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Folliculitis
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Folliculitis

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WOMEN'S HEALTH

Hair/Nails/Skin

With common names like hot tub folliculitis and barber'sitch, folliculitis may sound more like a bad joke than a skin disorder. But this infection of the hair follicles is no laughing matter. Severe cases may cause permanent hair loss and scarring, and even mild infections can be uncomfortable and embarrassing.

Folliculitis usually appears as small, white-headed pimples around one or more hair follicles - the tiny pockets from which each individual hair grows. Most infections are superficial, affecting just the upper part of the follicle, and although they may itch, they're seldom painful. The pimples can occur almost anywhere on your body, but they are especially common on the face, scalp, thighs, legs and in the groin area.

When to seek medical advice

Mild cases of folliculitis often clear up without any treatment. But if the infection doesn't improve in two or three days, appears to spread or recurs often, call your doctor or dermatologist. You may need antibiotics or antifungal medications to help control the problem.

Screening and diagnosis

Your doctor is likely to diagnose folliculitis simply by looking at your skin. When standard treatments fail to clear the infection, your doctor may send a sample taken from one of your pustules to a laboratory, where it's grown on a special medium (cultured) and then checked for the presence of bacteria. If your doctor suspects eosinophilic folliculitis, especially if you're HIV-positive, he or she may remove a small tissue sample (biopsy) from an active lesion for testing.

Complications

Mild cases of folliculitis aren't likely to cause complications, although the infection may recur or spread, leading to large, itchy patches of staph infection on the skin (plaques).

Complications of severe folliculitis may include:

  • Cellulitis. This potentially serious bacterial infection appears as a swollen, red area of skin that feels hot and tender and that may spread rapidly. It's most common on your legs, arms or face. Although the initial infection may be superficial, it eventually can affect the tissues underlying your skin or spread to your lymph nodes and bloodstream.
  • Furunculosis. This condition occurs when a number of boils develop under your skin. Boils usually start as small red bumps. But over a period of days they become larger and more painful as they fill with pus.
  • Scarring. Severe folliculitis may leave thick, raised scars (hypertrophic or keloid scars) or patches of skin that are darker than normal.
  • Destruction of the hair follicle. This leads to permanent hair loss.

Folliculitis > 1 > 2 > 3 > 4

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