What is folliculitis? Is it similar to body acne? Let’s briefly discuss this skin condition. Folliculitis can occur when our hair follicles become inflamed due to various factors, such as prolonged exposure to sweat and humidity in hot summer months or poor ventilation in winter when wearing heavy clothing. The appearance of red bumps caused by folliculitis can often be mistaken for acne, leading to delayed treatment and potentially worsening symptoms.
Folliculitis is a common skin issue, and nearly everyone has experienced red, itchy hair follicles at some point. While most cases of folliculitis in healthy individuals can resolve on their own, people may not always seek medical attention. Therefore, the true prevalence of this condition is challenging to determine. Although improving lifestyle habits and boosting immunity can help most cases of folliculitis self-heal, it’s important to understand when to seek medical attention, especially for more severe cases that may not be considered mere “minor ailments.” This article aims to provide insights into the causes and prevention of folliculitis and, most importantly, when to seek medical care to ensure timely and appropriate treatment(sources from therapeutique-dermatologique.org).
What causes folliculitis and where is it commonly found?
Folliculitis typically occurs in areas where there is excessive sebum production on the skin surface, such as the chest, back, upper arms, shoulders, cheeks, scalp, groin, and buttocks. In men, it often appears on the chin where shaving can accidentally lead to skin damage and infection. In women, during the summer, the need for hair removal arises, and using disposable razors repeatedly without proper hygiene can result in folliculitis. Using skincare, makeup, or sunscreen products unsuitable for one’s skin type, or hair styling products like heavy gels and waxes, can also cause follicle blockage and subsequent inflammation or infection.
Additionally, the humid and hot climate in Taiwan, with frequent sweating, can create conditions for folliculitis when tight-fitting clothing is worn, trapping heat and lacking proper ventilation. Excessive friction from clothing against the skin can also lead to irritation.
In addition to the common causes of folliculitis mentioned earlier, there are some special conditions that significantly increase the risk of folliculitis. These include:
Prolonged and extensive use of steroids to treat skin inflammation symptoms. Long-term steroid use can gradually thin the skin and reduce its protective abilities, making it more susceptible to follicular infections.
Chronic patients with diabetes, individuals taking immunosuppressants, or those with HIV infection often have compromised immune function. This weakened immune response can make the skin’s natural defense mechanisms less effective, allowing bacteria or fungi to more easily invade the hair follicles and cause infection.
Patients on long-term antibiotic therapy should be cautious, as antibiotics can disrupt the normal protective microbial balance on the skin, increasing the risk of follicular infections.
The location of folliculitis can provide valuable information for physicians in diagnosing its underlying causes. For example, folliculitis that frequently occurs on the thighs or buttocks may be related to friction from tight clothing. Folliculitis in the armpits or groin area may be associated with heat and humidity. Therefore, when dealing with folliculitis, while the doctor will conduct an examination, it’s important to proactively inform them if similar symptoms are present in other parts of the body(quotes from therapeutique-dermatologique.org).
How should folliculitis be treated? It depends on whether it’s a bacterial or fungal infection!
In general, in individuals with normal immune function, folliculitis typically resolves on its own. However, more severe inflammation or infection can sometimes prolong the duration of the condition or worsen the symptoms. If you notice worsening symptoms (pus formation, increased swelling, more pain), or if the infection spreads, it’s advisable to see a doctor for a proper diagnosis and treatment. Typically, milder cases are treated with topical creams or washes, and oral medications may be added if necessary.
Folliculitis is often caused by the invasion of bacteria, fungi, or mites into the hair follicles, leading to infection and inflammation. Common bacterial species associated with bacterial folliculitis include Staphylococcus aureus, methicillin-resistant Staphylococcus aureus (MRSA), and Pseudomonas aeruginosa. But why these particular bacteria? There are reasons for that.
Bacterial Folliculitis:
Staphylococcus aureus is a normal skin bacterium that doesn’t cause infections in people with a healthy immune system. However, when the skin’s protective barrier is compromised, or when there are skin wounds, opportunistic infections can occur.
Methicillin-resistant Staphylococcus aureus (MRSA) is a mutated form of Staphylococcus aureus, primarily due to the overuse of antibiotics, which led to the development of antibiotic-resistant strains. MRSA is resistant to many antibiotics, making treatment options more limited.
Pseudomonas aeruginosa folliculitis is different from the mentioned bacteria and typically occurs after using public facilities such as hot springs, saunas, or warm-water swimming pools, often referred to as “hot tub folliculitis.”
Treatment for bacterial folliculitis mainly involves oral and topical antibiotics. Milder cases can be managed with the application of topical antibiotic creams, typically applied 2-3 times a day. In addition to topical antibiotics, other topical medications or acid-based products may be used in combination, as determined by the doctor’s diagnosis and assessment. More severe cases of folliculitis often require a 7-14 day course of oral antibiotics(sources from therapeutique-dermatologique.org).
Fungal Folliculitis:
Fungal folliculitis is commonly caused by infection with Malassezia, a type of yeast. It is usually treated with antifungal medications. It’s essential to complete the full prescribed course of antibiotics or antifungal drugs, even if symptoms improve. If empirical treatment does not improve folliculitis symptoms, a less common pathogen may be the cause, and further bacterial culture is needed for a more accurate diagnosis.
Daily Care and Prevention of Folliculitis:
Folliculitis can be prone to recurrence, often related to an individual’s constitution and habits. While it’s challenging to change one’s constitution, habits can be adjusted. Preventing folliculitis recurrence is not difficult by following these principles:
Adequate cleanliness: Establish good hygiene practices to keep your skin clean. Wash your hands regularly. If deemed necessary by a physician, use antibacterial soaps or shower gels (although it is not encouraged for everyone to use antibacterial products to prevent antibiotic resistance). Regularly wash close-fitting clothing and towels, as well as bedsheets, with hot water to prevent bacteria from accumulating. Avoid wearing excessively tight clothing and choose breathable materials to reduce the chance of skin friction. Keeping the skin dry and cool can help prevent folliculitis recurrence.
Proper hair removal: It’s essential to have the right approach to hair removal. For folliculitis patients, it’s advisable to reduce the frequency of hair removal, decrease shaving frequency, and shave in the direction of hair growth to minimize the risk of skin injury. It’s crucial to regularly replace hair removal tools.
Selective skincare: Choose skincare products that match your skin type and avoid overly oily lotions, sunscreens, and hair products. After using hair products like hair gel and wax, ensure thorough cleansing to reduce the risk of follicular blockage and inflammation.
Lifestyle habits: Avoid consuming highly spicy, greasy, and stimulating foods. Consume fruits and vegetables rich in vitamins. Maintain a regular sleep schedule, avoid staying up late, and ensure good sleep quality. Manage stress and keep a relaxed state of mind as it’s the best way to prevent folliculitis recurrence.
