Folliculitis and Pseudofolliculitis

Folliculitis is a fairly common reaction to irritation of hair follicles that resembles acne. Folliculitis can occur in anyone, regardless of age or level of overall health. Anywhere hair follicles grow, folliculitis can occur; from the face, scalp, chest, back, buttocks, genital region, as well as legs.

What Causes Folliculitis?
Folliculitis is an inflammatory condition affecting hair follicles. It appears as a small red tender papule or pustule with a central hair. It has many causes as listed below, but most commonly folliculitis is due to an irritant or a bacterial cause.

Folliculitis can be caused when an individual shaves and causes micro-cuts along the skin surface. Depending on the product applied after or the number of bacteria that is able to get into these micro-cuts, folliculitis can develop. Pseudofolliculitis is the term used when the irritated hair turns back into the skin causing a foreign body reaction.

Types of Folliculitis

  • Acne Vulgaris
    Acne vulgaris occurs almost often in teenagers at puberty. Acne vulgaris specifically affects the hair follicles of the face, chest, and back but is seen in conjunction with blackheads.
  • Drug-Induced Folliculitis
    Systemically administered or topically applied steroids (cortisone-containing medications), or certain anti-cancer drugs are well-known causes of folliculitis.
  • Irritant Folliculitis
    Caused by constant rubbing from ill-fitting clothes or irritating contacts with the hair follicle

  • Pityrosporum Folliculitis
    A common cause of itchy small bumps commonly misdiagnosed as acne on the forehead, neck, and trunk. Pityrosporum folliculitis is caused by Malassezia, a yeast commonly found on skin that proliferates in sweaty environments.
  • Cutting Oil Folliculitis
    Machinists exposed to insoluble cutting oils that are used to decrease the friction in the fabrication of metal parts can develop a folliculitis on the exposed skin.
  • Bacterial Folliculitis
    Staphylococci are bacteria that commonly inhabit the skin. One species, S. aureus, is a frequent cause of folliculitis. Occasionally, this organism may be resistant to a number of commonly used antibiotics. In this situation, it is very important that a culture of the organism with sensitivities be performed so the ideal antibiotic is selected to treat the infection. Pseudomonas is another bacterial folliculitis that occurs after using infected hot tubs/heated pools.
  • Fungal Folliculitis
    Folliculitis from a fungus infection is seen mostly on the face and on the lower legs. It is often exacerbated by shaving. Certain fungi penetrate the skin and take over sites of hair follicles, through micro-cuts in the skin, caused by shaving.
  • Viral Folliculitis
    Folliculitis from a virus infection often affects the face and is from herpes simplex virus affecting the lips, commonly known as a cold sore.
  • FolliculitisDecalvans
    There are a variety of inflammatory, scarring types of folliculitis that can result in permanent hair loss.
  • Eosinophilic Folliculitis
    Eosinophilic folliculitis is an uncommon condition that is poorly understood and occurs occasionally as a response to certain drugs, in immunosuppressed patients (AIDS and bone marrow cancers), and in infants, affecting the scalp.

Treatment
Generally, pseudofolliculitis can be helped by using better shaving techniques, and better skin care. Hair Laser Reduction may prove to be curative. After careful examination, a board-certified dermatologist will determine the type and cause of folliculitis and the best course of treatment. Prevention is optimal, but treatments can range from topical exfoliating and anti-inflammatory lotions, to intralesional steroid injections, or oral medications. Chemical peels, microneedling, and laser treatment can be used to decrease the marks that can be left behind after the inflammation has resolved.

For more information on folliculitis and pseudofolliculitis, be sure to contact Nova Dermatology today.

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