Folliculitis is a very common dermatological condition affecting hair-bearing skin. People of all ages can develop it. Normally, the disorder is not dangerous but it can be very discomforting and embarrassing.
There are different types of it but all are characterised by swelling of the skin and inflammation of the hair follicles. In this article, we will look at the causes of each type as well as different ways of treating folliculitis.
Folliculitis is an infectious inflammatory condition of the hair follicles. It is a common skin problem and may occur in otherwise healthy people. Folliculitis can be present in any area where you have hair. Men and those with coarse and curly hair are more prone to having this disorder.
The progression of this disease can vary greatly among patients. Some experience only a mild occurrence that resolves by itself within 2-3 weeks. For some, it is a recurrent problem that lasts for years. That said, most cases are manageable but do require ongoing maintenance.
As a rule, folliculitis is not contagious. An infection, however, can potentially pass on to another person by being in the same tub/pool with an infected person. Having close skin-to-skin contact and sharing hygiene and cosmetic tools are also among the risk factors.
Various pathogenic microorganisms can initiate this condition: yeast, bacteria, viruses or ticks. The causes of folliculitis can be divided into exogenous (external factors) and endogenous (certain diseases and dysfunctions).
The symptoms of this condition depend on the type of folliculitis a person has. In superficial folliculitis, for instance, the bumps are really small and painless to touch. Generally, the skin around them looks reddish and inflamed.
This type is also known as hot tub rash or razor bumps. After a few days, the bumps get dry and flaky and form a brown crust. This can also affect the skin pigmentation and leave lasting brownish spots.
In deep folliculitis, the whole hair follicle is damaged. It is characterised by the formation of bigger pus-filled lumps with whiteheads that are sore and tender. It can be very itchy and leaves dark spots on the shaved area.
Prolonged antibiotics’ use can entail a fungal infection and result in folliculitis. It may look like severe acne, that is why it is considered under-recognised and often misdiagnosed.
One of the main differences between acne and this condition is that the latter tends to be itchy and does not form distinctive white or blackheads. People with fungal folliculitis often suffer from seborrheic dermatitis too, as both are triggered by the Malassezia genus of yeasts.
Viral folliculitis is associated with herpes. Herpes simplex virus causes painful cold sores that also affect hair follicles around them. This is not a common type of folliculitis and can be resolved without special treatment.
Certain medications can induce the infection of hair follicles too, e.g. some seizure drugs or topical steroids used to alleviate inflammation. Sometimes, the cause of the condition may be as simple as being in a polluted or unhygienic environment for a longer time.
When one is exposed to certain oils (due to working conditions), does not cleanse the skin regularly or even frequently uses makeup products, they are more likely to have inflamed hair follicles. This is also known as oil folliculitis. It is not triggered by bacteria but dirt clogging the pores, and normally is not deep or severe.
Folliculitis decalvans is the type of disorder that affects the scalp directly. It is a quite rare condition, the exact cause of which has not been yet discovered. In many cases, it is attributed to Staphylococcus aureus activity. Some small reports also suggest that there is a genetic predisposition for it.
Generally, this condition leads to tissue scarring and hair loss. Folliculitis decalvans is responsible for about 11% of cases of scarring alopecia. Unfortunately, there is no specific treatment for it. The condition tends to be long-term and requires continuous management of the symptoms.
Most times, the problem progresses mildly and only symptomatic treatment is required. The inflamed area needs up to 2 weeks to heal, generally, without any targeted treatment measures.
For mild folliculitis, doctors recommend applying warm compresses to ease discomfort, itch and burning. Clean the affected area with warm water, you can also dilute some sea salt in it or use antibacterial soap. Do not forget to change the towel every time you do this. Do such compresses 3-4 times a day for about 15 minutes each time.
Antiseptic washes are also needed to kill bacteria and relieve the symptoms. You can dilute some hydrogen peroxide or chlorhexidine with water and apply it onto the inflamed area with a cotton pad. This will help with both bacterial and yeast infection.
While you sleep, dust, sebum and microorganisms accumulate on the skin, thus creating perfect conditions for the growth of bacterial flora. You should do such rinses and compresses at least every morning to wash the dirt off.
If you experience folliculitis on the scalp, it is advisable to make use of antiseptic shampoos. They should contain mild cleansing formulas and be free of sulphates and other aggressive ingredients.
Avoid the scalp area while applying masks, conditioners or other cosmetic products. We also want to stress that you should never pop the folliculitis bumps. This will make it easier for the infection to spread and result in scarring.
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In addition to your regular treatment:
Your diet can also contribute to flare-ups of folliculitis. Eat plenty of vegetables and omega-3-rich foods and stay away from salty, spicy and processed meals, as they can worsen inflammation. Additionally, you can take A, E and B vitamins to speed up the healing process.
A great homemade remedy for folliculitis is aloe vera gel. It is a true hair all-rounder with antibacterial and antifungal properties. Aloe vera is soothing and cooling; it can also relieve swelling and redness. You need to clean your skin first with water and soap. Then, extract the gel from the leaves and apply it onto the inflamed patch. You can also cover it with gauze cloth.
Apple cider vinegar is also known to be effective in milder cases of the disorder. Due to its acidity, it inhibits the reproduction of certain bacteria, in particular Staphylococcus aureus. Always remember to dilute with water before applying. Use 1 teaspoon of vinegar per 1/2 cup of water. Soak a cotton pad in the solution and dab gently over the affected area.
Some essential oils, especially tea tree oil, can be used for bacterial folliculitis if it is not severe. It is best to apply it directly on the bumps with a cotton swab. This will make them heal faster and reduce itchiness.
If you stick to the above-mentioned measures but keep getting folliculitis anyway, you need to consult a doctor for more targeted treatment with antibiotics.
Folliculitis is not a life-threatening disease. However, it can still influence one’s life greatly as it often requires long-term management of symptoms. These include swelling, rash and redness of the skin, sore blisters (sometimes with pus) around hair follicles. Folliculitis of the scalp often entails hair loss too.
Mild cases can be controlled with proper hygiene, homemade remedies and certain cosmetic products like lotions and special shampoos. If you are prone to having skin infection, follow our recommendations for inhibiting the growth of bacteria.
You should also consider switching to high-quality hair care products with natural ingredients that will not contribute to flare-ups of folliculitis. Dr Balwi’s shampoo and hair serum are the ones to look for if you want to gently cleanse your scalp and ensure the strength of your hair follicles.
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