The human skin is an amazing organ and performs some of the most important functions in the body. It acts as a protection from the natural elements, helps in the healing of wounds and grows the hair on the body. With so many functions to perform, there is ought to be something going wrong once in a while.
The tiny pockets on the skin are known as hair follicles. They are present everywhere on the body except areas like the lips, palms and the soles of the feet. Folliculitis is a common skin condition which occurs because of the infection or inflammation in the hair follicles present on the skin. This condition is also known as Razor bumps, Barber’s Itch, Shaving rash or Hot tub rash. The appearance is like small and red bumps which are sometimes topped with dots of pus and surround the hair that grows from the follicle. Lesions which are older and have gotten rid of the pus have a reddish appearance around the opening of the hair follicle. The rashes most often look like pimples with white tips.
This condition might occur anywhere on the body, but it mostly affects the genitals, legs, chest, arms, back, buttocks, face and head. It appears on the places where friction is common. The condition might be limited to one hair follicle or might affect many hair follicles. This condition is not very serious, but can be very itchy and sore and might be embarrassing for the individual suffering from it. Infections of a severe nature might cause hair loss which is permanent and might also lead to scarring.
If it is a mild scenario, the condition clears up on its own with some very basic self-care steps and prevention methods at home. For recurring episodes and if the condition turns serious, a visit to the doctor might be required and some prescription medicines might be needed. Folliculitis is a very common condition but is relatively harmless. It can affect individuals of all age groups.
Types of Folliculitis:
The main types of folliculitis are deep and superficial. Deep folliculitis is a more serious condition as it affects the entire follicle whereas superficial folliculitis involves only a part of the hair follicle.
Types of Superficial folliculitis are:
Hot tub folliculitis:
On exposure to the bacteria associated with this condition, the individual might develop bumps which are red, round and itchy after one or two days of the exposure. The bacteria concerned is known as Pseudomonas bacteria which is mostly found in hot tubs, heating pools with unregulated chlorine and pH levels along with other places.
Pityrosporum folliculitis:
This type of folliculitis is caused by a yeast infection. The affected areas include back and chest and sometimes might also include face, shoulders, upper arms and neck. The signs of this kind of infection are mainly red and itchy pustules which are chronic in nature.
Bacterial folliculitis:
The main cause of this condition is the Staphylococcus aureus (staph). This bacteria is known to live on the skin all the time. But this is not always a cause for concern as they only create problems on entering the body through a cut or a wound on the skin. The signs that are seen are pus-filled bumps which are white and itchy.
Razor bumps:
This condition is also known as pseudofolliculitis barbae. It is an irritation caused by the ingrown hair. Curly haired men who shave too close are mainly affected. Individuals opting for bikini wax might also experience this in the groin area. It is most prominent on the cheeks and face. It might also leave behind scars that are dark and raised.
Types of deep folliculitis include:
Gram-negative folliculitis: This is experienced by people who might be undergoing ongoing acne therapy using antibiotics.
Eosinophilic folliculitis: The exact cause of this condition is unknown. It mostly occurs in people suffering from HIV/AIDS. This condition causes bumps/pimples on the hair follicles of the face and upper body which are itchy and recurring. It leaves dark skin after the condition has been healed.
Sycosis barbae: It is mostly seen in men who have just begun to shave.
Boils and carbuncles: This is caused by infection from the staph bacteria. A boil or a cluster of boils might appear which are generally painful and are red or pink in colour.
Risk factors:
Any individual might suffer from rashes due to folliculitis. This condition affects everyone at some point in time. But some people and certain groups of individuals are at a higher level of risk of developing folliculitis than others. People suffering from diabetes and people whose immune systems are compromised due to conditions like hepatitis, HIV/AIDS, cancer, chemotherapy and drugs that suppress the immune system are more likely to suffer from this condition.
Symptoms of Folliculitis:
Initially, folliculitis might appear as a rash, pimples with a white or yellow tip or a cluster of red bumps. Later, this can spread to the surrounding hair follicles and might turn into crusty sores. This might affect only one hair follicle lasting for a short time or might happen for a very long time.
The signs and symptoms of folliculitis include itching, burning, pain, crusty sore, small and red bumps, sores filled with pus, inflammation of the skin, pain with swelling, mild fevers etc. A large area of skin might become red and swollen and might break out and ooze pus from pimples, sometimes with white heads on them.
Causes of Folliculitis:
Folliculitis is most of the times caused by hair follicles infection because of Staphylococcus aureus bacteria are also known as the staph bacteria. Folliculitis might also occur due to viruses, fungi, physical trauma caused to the hair follicle or because of inflammation caused by ingrown hair.
Some of the causes linked are products such as personal care products that might irritate the hair follicles, tight clothing and clothing that causes friction with the skin, shaving, ingrowth of hair, tight braids, skin injuries like cuts, wounds and insect bites, substances that clog the skin, skin conditions mainly acne and dermatitis, infections in the wounds on the skin through which bacteria might spread in the hair follicles, using certain medications like antibiotics and steroid creams for a long time, obesity and being overweight, weak immune system because of conditions like HIV/AIDS, using hot tubs and swimming pools which are unclean, exposure to contaminated items, not showering after sweating excessively etc.
