What types of folliculitis are there?
Folliculitis is distinguished by depth and pathogen, and treatment directly depends on this. Superficial ones affect the mouth of the follicle and look like an abscess with a hair in the center. Deep ones capture the entire follicle, forming a painful nodule that can develop into a boil. The most common pathogen is Staphylococcus aureus, but fungal forms caused by the yeast-like fungi Malassezia and pseudomonas folliculitis after swimming in poorly chlorinated water are also found. Separately, non-bacterial irritation after shaving and hair removal is worth mentioning.
- Staphylococcal - the most common option
- Fungal (Malassezia) - itchy rash on the back and chest
- Pseudomonas - after the jacuzzi and swimming pool
- Irritation and ingrown hairs after shaving
- Medication - against the background of hormones and certain medications
- Scarring forms on the scalp
Why does the follicle become inflamed?
In order for the bacteria to get inside, microtrauma or blockage of the mouth is necessary. Shaving against hair growth, a hard washcloth, rubbing with a backpack, thick synthetic clothing and prolonged sitting create just such conditions. A humid and hot environment increases the risk: sweat dissolves the protective layer, and underwear prevents the skin from drying out. Additional factors include excess weight, diabetes, long-term use of antibiotics and hormonal drugs, as well as thick creams and oils that clog pores.
- Shaving, hair removal, ingrown hairs
- Increased sweating and heat
- Tight synthetic clothing
- Diabetes and obesity
- Long-term use of antibiotics and systemic hormones
- Oily cosmetics and oils on the skin
Symptoms
The rashes are located where there is hair: on the legs and bikini area, on the face and neck in men, on the back, chest, shoulders and buttocks. Usually these are multiple small pustules on a pink base, moderately itchy and slightly painful. After opening, a crust remains, and then a temporary dark spot. If the folliculitis is fungal, the rash is more uniform, very itchy, worsens in the heat and does not respond to antibacterial agents. The deep form produces a dense, painful nodule with throbbing pain.
- Pustule with a hair in the center
- Itching and mild soreness
- Crusts after opening the elements
- Dark spots at the site of a healed rash
- Fungal rash on the back and chest
- Dense painful node with a deep form
Survey
An examination by a dermatologist, if necessary with dermatoscopy, is usually sufficient. Culture of the discharge is prescribed for persistent and widespread rashes in order to identify the causative agent and select a drug based on sensitivity. If the picture indicates a fungal nature, a scraping is taken. For adults with recurring episodes, blood glucose and glycated hemoglobin are checked, and if the rash is severe, a complete blood count is assessed. If the scalp is affected and hair falls out with the formation of scars, a separate examination by a trichologist is required.
- Examination and dermatoscopy
- Culture of discharge with sensitivity determination
- Scraping for mushrooms
- Blood glucose and glycated hemoglobin
- General blood test for a common process
- Consultation with a trichologist for head damage
Treatment and prevention
Mild folliculitis often goes away on its own within a week if you stop shaving the affected area and treat it with an antiseptic. If this is not enough, the dermatologist prescribes external antibacterial agents, and for the fungal form, antifungal drugs and shampoos. Systemic drugs are needed only for widespread or deep process. Prevention is more important than treatment: shaving along the hairline with a fresh blade, moisturizing the skin after the procedure, loose, breathable clothing, showering immediately after sports. If there are frequent relapses, it is worth discussing alternative methods of hair removal.
- Antiseptic treatment of lesions
- External antibacterial or antifungal agents as prescribed by a doctor
- Temporary refusal of shaving and hair removal
- Shaving in the direction of hair growth with a clean blade
- Cotton loose clothing, shower after workouts
- Control of blood sugar and weight during relapses