 5 mm in diameter.
• Superficial folliculitis presents with multiple small papules and pustules on an erythematous base, with each papule or pustule pierced by a central hair.
• Deep folliculitis presents as tender plaques and nodules overlying the erythema and induration, usually heal by scarring.
• Pyrexia and systematic manifestation in deeper or immunocompromised patients

Laboratory Findings

• Folliculitis is a clinical diagnosis so the laboratory tests are generally done in cases of treatment resistance.
• CBC suggestive of leukocytosis and eosinophilia, with elevated immunoglobulin E levels in patients with eosinophilic folliculitis.
• RBS can be done in cases of the recurrent folliculitis.
• HIV testing can be done in suspected cases of esinophilic folliculitis.
• Gram stain and culture can be done when bacterial etiology is suspected.Gram stain usually shows gram-positive cocci, and culture grows S aureus. Pseudomonas species can be cultured from the pustules of hot tub folliculitis.
• In chronic cases,nasal culture of family members can be done to look for S aureus colonization.
• KOH preparation, fungal culture, or both can be helpful for diagnosing dermatophyte infections however skin biopsy is best to visualize Pityrosporum yeast forms in cases of Pityrosporum folliculitis.
• Viral culture, polymerase chain reaction (PCR), or immunofluorescence testing helps to confirm the diagnosis if herpes folliculitis is suspected.^[10]

Imaging Findings

• There are no imaging study findings associated with folliculitis.

Other Diagnostic Studies

• Folliculitis may also be diagnosed using skin biopsy and histology.
• Findings on biopsy and histology varies depending upon the causative agent and type of folliculitis.
  • Esinophilic folliculitis shows perifollicular infiltrates of lymphocytes and eosinophils associated with follicular eosinophilic spongiosis.
  • Bacterial and fungal folliculitis neutrophils infiltrating the walls and lumen of the hair follicles, with variable admix of lymphocytes and macrophages depending on chronicity of the folliculitis.
  • Histological picture of viral folliculitis suggestive of lymphocyte infiltrate in the walls and lumen of the hair follicles.
  • Demodex folliculitis shows perifollicular lymphohistiocytic inflammation is often seen along with mite Demodex folliculorum within the hair follicle.

Treatment

Medical Therapy

Folliculitis is a self limiting condition ,if uncomplicated. Complicated and recurrent cases requires treatment targeted against the specific organism.

• Due to increased resistance seen with fusidic acid, uncomplicated bacterial folliculitis (staph aureus) folliculitis is best treated with topical mupirocin and clidamycin.^[11]However complicated,recurrent and folliculitis resistant to the topical treatment can be managed with 7-10 days course of oral antibiotics.
• Psedomonas folliculitis can be treated with oral ciprofloxocin if the patient is immunocompromise and lesions are persistent.
• Gram negative folliculitis is usually seen due to complication of chronic antibiotic use so best managed by discontinuing the implicated antibiotic and administering oral trimethoprim-sulfamethoxazole.
• Esinophilic folliculitis usually responds well to the indomethacin treatment.Other therapies include PUVA, topical tacrolimus, and isotretinoin.
• Fungal folliculitis can be treated with oral antifungal agents such as fluconazole and itraconazole.
• Viral folliculitis responds well to valacyclovir, famciclovir, or acyclovir.
• Antiparasitic agents, such as permethrin and oral ivermectin, can be used for Demodex folliculitis

Surgery

• Surgical excision can be considered for severe cases of folliculitis keloidalis that are:
  1. resistant to medical therapy,
  2. large (>3 cm)
  3. if fibrotic plaques or nodules are present.
• Surgical approaches include excision with primary closure or skin grafting, and hair-removal lasers.^[12] Another surgical approach is excision with secondary intention healing. This can result in good cosmetics with little or no recurrence. ^[13]
• Excision by carbon dioxide laser 47 and electrosurgery 45 (followed by second-intention healing) have also been reported.

Prevention

• Effective measures for the primary prevention of folliculitis include:
  • Maintain good personal hygiene including regular bathing with antibacterial soaps and washing hands.
  • Avoidance of the precipitating causes like wearing tight fitted clothing.
  • Avoid sharing razors with others.
  • Shave only in the direction of hair grows, or use an electric razor.
  • Avoiding unsanitary hot tubs and pools.
  • Daily decontamination of personal items.
  • A five-day course of topical mupirocin ointment in the nares and daily chlorhexidine body washes can be used as decolonization regimen.

• Once diagnosed and successfully treated, patients with folliculitis are followed-up after 2 weeks to check the response of the treatment.

Gallery

Extremities

Folliculitis Of Barbae

Folliculitis cheloidalis

References

1. ↑ Brown M, Hernández-Martín A, Clement A, Colmenero I, Torrelo A (2014). “Severe demodexfolliculorum-associated oculocutaneous rosacea in a girl successfully treated with ivermectin”. JAMA Dermatol. 150 (1): 61–3. doi:10.1001/jamadermatol.2013.7688. PMID 24284904.
2. ↑ Poli F (2012). “Differential diagnosis of facial acne on black skin”. Int J Dermatol. 51 Suppl 1: 24–6, 27–9. doi:10.1111/j.1365-4632.2012.05559.x. PMID 23210948.
3. ↑ Basarab T, Russell Jones R (1996). “HIV-associated eosinophilic folliculitis: case report and review of the literature”. Br J Dermatol. 134 (3): 499–503. PMID 8731676.
4. ↑ Ramdial PK, Morar N, Dlova NC, Aboobaker J (1999). “HIV-associated eosinophilic folliculitis in an infant”. Am J Dermatopathol. 21 (3): 241–6. PMID 10380045.
5. ↑ Hayes BB, Hille RC, Goldberg LJ (2004). “Eosinophilic folliculitis in 2 HIV-positive women”. Arch Dermatol. 140 (4): 463–5. doi:10.1001/archderm.140.4.463. PMID 15096375.
6. ↑ Laureano AC, Schwartz RA, Cohen PJ (2014). “Facial bacterial infections: folliculitis”. Clin Dermatol. 32 (6): 711–4. doi:10.1016/j.clindermatol.2014.02.009. PMID 25441463.
7. ↑ Bachet JB, Peuvrel L, Bachmeyer C, Reguiai Z, Gourraud PA, Bouché O; et al. (2012). “Folliculitis induced by EGFR inhibitors, preventive and curative efficacy of tetracyclines in the management and incidence rates according to the type of EGFR inhibitor administered: a systematic literature review”. Oncologist. 17 (4): 555–68. doi:10.1634/theoncologist.2011-0365. PMC 3336835. PMID 22426526.
8. ↑ Oh RC (2005). “Folliculitis after smallpox vaccination: a report of two cases”. Mil Med. 170 (2): 133–6. PMID 15782834.
9. ↑ Greenberg RN, Schosser RH, Plummer EA, Roberts SE, Caldwell MA, Hargis DL; et al. (2004). “Urticaria, exanthems, and other benign dermatologic reactions to smallpox vaccination in adults”. Clin Infect Dis. 38 (7): 958–65. doi:10.1086/382360. PMID 15034827.
10. ↑ Böer A, Herder N, Winter K, Falk T (2006). “Herpes folliculitis: clinical, histopathological, and molecular pathologic observations”. Br J Dermatol. 154 (4): 743–6. doi:10.1111/j.1365-2133.2005.07118.x. PMID 16536821.
11. ↑ Williamson DA, Monecke S, Heffernan H, Ritchie SR, Roberts SA, Upton A; et al. (2014). “High usage of topical fusidic acid and rapid clonal expansion of fusidic acid-resistant Staphylococcus aureus: a cautionary tale”. Clin Infect Dis. 59 (10): 1451–4. doi:10.1093/cid/ciu658. PMID 25139961.
12. ↑ Glenn, Marcia J; Bennett, Richard G; Kelly, A.Paul (1995). “Acne keloidalis nuchae: Treatment with excision and second-intention healing”. Journal of the American Academy of Dermatology. 33 (2): 243–246. doi:10.1016/0190-9622(95)90242-2. ISSN 0190-9622.
13. ↑ Bajaj V, Langtry JA (2008). “Surgical excision of acne keloidalis nuchae with secondary intention healing”. Clin Exp Dermatol. 33 (1): 53–5. doi:10.1111/j.1365-2230.2007.02549.x. PMID 17927781.

