Foiling Folliculitis

You have a smattering of red bumps in your underarm area. It usually appears sometime after shaving. It is very itchy. You could have folliculitis.

Folliculitis is inflammation (redness, swelling and tenderness) in the small cavity around a hair that is called a hair follicle. Most of the time the inflammation is due to infection. But it can also be caused by harsh chemicals and other irritants on your skin (like shaving or friction from clothing). Folliculitis may be caused by viruses, fungi and even an inflammation from ingrown hairs.

Although folliculitis can appear anywhere on the body, it most often occurs on the face, arms, upper back and lower legs. Anyone can develop folliculitis but certain factors make you more susceptible to the condition such as:

·       Having a medical condition that reduces your resistance to infection, such as diabetes, chronic leukemia and HIV/AIDS.

·       Having acne or dermatitis.

·       Taking some medications, such as steroid creams or long-term antibiotic therapy for acne.

·       Being a male with curly hair that shaves.

·       Regularly wearing clothing that traps heat and sweat, such as rubber gloves or high boots.

·       Soaking in a hot tub that’s not well maintained.

·       Causing damage to hair follicles by shaving, waxing or wearing tight clothing.

Symptoms are multiple red pimples and/or pustules on hair-bearing areas on the body, rash and itchy skin.

You have hair almost everywhere on your body. Your hair has a larger purpose than appearance—it acts as an insulator, keeping you warm. It is part of your body’s protection system. The spot where an individual hair enters the skin is the follicle. The follicle holds the thin hair in place and is home to oil glands.

Unfortunately, follicles can gather bacteria and other material from the outside world that can cause inflammation or infection. When something is inflamed, it is swollen. A swollen hair follicle will bulge up and make a bump on the skin. If you have an infected hair follicle, you may experience redness, irritation, itching and bumps on the skin.

There are different types of folliculitis. Each type of folliculitis can have its own appearance, symptoms and cause. Often, the thing that causes the condition is one of the biggest factors that sets each type of folliculitis apart. Location can also play a role—where you experience this condition on your body can change depending on what type of folliculitis you have. The types of folliculitis include:

·       Staphylococcus aureus folliculitis. This is one of the most common forms of folliculitis. Small red or white pus-filled pimples seen on the skin. The affected area usually gets better in a few days and can be cared for at home. But if the condition gets worse, then you should see your doctor.

·       Pseudomonas aeruginosa folliculitis. This is a bacteria that thrives in heated, moving water (hot tubs, whirlpools and water slides). It can cause a rash similar to the staphylococcal species. This type of folliculitis occurs one to two days after exposure to the water source and typically fades on its own within a few days.

·       Malassezia folliculitis. Malassezia are a family of yeast that lives on the skin. Sometimes, when Malassezia gets into the hair follicles it can cause an itchy condition that resembles an acne breakout. It usually occurs on the upper chest and back. This type of folliculitis is made worse by sweat. Using an antidandruff shampoo every day on affected areas is helpful.

·       Pseudofolliculitis barbae. Referred to as “razor bumps,” pseudofolliculitis barbae occurs in the beard area. After trimming the beard area with a razor, the hairs are turned back towards the skin, causing irritation. Pseudofolliculitis barbae is more common in people who have curly hair like Black men. Saying no to shaving or using trimmers can help. Seek out your doctor if necessary as this can lead to scarring.

·       Sycosis barbae. This is a more severe form of shaving-related folliculitis. Red pustules appear on the infected area since the entire follicle is infected. Avoid shaving and discuss treatment options with your doctor.

·       Gram-negative folliculitis. This type of folliculitis can happen after prolonged antibiotic use to treat acne. Over time, the resistant bacteria will grow and multiply. The result is your acne could get worse.

·       Boils (furuncles). Boils occur when the hair follicle becomes deeply infected. The boil is red, tender and painful. It will come to a head after several days and it may leave a scar behind.

·       Carbuncles. A carbuncle forms when several boils appear in one spot. Carbuncles are larger and are the combination of multiple infected hair follicles.

·       Eosinophilic folliculitis. This form of folliculitis is seen in immunosuppressed (the immune system isn’t fully functioning) patients. There is a form seen in babies. Eosinophilic folliculitis is not infectious. It is characterized by itchy pustules that appear on the shoulders, upper arms, neck and forehead. The condition goes away on its own but can reoccur.

Folliculitis is treated with topical antibiotics, oral antibiotics and antifungal medicines. Treatment also involves preventing further damage to the hair follicles by minimizing friction from clothing, not shaving in the affected area if possible and keeping the area clean.

If you do shave, always do it with the grain. Use a minimum number of strokes. Try using glycolic acid lotion to control folliculitis. Use an electric razor instead of a traditional one. Avoid pulling the skin when shaving.

Folliculitis is a common condition which people will experience in their lifetime. The condition can be cared for at home and doesn’t necessarily require a trip to your doctor’s office. But depending on the type and severity, you should consult your doctor if needed.