Folliculitis

Definition

Folliculitis is inflammation or infection of one or more hair follicles (openings in the skin that enclose hair).

Description

Folliculitis can affect both women and men at any age. It can develop on any part of the body, but is most likely to occur on the scalp, face, or parts of the arms, armpits, or legs not usually covered by clothing.

Small, yellowish-white blister-like lumps (pustules) surrounded by narrow red rings are usually present with both bacterial folliculitis and fungal folliculitis. Hair can grow through or alongside of the pustules, which sometimes ooze blood-stained pus.

Folliculitis can cause boils and, in rare instances, serious skin infections. Bacteria from folliculitis can enter the blood stream and travel to other parts of the body.

Causes and symptoms

Folliculitis develops when bacteria, such as Staphylococcus, or a fungus enters the body through a cut, scrape, surgical incision, or other break in the skin near a hair follicle. Scratching the affected area can trap fungus or bacteria under the fingernails and spread the infection to hair follicles on other parts of the body.

The bacteria that cause folliculitis are contagious. A person who has folliculitis can infect others who live in the same household.

Factors that increase the risk of developing folliculitis include:

• dermatitis
• diabetes
• dirty, crowded living conditions
• eczema
• exposure to hot, humid temperatures
• infection in the nose or other recent illness
• tight clothing

Diagnosis

Diagnosis is based on the patient's medical history and observations. Laboratory analysis of the substance drained from a pustule can be used to distinguish bacterial folliculitis from fungal folliculitis.

Treatment

Bacterial folliculitis may disappear without treatment, but is likely to recur. Non-prescription topical antibiotics like Bacitracin, Mycitracin, or Neomycin, gently rubbed on to affected areas three or four times a day, can clear up a small number of bacterial folliculitis pustules. Oral antibiotics such as erythromycin (Erythocin)

may be prescribed if the infection is widespread. The drug griseofulvin (Fulvicin) and topical antifungal medications are used to treat fungal folliculitis.

A doctor should be notified if:

• pustules spread after treatment has begun or reappear after treatment is completed
• the patient's fever climbs above 100°F (37.8°C)
• the patient develops boils or swollen ankles
• redness, swelling, warmth, or pain indicate that the infection has spread
• unexplained new symptoms appear

Alternative treatment

Eating a balanced diet, including protein, complex carbohydrates, healthy fats, fresh fruits and vegetables, and drinking eight to 10 glasses of water a day may stimulate the body's immune system and shorten the course of the infection. Garlic (Allium sativum) and goldenseal (Hydrastis canadensis), both antiseptic agents against staph infections, may be taken. The daily dosage would vary from person to person and is based on the severity of the infection. Echinacea (Echinacea spp.) is helpful in modulating immune function. Again, the dosage would vary.

Daily doses of 30–50 mg zinc and 1,000–5,000 mg Vitamin C (taken in equal amounts at several times during the day), and 300–2,000 mg bioflavinoids can also strengthen the body's infection-fighting ability. High doses of vitamins and minerals should not be used without a doctor's approval.

Prognosis

If properly treated, the symptoms of bacterial folliculitis generally disappear in about two weeks. Fungal folliculitis should clear up within six weeks. But it can worsen if the condition is misdiagnosed and inappropriately treated with steroid creams.

Prevention

Anyone who has a tendency to develop folliculitis should cleanse the skin with antibacterial soap twice a day and before shaving and should not use oily skin lotions. Men should not shave while the beard area is infected. When they begin shaving again, they should use a new blade each time. Women who have had fungal folliculitis should use depilatory creams instead of razors. Daily shampooing can help prevent folliculitis in the scalp. The spread of infection can be prevented by not sharing towels or washcloths

BOOKS

The Editors of Time-Life Books. The Medical Advisor: The Complete Guide to Alternative and Conventional Treatments. Alexandria, VA: Time Life, Inc., 1996.

OTHER

"Bacterial folliculitis." ThriveOnline. 5 Apr. 1998 <http://thriveonline.oxygen.com>.

"Folliculitis." ThriveOnline. 5 Apr. 1998 <http://thriveonline.oxygen.com>.

"Fungal Folliculitis." ThriveOnline. 5 Apr. 1998 <http://thriveonline.oxygen.com>.

Maureen Haggerty