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Hot Tub Folliculitis in a 5-Year-Old Girl

A 5-year-old girl presented with a 2-day history of a widespread pruritic rash that began while the family was on vacation. The rash appeared suddenly as small pink macules and progressed to papules and pustules. Her brother had a similar-appearing but milder rash. She denied fever, chills, or constitutional symptoms. On further questioning, her father reported that she and her brother had been in a hot tub at their vacation home.

The otherwise well-appearing patient had numerous 2- to 4-mm papules and pustules with surrounding erythema scattered on her trunk, arms, and legs.

Hot tub folliculitis, also known as Pseudomonas folliculitis, was diagnosed. This community-acquired bacterial infection of the hair follicle occurs after exposure to contained, contaminated water.

The ubiquitous gram-negative bacterial organism that causes hot tub folliculitis, Pseudomonas aeruginosa, gains entry through hair follicles or via breaks in the skin. Minor trauma from wax depilation, vigorous rubbing with sponges, or shaving may facilitate the entry of organisms into the skin. Hot water, prolonged water exposure, excessive numbers of bathers, and inadequate pool or hot tub care are all associated with outbreaks of hot tub folliculitis.

Hot tub folliculitis is characterized by the onset of a rash usually 48 hours after exposure to contaminated water; however, it can occur as long as 14 days after exposure. Lesions begin as pruritic, erythematous macules that progress to papules and pustules. The rash usually clears spontaneously within 2 to 10 days, rarely recurs, and heals without scarring.

The differential diagnosis includes acne, bromide sensitivity, staphylococcal folliculitis, and gram-negative folliculitis-an uncommon complication of prolonged antibiotic use in patients with acne and associated with Klebsiella, Escherichia, Serratia, and Proteus species. The diagnosis of hot tub folliculitis is usually made after a thorough history and physical examination. However, it can be verified by results of bacterial culture growth from either a fresh pustule or a sample of contaminated water.

Adequate chlorination of the hot tub is necessary to prevent recurrences and to protect others from infection. Symptomatic relief may be achieved through the use of acetic acid 5% compresses for 20 minutes, 2 to 4 times a day.

90,000 Folliculitis: causes, signs, symptoms with a photo. Treatment of scalp folliculitis with the best doctors

Not sure what to do in a delicate situation? Have strange pustules appeared on your head? Hair is losing its healthy appearance? Most likely, you are worried about folliculitis of the scalp . Many do not pay attention to a slight external defect in the form of redness, which can lead to complications. Do not be embarrassed and wait for natural healing – the health problem can be solved in a short time.In this article we will consider all aspects of the issue, and informatively tell you the details of the onset, symptoms and treatment of the disease.

Scalp folliculitis – what is it?

Inflammation of the scalp follicle is called folliculitis. The disease has a dermatological (seborrheic) nature, and can manifest itself in a person regardless of his health condition, age or gender. It is noted that seborrheic folliculitis is more common in men, but women and children can also be exposed to infection.The problem of folliculitis should be solved in the early stages, which begin with redness – preferably after self-diagnosis at home, since the disease has many complications. Inflammation can affect not only the surface layers of the hair shaft, but also the shafts, as well as the sebaceous gland. The result will be a chronic, deep form – sycosis. A good dermatologist or trichologist will help you recognize hair folliculitis.

Photo. A single focus of folliculitis on the scalp with a halo of inflammation

The appearance of the disease can be caused by various infections, viruses, fungi or bacteria.The disease is distinguished by the following types:

• Staphylococcal – the bacterium enters the body with poorly chlorinated water or cuts from shaving. With a strong lesion, it is possible to develop a deep form or a more serious and complex purulent form – an abscess or a boil. With the development of chronic pathology, the disease is called decaltivating folliculitis.
• Disruptive folliculitis Hoffmann – is a rare form of the pathology under consideration. It has long-term development and serious consequences, as it affects not only the hair shafts and follicles, but also the skin.In most cases, the affected area becomes bald due to the complete destruction of the hair structure.
• Candida folliculitis – the causative agent in this case is the Candida fungus.
• Herpetic form – caused by the herpes virus, which often creates problems at the most inopportune moment.
• Syphilitic type – arises from the presence of secondary syphilis in the patient.
• Parasitic folliculitis – when diagnosing this type of ailment, a tick can be found in a patient.

When harmful microorganisms enter the bloodstream, a strong inflammatory process begins, which causes the appearance of abscesses.

Symptoms of seborrheic folliculitis

Pathology appears due to the development of inflammation – various viruses, bacteria and other infections begin to develop rapidly. This is the main cause of folliculitis on the head. Weakened immunity, various negative factors and stress contribute to the early spread of folliculitis.

Photo. The appearance of seborrhea or dandruff is one of the causes and signs of incipient folliculitis

Due to the way the body perceives the infection, the symptoms of folliculitis on the head may differ. But the main manifestation of pathology is the appearance of multiple abscesses, as well as painful sensations during palpation and pressure on them. Also, symptoms may differ at different stages of development.

After two to three days from the onset of abundant rashes, a dense crust will be covered and the skin will dry out.During the process, age spots may appear on the epidermis as a result of crust falling off.

With a deep form of the disease, folliculitis is localized on the hair follicles and the symptomatology is complemented by a serious lesion of the shafts – the abscesses are larger and painful to the touch. During maturation, the patient experiences unbearable itching and pain.

Causes of folliculitis on the scalp

Why is the scalp affected? Poor hygiene (for example, during a long trip without stopping) can be the reason for the appearance, as well as:

• High humidity and temperature conditions – hot climate is a favorable environment for the development of various infections.
• Incorrectly applied medical bandage – untimely provision of medical care can lead to the multiplication of streptococcus or staphylococcus that has got on the wound.
• Various ailments (foci of chronic infection): diabetes, liver disease (cirrhosis), syphilis, gonorrhea, and so on.
• Poor diet and abuse of bad habits.
• Synthetic hats can cause seborrheic folliculitis.

In order to prevent the appearance of folliculitis, you should carefully monitor your hygiene – do not give individual accessories to anyone, and also do not use strangers.Be sure to keep your immune system high with a healthy diet and supplemental vitamins during the cold season.

Photo. Hot and humid climate as one of the causes of scalp folliculitis

Stages of folliculitis development

The disease has its own stages of development, since the inflammatory process extends not only to the follicles, but also to the sebaceous glands. There are four stages:

1. Developing – at this time, the infection begins to affect the rods and bulbs, leading to the appearance of abscesses.The person feels itching and pain.
2. Significant growth – if at the beginning several inflamed areas could appear, then at the growth stage the maximum area of ​​the head is affected.
3. The transition phase – the recession of the disease begins, in which the abscesses are covered with a crust.
4. Rest – the last stage does not mean recovery. On the contrary, the infection is firmly “settled” in the body and continues to have a negative impact.

