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What Is Folliculitis And How Does It Impact My Hair?

[caption id="attachment_338" align="alignleft" width="300" caption="Staph Infection"]Staph Infection

Question

Dear Karen,

My doctor told me I have folliculitis, but didn't really explain how I may have gotten the condition.

Do you know if that has anything to do with my scalp?  How does it impact my hair?

Jane

Answer

Dear Jane,

Folliculitis is the inflammation of one or more hair follicles anywhere on the body where hair grows.

Folliculitis (also called Barber's Itch, beard rash, or bikini rash) is an inflammation or infection of the hair follicles.  Hair follicles are the small sacs beneath the skin from which hair grows.  The infection can be caused by either bacteria or fungus. Folliculitis is related to carbuncles and furnucles.

[caption id="attachment_341" align="alignright" width="226" caption="Terrasil Anti Fungal Ointment"]Terrasil Anti Fungal Ointment

Depending on the condition of your scalp you may experience pimples, swelling, itching or a rash.   In more severe cases of folliculitis pus may collect under the skin.  The condition can cause ongoing discomfort.  If folliculitis is due to ingrown hairs the hair may become infected while still embedded in the skin.

The cause of folliculitis, when occurring on strands of hair adjacent to the scalp, may be due to blockage of the follicles from excessive or continued use of hair styling products.   Oil folliculitis is the inflammation of hair follicles due to exposure to various oils including hair oils and make-up.  It can also occur on forearms or thighs.

Folliculitis Due To Ingrown Hairs

When normal hair bends or curls backwards or sideways and grows back into the skin the condition is defined as an ingrown hair.   Ingrown hairs are typically more common amongst people with naturally curly or textured hair.

An ingrown hair may or may not become infected causing a case of folliculitis.  Ingrown hairs also are more common in areas of the body where the skin is shaved, waxed (eyebrows, beard, legs, arms, pubic region or etc) or plucked.  Ingrown hair which become infected are defined as razor bumps or pseudofolliculitis barbae.

[caption id="attachment_344" align="alignleft" width="300" caption="Shaver"]Shaver

Treatments for ingrown hairs include putting a clean warm washcloth over the ingrown hair as well as making a point to shave in a different direction.

Other options include tweezing the offending hairs, exfoliating the skin with facial scrubs to encourage the hair to pop out or use of sponges, towels, or creams containing acids.  For pain ibuprofen or other NSAIDs can provide relief.

Prophylactic treatments include twice daily topical application of diluted glycolic acid. If this is caused by waxing or shaving, one can try a topical application such as a salicylic acid solution which also aid dramatically in the treatment of the ingrown hair.

Folliculitis Due To External Damage

Folliculitis may sometimes start from follicles which become damaged by ongoing friction from wearing hats, certain types of head coverings, tight twisted or secured hairstyles or braids.  It can also occur due to excessive pressure on the scalp.

Folliculitis is most often caused by bacterial or fungal infections.  Most cases of folliculitis develop from Staphylococcus aureus or Pseudomonas aeruginosa.

Folliculitis Directly Related To Hair On Or Adjacent To Scalp

[caption id="attachment_345" align="alignright" width="283" caption="Cutting Hair"]Cutting Hair

When hair grows in such a manner as to curve back into the skin and cause inflammation it is defined as pseudofolliculitis barbae.

Folliculitis decalvans, also known as tufted folliculitis, affects the scalp. With this condition several hairs arise from the same hair follicle. This condition may cause scarring and permanent hair loss in some cases. The cause of this condition is unknown.

Iron deficiency anemia is sometimes associated with chronic cases of folliculitis.

People with curly or tightly textured hair may develop a condition known as folliculitis keloidalis which causes ingrown hair and scarring on the nape of the neck.  Although most common for males, it can also occur with women.  In some cases it can be related to how the hair is cut.

Sycosis barbae or Barber's itch is a staph infection of the hair follicles in the bearded area of the face.  The condition usually is focused on the upper lip and can be aggravated by shaving or trimming.

Suggested Treatments

[caption id="attachment_346" align="alignleft" width="184" caption="Tend Skin For Ingrown Hair"]Tend Skin For Ingrown Hair

In mild cases a topical antiseptic treatment will work to clear up the condition.  Topical ointments containing mupirocin or neomycin are also effective for most cases.

For more serious or persistent cases a dermatologist or physican might treat folliculitis with systemic narrow-spectrum penicillinase-resistant penicillin such as dicloxacillin or similar.

In some cases it should be noted that fungal related folliculitis can get worse when treated with antibiotics.  When that happens the condition may need to be treated with Fluconazole or topical antifungals.  Econazole Nitrate is known to be effective as a topical antifungal.

Best wishes,

Karen Marie Shelton

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