People with damaged follicles are more prone to get affected with this condition. This can be a result of various factors like shaving, injuries to the skin, tight clothing etc.
Diagnosis of Folliculitis:
Everyone can develop the skin condition in the areas where hair follicles are present. Folliculitis lesions mostly occur in regions such as face, chest, back, scalp, groin, buttocks and thighs. Folliculitis does not affect the mouth, palms, eyes or soles because there is no hair growth in those areas. Doctors diagnose folliculitis on the basis of physical examination. The doctor examines the skins, they make notes of symptoms and check the person’s medical history and their family’s medical history.
The doctors can usually diagnose folliculitis just by looking at the person’s skin closely and asking questions about medical history. Most people don’t really need to take tests unless most treatments don’t work. The doctors will use a small swab to get a skin sample, to check what is the reason for the problem. In rare cases, the doctors might conduct a skin biopsy in order to exclude possibilities of other causes. The doctors will also suggest seeking help from a dermatologist or skin doctor.
Treatment of Folliculitis:
Many people with folliculitis don’t really require treatment for the skin condition. The treatment for folliculitis varies for each type and the severity of the condition. Mild cases of folliculitis just require remedies that can be followed at home. But, severe or worse conditions may require various therapies and medications. Treatments for folliculitis include:
Medication:
Many medications are available for the treatment of folliculitis. Medications can be prescribed for the treatment of fungal or bacterial infection, based on the cause for the skin condition. Anti-inflammatory creams and ointments are suggested by the dermatologist or the doctors. Types of medications suggested by the doctors to treat the skin infection may include:
1. Oral antibiotic medicines
2. Topical antibiotic creams
3. Topical anti-fungal creams
4. Oral anti-fungal medicines
5. Anti-fungal shampoos
6. Oral corticosteroids
7. Steroid Creams
The doctors might also suggest painkillers, antihistamines or nonsteroidal anti-inflammatory drugs (NSAID) to ease the itching or the pain caused because of the folliculitis.
Light Therapy
Sometimes light therapy is used to treat the skin conditions. According to some research papers, photodynamic therapy or light therapy helps in curing or reducing the symptoms of severe folliculitis. The doctors expose the patient’s skin to ultraviolet rays from the light to reduce or kill off the fungi, viruses or bacteria in the skin which cause the infection. The use of light therapy is very uncommon in the cases of minor skin conditions such as folliculitis.
Lancing
The doctor will sometimes cut open a boil or a carbuncle to drain out the pus from the skin. The incision in the lesion is made to relieve any minor pressure built up in the skin of the patient. The area is treated using an antiseptic such as an iodine-based solution and then making a small cut in the skin to puncture it using a pointed sterile scalpel, a clean sharp needle or a sterile lancet. This will allow the pus or the fluid causing the boil to escape the skin from the incision made in the skin of the patient.
Laser Hair Removal
When no other possible treatment works in making the skin condition better or reducing the symptoms, the doctors will usually suggest laser hair removal surgery to remove hair from the body as the last resort. Laser hair removal is the process of removal of hair from the body or a part of the body by exposure to laser light pulses which destroy the hair follicles so they do not get infected or inflamed. Laser hair removal is practised in many clinics and nowadays, laser hair removal devices made for self-treatment at home can also be found.
In mild or less severe cases of folliculitis, the patient does not require any medication or therapy to treat the skin condition. There are many home remedies to treat the skin infection and for reduction of the symptoms caused by folliculitis. The home remedies for folliculitis include:
1. Placing a warm compress on the affected area helps in reducing the pus draw out and itching effectively. Soaking a cloth in warm water and wringing out any excess of the water is done to make a warm compress. Applying for 20 minutes and repeating if necessary helps in treating the folliculitis.
2. There are several topical gels, creams, ointments and washes that help in preventing folliculitis. These can be bought unprescribed by the doctors.
3. Following good hygiene is a must to avoid any symptoms. Washing the affected area twice a day using a mild body lotion or soap helps in reducing the infection. Washing hands and using only clean hands to wash the area is also a must. Avoid any use of washcloth as it may cause more irritation to the infected skin. For drying, use a clean towel and all towels must be washed to prevent the disease from being transmitted to other people.
4. Avoid wearing tight clothing such as tight pants. Also, avoid wearing any fabric that may cause irritation to your skin. Avoid using harmful skincare products and protect your skin from chemicals that may cause irritation or allergies. For shaving, only use a clean and sharp blade and also use a lubricant.
5. Taking a soothing bath in a tub full of warm water helps in providing relief from the pain and the itching caused due to folliculitis. You may even add baking soda in your bath as it has anti-inflammatory properties. After the bath dry yourself properly.