In the future, the course will pass into a chronic form, and the process will cause complications.Baldness is among the first signs of neglect.

Methods for the diagnosis of seborrheic folliculitis

The first and most important method of diagnosing an ailment is an external examination of the patient’s scalp. A specialist in our clinic will be able to quickly determine the presence of fulliculitis. Also, special procedures and tests are prescribed to determine the type of infection – to prescribe an effective treatment.

Photo. Test tube with blood for analysis in the hand of a laboratory assistant

Modern methods include:

Phototrichogram – determines the nature of the pathology, the presence or absence of infection in each case.It also helps to find the most affected areas, which makes it easier to find places of special concentration of the inflammatory process.

Analysis of hair for trace elements – the study helps to collect the most accurate data on the presence in the body of important trace elements and other substances that take part in biochemical reactions. In the presence of a disease, the standard balance of substances will be disturbed – the doctor will be able to determine the severity of the damage inflicted, and prescribe a more accurate l treatment of hair folliculitis.

Blood test for hair loss – a mandatory diagnostic method is blood sampling. With its help, it is possible to determine the type of infectious agent, respectively, to prescribe high-quality and effective treatment.

Methods of folliculitis treatment

Treatment of scalp folliculitis begins after determining the type of infectious agent, as well as the stage of development.

At the initial stage, simple but effective means are used: salicylic or camphor alcohol (1-2%).The solutions are rubbed into the inflamed areas; compresses can also be applied.

Photo. The doctor holds a bottle of salicylic alcohol in his hand

With a large accumulation of abscesses and deep penetration of the infection, the doctor will recommend a procedure for removing large accumulations – the abscess is opened, pus is removed from it, and the wound is treated with a solution selected for treatment (brilliant green, camphor or salicylic alcohol, tea tree oil).

In case of relapses and the development of a chronic form, antibiotics are prescribed that affect the focus of infection, as well as sulfonamide-type drugs.

Important: In no case should you try to squeeze out pustules – the disease can be complicated by the appearance of large boils.

Photo. The surgeon holds a scalpel in his hand before removing the abscesses – follicles

In modern clinics, in addition to the listed methods, a modern procedure is used that has shown excellent results – laser therapy. After completing the course, the state of the follicles improves significantly, and the inflammatory process is completely destroyed.The program is designed for six to ten procedures and helps with other types of alopecia.

Plasma therapy is another modern and effective means of follicle restoration. The human blood plasma contains a huge amount of nutrients and trace elements. But the main component is platelets – protective microorganisms. By injecting its own plasma into the scalp, it helps the body to quickly cope with the developing pathology.

Mesotherapy is an injection method of treatment that allows you to restore the balance of substances necessary for complete recovery.

Traditional methods of treatment

At the moment, the mass media, including the Internet, are disseminating data on traditional methods of treatment. For example, one of the most effective remedies is tea tree oil, which has a powerful antioxidant and anti-inflammatory effect.

Among other products for the treatment of seborrheic folliculitis, various herbal decoctions are offered: chamomile, calendula, thistle.

Professional trichologists note that self-treatment can result in complications .Only at the initial stage of folliculitis can herbal and oil compresses give a positive result. It is recommended that any remedy be used only after consultation with a specialist.

Complications and consequences of folliculitis

As already mentioned, folliculitis can develop into a chronic form. In addition, the pathology is dangerous:

• Development of boils and abscesses.
• The appearance of a carbuncle or dermatophytosis.
• Follicular scars may form.

Photo. Chronic folliculitis with multiple lesions

Cost of treatment

In any of the modern clinics in Kiev, which specialize in dermatology or trichology, highly qualified specialists, modern equipment and a professional approach are waiting. In a short time, you can get rid of the problem and forget about the infection forever.

All prices can be viewed on the websites of the clinics, as well as consult with the specialists of the medical centers by phone numbers listed under each clinic.

Video review of the problem of folliculitis

Answers to private questions of patients or visitors on folliculitis:

I am concerned about a small rash on the scalp, but no pain.

In the initial stages, folliculitis does not cause any discomfort. To correctly diagnose the disease, be sure to consult a doctor.

How can I get an appointment with a trichologist or dermatologist?

You can make an appointment by phone or come to any of the clinics from the list indicated on the website, where specialists will be happy to help you deal with the problem.

I squeezed out several abscesses and it got worse – an even larger abscess formed at the place of squeezing out. It hurts a lot. What to do?

Urgently go to the clinic, as extrusion could lead to the formation of a boil or abscess.

90,000 Folliculitis: treatment, diagnosis, symptoms

Folliculitis is an infectious process that develops in the middle and deep sections of human hair follicles.Pathology is accompanied by the formation of multiple pustules with purulent contents. The causative agent of the disease can be bacteria, viruses, fungi and parasites. As the infection progresses, the number of pustules on the patient’s skin increases. When the primary focus is opened, ulcers are formed, and when they heal, small scars are formed.

General information

Pathology is widespread among residents of countries with high humidity and air temperature. Such climatic conditions contribute to the spread of infectious lesions of hair follicles.The risk group is represented by socially disadvantaged segments of the population: non-observance of the rules of personal hygiene by a person leads to the active reproduction of pathogens on the skin.

Often the causes of folliculitis are superficial inflammation of the follicles – ostiofolliculitis. The spread of infection to the lower parts of the follicle leads to the formation of purulent pustules.

The reasons for the development of pathology

In 70% of cases, inflammation of the hair follicles develops under the influence of staphylococci and streptococci.Somewhat less often, the causes of the disease are pseudomonas, causative agents of syphilis and gonorrhea, or fungi of the Candida species. Molluscum contagiosum and herpes zoster viruses are less common causes of folliculitis. About 10% of clinical reported cases of inflammation of the hair follicles are manifested against the background of the activity of parasitic mites Demodex folliculorum and Demodex brevis.

Pathogens enter the follicles through damaged areas: scratches and abrasions. Persons suffering from itchy dermatitis and excessive sweating are susceptible to infection.Weakening of the patient’s immunity leads to the penetration of infection into the hair follicles. For this reason, dermatologists recommend taking preventive measures for men and women diagnosed with diabetes mellitus and chronic infections. It often occurs in HIV-infected people and patients taking immunosuppressive drugs.

Types of pathology

In the process of diagnosing folliculitis, dermatologists determine the form of the disease that the patient is suffering from.So, the staphylococcal type of pathology is often localized on the face of men, affecting the chin and the skin around the lips. Infection occurs when shaving bristly hair.

The pseudomonas form of the disease becomes the result of bathing the patient in hot water with insufficient chlorination level. The heat helps to open the pores in which infectious agents enter. Inflammatory lesions form on the face and upper body of a child or adult.

The syphilitic type of pathology develops against the background of secondary syphilis.Typical symptoms of folliculitis of this form are the formation of zones of bristly hair loss in men and multiple pustules on the temples in women.

The herpetic type of hair follicle infections affects the skin of the chin and nasolabial triangle of patients. It is characterized by the formation of large vesicles in the follicular orifices.

The candidal form of pathology manifests itself when occlusive dressings are applied to the patient’s skin, preventing pathogenic microflora from entering the wound on the chest.

The gonorrheal form of the disease becomes a complication of the gonococcal infection. Pustules form in the perineum (in women) and on the foreskin (in men).

Folliculitis caused by ticks can be localized on any part of the human skin. The activity of Demodex folliculorum and Demodex brevis leads to the formation of clusters of small pustules.

