Folliculitis is defined histologically as the presence of inflammatory cells. Folliculitis is the infection of hair follicles. This can occur anywhere on the skin or scalp. It may be superficial or deep, and it causes the formation of a pustule or inflammatory nodule surrounding the hair. The inflammation can be either limited to the superficial aspect of the follicle with primary involvement of the infundibulum or the inflammation can affect both the superficial and deep aspects. Severe cases may cause permanent hair loss and scarring, and even mild folliculitis can be uncomfortable and embarrassing. Folliculitis may arise as hairs regrow after shaving, waxing, electrolysis or plucking.
Folliculitis starts when hair follicles are damaged by friction from clothing, blockage of the follicle, or shaving. In most cases of folliculitis, the damaged follicles are then infected with the bacteria Staphylococcus. Most folliculitis is caused by the common organism Staphylococcus aureus. Hot tub folliculitis is different in that it is caused by Pseudomonas aeruginosa. Pseudomonas survives in hot tubs, especially hot tubs made of wood, unless the pH and chlorine content are strictly controlled. Sometimes stiff hairs in the beard area curl and reenter the skin after shaving, producing irritation without substantial infection. This type of folliculitis is particularly common in black men.
The signs and symptoms of folliculitis are varying. Its depending on the type of infection. In superficial forms of the disorder, small pimples develop around one or more hair follicles. It then turns into a small, raised area of skin that contains pus and often itches or burns. When these pustules break open, they may drain pus and or blood.
Hot tub folliculitis” typically appears about 72 hours after you have been in a hot tub or spa. Many small pustules appear on your torso and sometimes your arms and legs. You may have a mild fever and feel ill. This type of folliculitis usually goes away on its own within 7 to 10 days.
Hot tub folliculitis rarely requires treatment, although your doctor may prescribe an oral or topical medication to help relieve itching (anti-pruritic). If the patient is immunocompromised or the lesions are persistent oral ciprofloxacin may be given. Topical antibiotics, such as bacitracin with polymyxin B, may be administered. Fusidic acid is available both as a cream and as an ointment. You should apply it thinly on to the infected area 3-4 times daily.Mupirocin is available both as a cream and an ointment. You should apply it thinly on the affected area 3 times a day for up to 10 days.
Common treatment of Folliculitis:
· Topical antiseptic treatment is adequate for most cases.
· Some patients may benefit from systemic flucloxacillin.
· For deeper, more severe infections, your doctor may prescribe antibiotic or antifungal pills.
· In some cases, laser hair removal may be an option. Laser treatment destroys the hair follicles so they can’t become infected.
Hot moist compresses may promote drainage of extensive folliculitis. Treatment may include antibiotics applied to the skin (mupirocin) or taken by mouth (dicloxacillin), or antifungal medications to control the infection.