Symptoms of pathology

The symptoms of folliculitis in men and women are the same in most forms of the disease – dermatologists prescribe similar treatment for patients of both sexes.The most pronounced sign of an infectious lesion of the hair follicle is a single pustule filled with purulent contents, the center of which is penetrated by hair. After a few days, the formation opens on its own, separating a small amount of pus. An ulcer with a dense bloody purulent crust forms in place of the pustule. The healing of the resulting wound leads to the formation of a focus of hyperpigmentation or a scar.

In 80% of clinically diagnosed cases of the disease, multiple pustules form on the skin of patients.Common places of their localization are the face, scalp, armpits, pubis, inner thighs. Severe soreness and itching appear after the formation of a large accumulation of pustules. In the absence of medical care and refusal to comply with the rules of personal hygiene, the patient may face complications: abscesses, phlegmons and hydradenitis.

Diagnostics

The diagnosis is made by a dermatologist.The doctor examines the patient, during which he performs a dermatoscopy. The study of damaged hair follicles using an optical device makes it possible to establish the depth of penetration of pathogens into the structures of the dermis. Samples from the pustules obtained during the examination are subjected to laboratory tests. The study of biomaterials in the laboratory is performed to identify the causative agent of the infection. If signs of gonorrhea or syphilis are found, the doctor will refer the patient for PCR testing.

Differential diagnosis allows doctors to exclude drug toxicoderma, lichen rosacea, streptococcal impetigo, furunculosis and ostiofolliculitis from the patient’s history.

Treatment

The tactics of treating folliculitis is determined by the doctor, taking into account the type of disease identified in the patient. With the bacterial type of pathogens, adults and children are shown ointments with antibiotics. The fight against pathogens of a fungal nature is carried out using antifungal agents. Antiviral drugs are used to combat the herpes disease.

Local therapy in the treatment of folliculitis localized on the face is effective at the initial stage of the disease.When multiple pustules appear, the patient will need to treat the rash with alcoholic solutions of brilliant green or fucarcinum. You can stop the spread of infection with regular treatment of the skin with salicylic or boric alcohol. An auxiliary therapeutic measure is ultraviolet irradiation of the body and limbs of a child or adult.

The complicated course of the pathology requires complex therapy aimed at treating the disease that is the root cause of folliculitis – gonorrhea or syphilis.

Diagnosis and treatment of folliculitis in Moscow

JSC “Medicine” (Clinic of Academician Roitberg) has all the necessary equipment for the diagnosis and treatment of infectious lesions of hair follicles. The reception of patients is carried out in a modern diagnostic complex, built taking into account the latest achievements of medicine.

Questions and answers

Which doctor treats human hair follicle infections?

– Treatment of pathology is carried out by a dermatologist.In case of a complicated course of the disease, the patient may need to consult with other doctors – a venereologist, immunologist, therapist.

Are there measures to prevent folliculitis?

– Adults and children are advised to avoid contact with chemicals that can lead to skin damage and the penetration of pathogens into the hair follicles. Individuals suffering from diabetes mellitus and excessive sweating should carefully follow the rules of personal hygiene.

Is the infection transmitted from a carrier to a healthy person?

– The probability of infection of a healthy person by contact with a carrier of the disease exists. For this reason, dermatologists do not recommend that children and adults share towels and personal hygiene products.

Folliculitis: causes, symptoms, treatment

What is folliculitis? This is a fairly common problem that can worsen skin condition.When faced with minor irritation or experiencing mild itching, many do not attach much importance to this and do not even realize that the phenomenon can reduce the quality of life and cause serious complications. Folliculitis should be treated in a timely manner to avoid alopecia, furunculosis, dermatophytosis, nephritis, meningitis.

Folliculitis is an inflammation of the hair follicles, accompanied by the formation of abscesses. Infection begins from the surface layer of the epidermis, gradually spreading to the follicle.First, single or multiple papules filled with white or light yellow secretions are formed in the places of hair growth. They increase in size and begin to rise above the skin. The opened papules turn into sores. If you do not know how to treat folliculitis, or ignore the problem, the disease will become chronic. The risk group includes residents of regions with hot climates and people with weak immunity. The problem can also arise from neglect of personal hygiene or living in unsanitary conditions.

Causes of folliculitis infection

The etiology of folliculitis and how to treat it can be different:

• Decreased general and local immunity. This is due to prolonged use of antibiotics or the progression of chronic diseases.
• Continuous contact with skin irritants.
• Injuries (abrasions, scratches) that have not undergone antiseptic treatment.
• Pets that carry bacteria.
• Some diseases: dermatitis, allergies. Periodontal disease, gingivitis, tonsillitis, pharyngitis can indirectly contribute to the development of folliculitis.

Frequent causative agents of the disease are bacteria (staphylococci, treponema, gram-negative flora), fungi of the genus Candida and Pityrosporum, herpes simplex viruses, mites (demodectic and scabies).

Symptoms of folliculitis

The main symptom of folliculitis is inflammatory nodules in the area of ​​the hair follicle.The affected hair can be easily removed, but this does not solve the problem, as new papules appear. Sometimes hair can grow into the skin, leading to chronic irritation. Other signs include:

• Local redness accompanied by moderate itching.
• The presence of abscesses, swelling.
• Feeling of soreness when touching the affected area.
• Dry skin and burning.

In children and people with weak immunity, sometimes there is an increase in temperature, lethargy, but such cases are rare.Usually, the general well-being of patients with folliculitis does not deteriorate. The disease occurs locally. You can relieve the condition if you know what ointments to use for folliculitis. With the staphylococcal variety, “Mupirocin” will help. Compresses with ichthyol ointment contribute to the opening of abscesses.

Classification of the disease

Folliculitis is heterogeneous. Depending on the nature of the inflammatory process, several types are distinguished.

Hormonal folliculitis

The reason for the appearance is a hormonal disruption, which reduces the body’s defense reaction.The use of hormonal-based drugs can also provoke the development of pathology. Treatment should be comprehensive. Using only ointments or solutions will not give the expected results.

Candidal folliculitis

It often appears in people who have undergone surgery (occurs under bandages), in adolescent girls, against the background of chronic thrush or with prolonged fever. Bedridden patients also face this species. It is characterized by the absence of large abscesses.

Disruptive folliculitis

One of the most severe forms that are difficult to treat. Large neoplasms are formed on the skin, interconnected by fistulous passages. Even with light pressure on the follicle, purulent contents are released. The hair follicles are destroyed, resulting in hair loss.

Folliculitis of the scalp is called disruptive, as the resulting papules “undermine” the condition of the skin and lead to frequent relapses.After blocking the inflammatory process, persistent alopecia areata occurs. The best treatment is to take Roaccutane for six months. The main method can be supplemented with systemic antibiotics, retinoid ointments.

Decalvating folliculitis

Another name is Quinquad folliculitis. Its causative agent is one of the types of staphylococci – aureus. Also, gram-negative microflora can provoke the disease. It occurs in elderly and middle-aged men.It is usually localized in the beard area and on the head. Women also face the disease. They are characterized by decalvating folliculitis in the pubis, in the armpits, on the back of the head.

The cause may be endocrine pathologies (diabetes mellitus), connective tissue diseases, seborrhea, and immunodeficiency states. It is characterized by the absence of pronounced papules, but ulceration of the hair follicle. Leads to alopecia and atrophic skin changes.

Staphylococcal folliculitis

It is localized in the bristle growth zone (around the mouth and on the chin).It often occurs in men, but it can also develop in women. It is caused by an increase in the number of Staphylococcus aureus.

Bacterial folliculitis

Includes the staphylococcal variety. Also, the causative agents are gram-negative microorganisms and pseudomonas.

Eosinophilic folliculitis

A rare variety. It is mainly found in HIV-infected people. Small rashes resemble insect bites and are accompanied by severe itching.Usually, this folliculitis does not occur on the head. It is localized on the limbs, trunk, face.

Main affected areas

Folliculitis can affect different areas. Inflamed bulbs are often observed:

• On the scalp. The main reasons are frequent injuries, the use of other people’s hygiene products, and the lack of daily care.
• On the limbs. Folliculitis on the legs occurs after shaving hair.It appears as a result of skin injury from blades used repeatedly.
• On the face. It is caused by pathogenic microflora. Hormonal fluctuations can also affect the appearance of the rash. Facial folliculitis often occurs during puberty.
• On the genitals. They look like rashes and bumps of different sizes.

Effective treatments for folliculitis

Quite often, inflammation of the follicles is a consequence of the removal of unwanted vegetation.Dull blades, shugaring, or waxing will traumatize the skin, leaving sores for infection. Today there are different drugs for the treatment of folliculitis. But you need to use them only after consulting a dermatologist.

If you are faced with folliculitis caused by shaving, sign up for laser hair removal. This method will not only solve the problem of rashes, but also save you from unwanted hair. The smooth effect will last for many months if you undergo a course of procedures.The laser has other advantages over a razor, namely, it does not leave cuts, does not cause severe irritation, and removes blackheads.

Treatment of folliculitis: symptoms, diagnostics, services, doctors

Folliculitis is an inflammation of hair follicles. Passes with damage to the deep and / or middle sections, rarely – only in the mouth (ostiofolliculitis). It occurs as a result of infection by infections, bacteria, viruses, fungi or parasites. Through microcracks, the infection enters the follicle, causing an inflammatory process.Develops against the background of weakened immunity, hormonal disorders, chronic diseases.

A characteristic symptom is the appearance of an infiltrate in the area of ​​the hair follicle. First, redness is noted, then a conical pustule with hair inside is formed. The inflammatory process lasts up to 7 days, after which the abscess breaks out, the contents come out, scarring occurs. Treatment: local application of ointments containing antibiotics, antifungal components. In severe forms, systemic therapy.

Dermatologists of Moscow – latest reviews

Everything went well. The doctor consulted me. At the reception, the doctor took tests from me. Attentive, good specialist. I chose the doctor for myself according to the reviews. I will contact this specialist again.

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September 18, 2021

The reception went well.The bad news is that they do not warn in advance about the full cost of services. I counted on one amount, but in the end it turned out to be higher. The doctor examined me, conducted a survey, ordered me to pass the necessary tests, gave appropriate recommendations. If necessary, I will recommend a doctor to my friends. I am satisfied with the quality of the reception.

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September 16, 2021

I am satisfied with the reception and the doctor.Everything went quickly and professionally. The doctor examined, diagnosed and gave some advice. She calmed me down, saying that there was nothing wrong, everything was being treated. Continuous positive emotions! I recommend a specialist! Tatyana Vladimirovna is attentive, polite, professional and friendly. Dignified and understandable told all the information. There were no questions left and no complaints.

Tatiana,

September 13, 2021

My child and I often go to doctors and have been to many places.I expected to receive a specialist with extensive experience and a high rating. As stated on the site. And in fact, when we came to the session, I realized that this doctor does not work with children at all. Although I was told the opposite. Olga Fedorovna did not communicate with her daughter in any way, nor did she look at the skin on the device. I just touched a little problem areas and that’s it. I didn’t say at once what tests should be taken, I constantly asked someone everything. Then the doctor called me many times and eventually sent me to the post office what examinations we need to undergo.Never before have I seen such an indifferent doctor. Compared to other specialists, this doctor is just heaven and earth! I also delayed the appointment for fifteen minutes, and in our time I took another patient. We will not turn again.

Yuliya,

08 September 2021

The appointment was on time.The doctor is a highly professional specialist, qualified and correct. She filled out all the documents well, diagnosed us and prescribed treatment. Let’s go back in a week.

Nina,

August 25, 2021

At the reception, Sergei Ivanovich prescribed me a treatment that, in my opinion, was dubious.Because he immediately prescribed me a strong drug with antibiotics on my face. The doctor did not take a smear, only shone a flashlight and that’s it. My visit itself lasted about five minutes. I turned to this specialist because I liked the reviews and the doctor had prescribed the specialization I needed.

Ksenia,

August 19, 2021

A good doctor.Gave a consultation. Prescribed treatment, but I. unfortunately, I cannot pass it. Conducted an examination of the eyes with a special mirror. Communicated well with me. Was attentive. Clearly explained everything on my problem. I would recommend this specialist to my acquaintances and apply myself, if necessary.

Milufa,

August 18, 2021

Unfortunately, the diagnosis was not correct

Anonymous,

02 August 2021

A good, pleasant, attentive specialist.The doctor prescribed medications, they helped us a lot. The doctor solved the problem. All perfectly. We were very pleased with the reception, we liked everything. Let’s go to her appointment again. Have already recommended this doctor.

Helena,

July 29, 2021

We have a wart on our leg.The doctor told about all the methods of treatment and explained everything in an accessible way. We used one of the methods to remove the wart. The doctor also explained that this type of procedure is painless. The doctor also explained how to behave after the procedure. The specialist treats children very well. We will come to her for a second appointment to see the condition. Very clean office!

Lily,

June 22, 2021

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Abscessive Disruptive Folliculitis and Hoffman Perifolliculitis and Follicular Occlusion Syndrome | # 08/17

Abscessive disruptive folliculitis and Hoffman’s perifolliculitis is an inflammatory recurrent disease of the scalp, characterized by the formation of abscesses, followed by cicatricial atrophy.The disease occurs mainly in men and is characterized by a long course [1].

The cause of Hoffmann’s abscessing disruptive folliculitis and perifolliculitis is not fully understood. Pathophysiological changes in the skin in this disease are associated with follicular occlusion, expansion and rupture of the follicular canal, which leads to an inflammatory reaction. Bacterial infection on the rash develops for the second time and is not the cause of this disease [2, 3].

The clinical picture of the disease is represented by multiple painful nodes with purulent discharge, which, merging, form interconnected abscesses and sinuses (sinuses) [1].The process has typical localization sites with damage to the scalp (more often the parietal and occipital regions), the back of the neck. The trigger mechanism in the formation of inflammatory elements is associated with the occlusion of the sebaceous glands, which explains the characteristic location of the localization [4–7]. According to the topographic anatomy, the largest sebaceous glands are located on the scalp, with up to 5 lobules, deeply lying, with long convoluted ducts [8].

After the resolution of the inflammatory process, hypertrophic or atrophic scars of the scalp remain, which leads to limited foci of cicatricial alopecia, localized at the sites of inflammation [7].

Some authors point to the possibility of complications such as squamous cell carcinoma and marginal keratitis [2, 3, 7, 9].

Diagnosis of abscessing disruptive folliculitis and Hoffman’s perifolliculitis is based on the clinical picture, trichological examination, and if necessary, histology.

The histological picture of the disease depends on the degree of inflammation. At an early stage, follicular hyperkeratosis with blockage and follicle dilatation is observed.As a result, apoptosis occurs and the follicular epithelium is destroyed. In the future, infiltrates from neutrophils, lymphocytes and histiocytes are formed. Later, the formation of an abscess is observed, leading to the destruction of the hair follicle. Abscesses can penetrate the dermis and subcutaneous fat. With the development of the process in the dermis and subcutaneous fat, granulation tissue is formed, containing lymphoplasmic infiltrate and histiocytes, as well as multinucleated giant cells around keratin and hair shafts.The healing process culminates in extensive fibrosis. In the later stages, there is scarring, fibrosis, subcutaneous sinuses, chronic granulomas, which are represented by lymphocytes, macrophages, giant cells of foreign bodies, blood plasma cells [2, 4, 9, 10].

The trichoscopy method can detect characteristic signs: “3D” (“three-dimensional”) yellow dots in the area of ​​dystrophic hair, yellow amorphous areas, white dots with halos, milky-red areas without follicular holes [4, 11].

The patients we observed with the diagnosis “abscessing disruptive folliculitis” and “Hoffman’s perifolliculitis” are shown in the photographs (Fig. 1, 2). Clinical examples demonstrate abscesses and hypertrophic scars at the site of former scalp lesions in men 23 and 28 years old. In the presented patients, the process was localized only on the scalp, the skin in other areas was not affected, and acne was absent.

Abscessing subversive perifolliculitis may be one of the symptoms included in follicular occlusion syndrome, which includes a combination of skin diseases similar in pathophysiological manifestations: acne conglobata, inverse acne, abscess subversive perifolliculitis, pilonidal cyst.Currently, the literature describes double follicular occlusion syndrome, follicular occlusion triad and follicular occlusion tetrad.

Double follicular occlusion syndrome combines abscessing subversive perifolliculitis and acne conglobata. A clinical example is shown in Fig. 3. A 25-year-old man has hypertrophic scars on the scalp at the site of the former rashes in the scalp, post-acne scars on the skin in the face, 2-3 degree acne (Fig.3).

The triad of follicular occlusion occurs in patients with acne conglobata, abscess subversive perifolliculitis and inverse acne (or hydradenitis), and in the presence of a pilonidal cyst it is diagnosed as a tetrad of follicular occlusion [2, 9]. The exact pathogenesis of this group of diseases is unknown, but evidence suggests that they have the same pathological process initiated by follicular occlusion. Recent studies have shown that cytokeratin 17 (normally found in the duct of the sebaceous gland) is absent in the epithelium of the duct of the sebaceous gland of patients with inverse acne, which contributes to fragility of the epithelium and leads to rupture of the follicular duct wall [12].

Follicular occlusion syndrome occurs more often in the third or fourth decade of life in males. However, this syndrome has been described in adolescence, as well as in women [2, 9, 13]. According to the literature, in rare cases, follicular occlusion syndrome can be combined with spondyloarthritis, osteomyelitis, Crohn’s disease, sternoclavicular hyperostosis, Reid’s syndrome (a rare combination of keratitis, ichthyosis and deafness) [2, 9, 14].

Inverse acne can be both an independent disease, and can be a symptom of follicular occlusion syndrome.According to the definition of European clinical guidelines, inverse acne is a chronic, inflammatory, recurrent dermatosis, with a primary lesion of the hair follicle that occurs after puberty and is characterized by painful, deep rashes localized in parts of the body where the apocrine glands are located (axillary, inguinal, anogenital areas) …

Inverse acne was first described in 1839 by Velpeau, who originally called the disease “hidradenitis suppurativa”, considering that inflammatory changes in this disease occur in the sweat glands [2, 9].In 1939, Brunsting, on the basis of a histological study, proved that hyperkeratosis of the follicular ducts of the sebaceous hair follicle is the central link in the pathogenesis of hydradenitis, which disrupts scalp folliculitis and conglobate acne [15]. In 1989, Plewigand and Steger coined the term “inverse acne”, pointing to the incorrect term “hydradenitis”, since the pathogenetically important is follicular duct hyperkeratosis, not inflammation of the sweat glands. The difference between inverse acne and acne vulgaris, in addition to localization, is the absence of an increase in the secretion of the sebaceous glands [13, 16].

Currently, the diagnostic criteria for inverse acne have been determined, in which the main and additional ones are highlighted.

I. Basic:

1. Recurrence of rashes two or more times within 6 months.
2. Rashes are localized in the axillary, inguinal, anogenital and gluteal regions, under the mammary glands (in women).
3. The presence of nodes (inflammatory or non-inflammatory), sinuses (inflammatory or non-inflammatory), abscesses, scars (atrophic, hypertrophic or linear).

II. Additional:

1. Family history.

2. Absence of pathogenic flora in the smear from the discharge (only the presence of normal microbiota) [7].

There are several stages of inverse acne:

• Stage I: abscesses, single or multiple, without sinuses or scars.
• Stage II: recurrent scarring abscesses, single or multiple, with areas of unaffected skin.
• Stage III: diffuse or almost diffuse lesions of the scalp, multiple sinus cavities and abscesses connected to each other over the entire area (Hurley, 1989) [17].

Severe variants of the course of follicular occlusion syndrome are associated with metabolic syndrome, obesity, eating large amounts of simple carbohydrates, smoking, and male sex [7].

We present clinical cases of the follicular occlusion triad in Fig.4, 5. Patients 43 and 52 years old complained of rashes on the scalp, face, back, chest, axillary region, groin (Fig. 4, 5). The patients had similar medical histories and clinical presentation. Consider themselves ill from adolescence, when rashes first appeared on the skin of the face, chest and back. Were treated on an outpatient basis with a diagnosis of acne conglobata. At the age of about 30, painful skin rashes began to appear on the scalp and armpits.Patients were treated on an outpatient basis, doxycycline for 2-3 weeks, excision of large nodes. The treatment brought a temporary improvement, remission lasted less than six months.

Differential diagnosis of abscessing subversive folliculitis and perifolliculitis Hoffman

Differential diagnosis must be carried out, first of all, with diseases localized on the scalp. Acne-keloid (syn: papillary dermatitis of the head, sclerosing folliculitis of the occiput) is also observed in men in the occiput and on the back of the neck.Initially, groups of small follicular pustules appear, which are arranged in the form of a strand. The skin around them is significantly compacted, the skin grooves are sharply expressed, in connection with which the impression of the existence of papillary tumors is created, the hair grows in bunches. When follicles resolve, keloid scars remain. The process proceeds slowly, without the formation of abscesses [1]. The absence of fluctuating nodules, large abscessed formations, fistular passages is the main difference between acne-keloid and abscessing subversive folliculitis and Hoffman’s perifolliculitis.

Often, cases of cicatricial alopecia due to prior folliculitis are usually diagnosed as abscessing and disruptive Hoffman’s perifolliculitis. Decalvating (epilating) folliculitis was first described in 1888 by Quinqaud. Decalvating folliculitis also occurs in adults and is more common in men. Lesions with decalvating folliculitis are usually located on the scalp, but sometimes they can be localized on other parts of the body covered with hair: beard, axillary region, pubis.The process begins with folliculitis surrounded by an area of ​​erythema. After the resolution of the inflammation, small round or oval foci of cicatricial atrophy are formed. Merging with each other, small foci become larger, usually retaining a rounded shape. Old areas, on which the inflammatory process has ended, are represented by areas of cicatricial atrophy. Thus, the clinical picture is represented by small foci of cicatricial alopecia with bundles consisting of 5-10 hairs emerging from dilated follicular openings.

Mycotic lesion of the scalp is characterized by the absence of acute inflammatory phenomena and a positive fungal culture.

Other conditions that can mimic abscessing subversive folliculitis and Hoffman’s perifolliculitis include malignant proliferating pilar cysts, folliculotropic fungal mycoses with large cell transformations, and erosive-pustular dermatosis of the scalp [4, 18, 19].

Treatment of abscessed disruptive folliculitis and Hoffman perifolliculitis and follicular occlusion syndrome

Therapy for follicular occlusion syndrome usually begins with treatment with antibacterial drugs given orally (tetracycline, clindamycin, rifampicin) and externally (clindamycin).Some authors recommend 250–500 mg ciprofloxacin or 300 mg clindamycin and rifampicin [20].

However, antibiotic therapy has a short-term effect. According to some authors, it is more effective to combine antibiotic therapy with injections of corticosteroids into the lesions [21]. Dapsone 50–150 mg daily is recommended for the treatment of treatment-resistant cases [13].

However, according to the literature, it is often necessary to resort to surgical intervention.Surgical treatment is carried out against the background of antibiotic therapy with complete resection of the affected scalp in staged procedures followed by skin reconstruction [22].

Currently, most of the publications devoted to the treatment of follicular occlusion claim the high efficacy of isotretinoin in the treatment of this dermatosis. Isotretinoin is recommended to be prescribed in the same dosages as for acne vulgaris – 0.5–1 mg / kg for 3–12 months [20, 21].

Some authors recommend a combination of oral antibiotics and topical application of isotretinoin [20, 21].

In the modern literature, there are isolated publications demonstrating the high efficiency of genetically engineered biological drugs, such as adalimumab, infleximab, which are offered as a third line of therapy [23, 24].

We observed a 52-year-old patient with a triad of follicular occlusion (acne conglobata, abscessing subversive perifolliculitis and inverse acne), treated with isotretinoin at a dose of 30 mg per day for 6 months.As a result of therapy, there was a long-term remission within a year. The photographs show the results of therapy after 2 months of taking the drug (Fig. 6). The process was completely resolved, represented by post-inflammatory spots and hypertrophic scars.

Thus, the presented clinical cases demonstrate various variants of the follicular occlusion syndrome, as a result of which nodules of a different nature (inflammatory or non-inflammatory), abscesses and, as a consequence of the inflammatory process, the formation of various scars are formed on the skin.Currently, the most effective drug for the treatment of abscessing disruptive folliculitis and Hoffman’s perifolliculitis and follicular occlusion syndrome is isotretinoin in dosages recommended by the instructions.

Literature

1. Berenbein B. A., Studnitsin A. A. Differential diagnosis of skin diseases. M .: Medicine, 1989.672 p.
2. Scheinfeld N. Diseases associated with hidranitis suppurativa: part 2 ofaseriesonhidradenitis // Dermatol Online J.2013, Jun 15; 19 (6): 18558.
3. Badaoui A., Reygagne P., Cavelier-Balloy B., Pinquier L., Deschamps L., Crickx B. et al. Dissecting cellulitis of the scalp: a retrospective study of 51 patients and review of literature // Br J Dermatol. 2016, Feb. 174 (2): 421-423.
4. Gaopande Vandana L., Maithili M. Kulkarni, Avinash R. Joshi, Ashish N. Dhande. Perifolliculitis Capitis Abscedens et Suffodiens in a 7 Years Male: A Case Report with Review of Literature Case Rep Surg.2016: 21230 // Int J Trichology. 2015 Oct-Dec; 7 (4): 173-175.
5. Mihic L. L., Tomas D., Situm M., Krolo I., Sebetic K., Sjerobabski-Masnec I., Barišic F. Perifolliculitiscapitisabscedens et suffodiens in a caucasian: diagnostic and therapeutic challenge // Acta Dermatovenerol Croat. 2011; 19 (2): 98-102.
6. Karpouzis A., Giatromanolaki A., Sivridis E., Kouskoukis C. Perifolliculitiscapitisabscedensetsuffodiens successfully controlled with topical isotretinoin // Eur J Dermatol.2003, Mar-Apr; 13 (2): 192-195.
7. Zouboulis C. C., Desai N., Emtestam L., Hunger R. E., Ioannides D., Juhász I. et al. European S1 guideline for the treatment of hidradenitis suppurativa / acne inverse // J Eur Acad Dermatol Venereol. 2015. Apr. 29 (4): 619–644.
8. Sobolevskaya I. S. Some morphometric indicators of lipid-accumulating and lipid-synthesizing structures of human skin // Vestnik VSMU. 2012, vol. 11, No. 2.
9. Scheinfeld N.Review Dissecting cellulitis (Perifolliculitis Capitis Abscedenset Suffodiens): a comprehensive review focusing on new treatments and findings of the last decade with commentary comparing the therapies and causes of dissecting cellulitis to hidradenitissuppurativa // Dermatol Online J. 2014, May 16; 20 (5): 22692.
10. Branisteanu D. E., Molodoi A., Ciobanu D. The importance of histopathologic aspects in the diagnosis of dissecting cellulitis of the scalp // Rom J Morphol Embryol.2009; 50 (4): 719-724.
11. Rakowska A., Slowinska M., Kowalska-Oledzka E., Warszawik O., Czuwara J., Olszewska M., Rudnicka L. Trichoscopy of cicatricial alopecia // J Drugs Dermatol. 2012, Jun; 11 (6): 753-758.
12. Kurokawa I., Nishijima S., Kusumoto K. et al. Immunohistochemical study of cytokeratins in hidradenitissuppurativa (acne inversa) // J Int Med Res. 2002; 30: 131-136.
13. Vani Vasanth, Byalakere Shivanna Chandrashekar. Follicular occlusion tetrad // Indian Dermatol Online J. 2014, Oct-Dec; 5 (4): 491-493.
14. Kohorst J. J., Kimball A. B., Davis M. D. Systemic associations of hidradenitissuppurativa // J Am Acad Dermatol. 2015, Nov; 73 (5 Suppl 1): S27–35.
15. Brunsting H. A. Hidradenitissuppurativa: abscess of the apocrine sweat glands // Arch fur Dermatol und Syph (Berlin). 1939.39: 108–120.
16. Plewig G., Steger M. Acne inversa (alias acne triad, acne tetrad, or hydradenitissuppurativa).Marks R., Plewig G., eds. Acne and Related Disorders. London: Martin Dunitz Ltd; 1989.343–357.
17. Hurley H. Axillary hyperhidrosis, apocrine bromhidrosis, hidradenitissuppurativa, and familial benign pemphigus: surgical approach. In: Roenigh R. R. H., ed. Dermatologic surgery. New York: Marcel Dekker, 1989: 729-739.
18. Von Laffert M., Stadie V., Wohlrab J. et al. Hidradenitissuppurativa / acne inversa: bilocated epithelial hyperplasia with very different sequelae // Br J Dermatol.2011; 164: 367-371.
19. Torok R. D., Bellet J. S. Tinea capitis mimicking dissecting ce llulitis // Pediatr Dermatol. 2013, Nov-Dec; 30 (6): 753-754.
20. Khaled A., Zeglaoui F., Zoghlami A., Fazaa B., Kamoun M. R. Dissecting cellulitis of the scalp: response to isotretinoin // J Eur Acad Dermatol Venereol. 2007 Nov; 21 (10): 1430-1431.
21. Koudoukpo C., Abdennader S., Cavelier-Balloy B., Gasnier C., Yédomon H. Dissecting cellulitis of the scalp: a retrospective study of 7 cases confirming the efficacy of oral isotretinoin // Ann Dermatol Venereol.2014 Aug-Sep; 141 (8-9): 500-506.
22. Hintze J. M., Howard B. E., Donald C. B., Hayden R. E. Surgical Management and Reconstruction of Hoffman’s Disease (Dissecting Cellulitis of the Scalp) // Case Rep Surg. 2016; 2123037. DOI: 10.1155 / 2016/2123037. Epub 2016 Feb 7.
23. Martin-García R. F., Rullán J. M. Refractory dissecting Cellulitis of the Scalp Successfully controlled with Adalimumab // P R Health Sci J. 2015, Jun; 34 (2): 102-104.
24. Sand F. L., Thomsen S. F. Off-label use of TNF-alpha inhibitors in a dermatological university department: retrospective evaluation of 118 patients // Dermatol Ther. 2015, May-Jun; 28 (3): 158-165.

A.A. Kubanov ¹ , Doctor of Medical Sciences, Professor, Corresponding Member of the Russian Academy of Sciences
Yu.A. Gallyamova, Doctor of Medical Sciences, Professor
T.A. Sysoeva, Candidate medical sciences

FGOU DPO RMAPO, Moscow

¹ Contact information: derma2006 @ yandex.ru

90,000 Folliculitis after hair removal – what to do

Last update:

11/27/2020

A client came to our consultation, who had waxed her legs 2 days earlier from a private master.

After the procedure, red spots appeared, then the redness intensified and white spots appeared. She came to find out our opinion of what it is and how she should be.

Photo from www.shutterstock.com

When folliculitis can occur and how to treat it

Folliculitis after hair removal is a bacterial infection that occurs 2-3 days after the procedure and is expressed in punctate cavities filled with whitish contents.

They are located on a hyperemic background (that is, at places of redness) and may be accompanied by pain or itching.

We will try to sanctify the possible causes of the problem.

Wax depilation is a temporary method of dealing with unwanted vegetation by applying a heated material and then tearing it off along with the cover. The sprouts are removed from the roots, leaving behind a microtrauma.

An unprotected surface is formed. In other words, within 24 hours, the skin is extremely susceptible to various pathogens.

This fact is the basis for the basic set of rules for caring for the post-epilation area.Violation of hygiene standards, the use of non-sterile materials with no antiseptic treatment, especially when depilation from a private owner at home – all this can be responsible for the condition that has arisen.

Tight-fitting clothing provokes friction, creating additional conditions for the attachment of microorganisms.

Continuous touching of freshly peeled skin will lead to the same outcome.

Visiting saunas and baths increases the risk of infection.Intense exercise and intimate relationships are also undesirable during the first days until the damaged surface heals.

Taking immunosuppressive drugs suppresses the protective function, which will increase the chances of infection.

How to treat?

Treatment should include several aspects.

It is very important not to “disturb” the education, not to fiddle with or tear off the element covers. Change bed linen and towels.Avoid scrubs and traumatic washcloths.

For a while, give up perfumed cosmetics in the affected area. Postpone visits to the sauna and pool until you are cured. Try to reduce the physical activity that leads to sweating.

Clothes should be clean, ironed and loose.

Outwardly, it is necessary to apply antiseptic solutions: miramistin, chlorhexidine, bactroban, chloramphenicol alcohol.

If the symptoms do not disappear after a few days, or if the condition worsens significantly, you should consult a doctor who will make an accurate diagnosis and prescribe medications inside.

It is not recommended to take antibiotics without medical supervision, as this can lead to deterioration or cause complications.

It is very important to carefully choose a salon with a medical license and experienced craftsmen, and remember that contacting “homeworkers” is dangerous.

If this outcome repeats several times, check your blood sugar level and consult your doctor.

Authors:

Medically written and reviewed by: Julia Nicholson, dermatologist, physiotherapist
Published by: Olesya Smagina, Assistant Director of the Universe of Beauty Hair Removal Centers

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Folliculitis, drugs from the pharmaceutical company Vishpha

For the development of the disease, only a pathogenic agent is not enough. In order for the infection to actively manifest itself in the body, in order for an inflammatory reaction to occur, pus-filled pustules, favorable conditions are necessary for this, for example, weak immunity, insufficient skin care, microtrauma, etc.

Bacterial infectious diseases of the skin are classified as infections of the skin, soft tissues and acute infections of the skin, structures.The primary pathogens for infections of the skin and soft tissues are asporogenic gram-positive chemoorganotrophic facultative anaerobic bacteria and aerobic microorganisms, including methicillin-resistant Staphylococcus aureus (Staphylococcus aureus).

Features, causes of folliculitis

Infectious diseases of the skin and soft tissues include such a disease as folliculitis – a bacterial skin infection of the upper layers of the epidermis, in which the hair follicles suppuration occurs.The disease is caused by gram-positive anaerobic bacteria, aerobic microorganisms. The infection can affect any part of the skin where there are hair follicles.

Infection can penetrate the skin if the integrity of the skin is broken through cuts, scrapes, scratching after an insect bite, when shaving, excessive sweating, skin blockages, etc. The disease is manifested by erythema, pustules, superficial pimples on the skin.

Pathogens (bacteria, microorganisms, etc.) can constantly be in the body, on the skin, on mucous membranes, with high immunity, these infectious agents do not cause dermatological diseases. If immunity is reduced, after introduction, pathogens begin to multiply rapidly, using the nutrient medium of the epidermis, causing various skin diseases, including bacterial folliculitis.

Bacterial folliculitis treatment

Several types of pathology are classified, each of which has its own characteristics of the course, differs in symptomatology.Usually, the antibiotic of choice in the treatment of folliculitis is mupirocin, on the basis of which Vishpha has created an effective drug Bactialis for the treatment of bacterial skin infections. The antibiotic inhibits the growth and reproduction of bacteria in minimal concentrations; in high concentrations, when applied topically, it has bactericidal properties. Mupirocin is active against gram-positive aerobic, facultative anaerobic bacteria that cause the development of skin infections, including folliculitis.

Bactialis is indicated for external use in primary, secondary bacterial infectious diseases of the skin, minor damage to it. When penetrating through damaged skin, the antibiotic is rapidly metabolized and excreted by the kidneys.

Timely, correctly prescribed therapy, adherence to the doctor’s recommendations allow you to quickly cure bacterial folliculitis with the help of the drug Baktialis.

Bactialis – antibiotic for treating bacterial skin infections

In the treatment of infectious diseases of the skin and soft tissues, an antibiotic for topical use based on mupirocin is often prescribed.It is a powerful antibacterial agent for external use, the active action of which is aimed at suppressing infectious agents that cause dermatological diseases. The drug is active against most gram-positive aerobic, facultative anaerobic bacteria, microorganisms that cause skin infections (Staphylococcus aureus), exhibits antibacterial activity against gram-negative microorganisms (intestinal, Haemophilus influenzae), has a bactericidal and bacteriostatic effect.

Bactialis can be used externally by adults, children from 2 months for the treatment of folliculitis, furunculosis, impetigo and other dermatological diseases of infectious, non-infectious genesis.

Buy antibacterial agent for external use

The pharmaceutical company Vishpha offers a diverse range of high-quality medicines, including the antibiotic Bactialis for the treatment of bacterial skin infections for adults and children from 2 months, which can be bought using the Internet service, the current price is indicated on the website.The pharmaceutical company’s medicines are sold through pharmacies in Ukraine, many of which work around the clock (24/7) and have a convenient location for buyers.

Vishpha pharmaceutical company produces high-quality medicines, topical antibacterial preparations for the treatment of bacterial infectious diseases of the skin, soft tissues, which have a bactericidal and bacteriostatic effect. All products are certified and meet quality standards, the price is affordable.

The company Vishpha (VISHFA) carries out constant internal control, timely tracking information about medicines, their expiration dates, storage conditions, transportation of pharmaceuticals, which excludes the possibility of selling low-quality or expired medicinal products.

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