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Folliculitis : Symptoms, Causes, Treatment, and Prevention

Folliculitis is inflammation that occurs in the hair follicles or the place where hair grows which is usually caused by a bacterial infection. Although it can cause itching and pain, this disease is generally harmless. However, a severe stage of folliculitis can cause hair to be permanently lost and scars arise.

Folliculitis is divided into three, namely:

  • Sycosis Barbae. Which is chronic folliculitis which attacks the part of the face overgrown with the beard? This type of folliculitis also causes pain and sometimes affects the upper lip, making it difficult to handle.
  • Tubal folliculitis. This type of folliculitis is experienced by people who often soak in warm water, which supports the growth of Pseudomonas spp. This type of folliculitis is harmless and can be prevented by routine treatment at the bathing place.
  • Gram-negative folliculitis, which is a folliculitis that results from the use of long-term antibiotics to treat acne. Other types of bacteria are involved in this folliculitis.

Apart from the ones mentioned above, there are also those called pseudo-folliculitis or fake folliculitis. Similar to folliculitis, this condition also causes inflammation due to the tip of the hair that does not grow out. The tip of the hair that grows inside can be caused by dead skin cells that prevent hair from coming out of the pores normally. Pseudo-folliculitis can also occur due to the tip of the hair returning to the skin. This is common for people with curly hair, especially after being shaved.

The tip of the hair that grows inside often irritates the skin and causes inflammation in the form of small reddish lumps that sometimes feel painful. In men, this condition can occur on the cheeks, chin, or neck, after shaving. Whereas in women, it usually attacks the limbs or groin. False folliculitis can disappear on its own, but can also cause infection, make the skin more black, or leave scars, especially if scratched.

Symptoms of Folliculitis

Symptoms that appear in folliculitis include:

  • Many small red bumps or pimples appear on the skin where the hair grows.
  • Painful lumps filled with pus can be enlarged or broken.
  • Itching and burning sensation on the skin.

Causes of Folliculitis

Folliculitis can be caused by bacterial, viral, fungal, or parasitic infections. However, the most common is an infection caused by the bacterium Staphylococcus aureus. Bacteria usually enter through follicles that are damaged until they eventually trigger infection.

Folliculitis can also occur due to non-infectious causes - such as hair follicle trauma, friction, inflammation, excessive sweating, and blockage. Also, folliculitis can occur in people who are susceptible to infection. For example in those who suffer from a decrease in the immune system due to HIV.




Also, folliculitis that arises due to non-infectious causes can occur due to the habit of soaking in warm water using less clean water, the shaving process that is vulnerable causing damage to hair follicles, or consumption of antibiotics in the long term to overcome acne problems.

Risk Factors for Folliculitis

Folliculitis can affect all people of all ages. However, several factors can increase the risk of folliculitis, including:

  • Suffering from diseases that reduce immunity, such as diabetes, HIV / AIDS, and cancer.
  • Has acne or inflammation of the skin.
  • Soak in a hot tub that is not clean.
  • Using external drugs (creams) for the long term, especially creams containing corticosteroids or antibiotics (for acne treatment).
  • Wear tight clothing, do not absorb heat and sweat, or often use rubber gloves or boots.
  • Damage to the skin due to shaving or waxing of hair, and friction with tight clothing.

Diagnosis of Folliculitis

Diagnosis of folliculitis can be done by knowing the history of the disease and seeing the patient's skin condition. If needed, the doctor will do dermoscopy, which is the examination of the skin using a tool such as a microscope to see the skin more clearly.

If the infection continues even though the patient has been treated, the doctor will take swabs of infected skin or hair to be examined in the laboratory and determine the cause of the infection. Skin biopsy by taking skin samples is done if other conditions are suspected, but it is rarely done.

Treatment of Folliculitis

The treatment method for folliculitis depends on the type of infection and the severity experienced, including:

  • Drugs

To deal with minor infections, the doctor will prescribe antibiotics in the form of creams, lotions or gels. Whereas to treat folliculitis caused by fungal infections, antifungal drugs in the form of creams, shampoos or tablets can be used.

For folliculitis that occurs in people with HIV / AIDS, the condition will improve by also providing therapy for HIV.

  • Operation

Other treatment options for folliculitis are small surgical procedures, namely by removing pus from a lump. This action can make the patient heal faster and not leave a lot of scars.

Although successfully treated, folliculitis can occur again. Another option for treating folliculitis is laser removal. This is done if other methods fail. However, this method is quite expensive and will permanently remove hair, so that hair density in certain areas can be reduced.

Mild folliculitis can be treated with home care. Some things that can be done include:

  • Clean the infected area with warm water and antibacterial soap. Be sure to always use clean clothes and towels.
  • Soak the cloth in a mixture of 1 teaspoon salt, with 2 cups of water, then paste it in the area of the infected body. Vinegar can also be used instead of salt.
  • Avoid shaving, scratching, or wearing clothes that are too tight on the infected area.

Complications of Folliculitis

Folliculitis can heal on its own and rarely causes more severe disorders. However, some complications that might occur are:

  • Spread or recurrent infection
  • Formed boils
  • Permanent skin damage can be a scar or blackened skin
  • Permanent baldness and follicular damage

Prevention of Folliculitis

Folliculitis can be prevented by maintaining the cleanliness and moisture of the skin, especially in susceptible individuals, such as diabetics. Routine use of antiseptics is not recommended, because it can make the skin dry.

Patients must also be careful when shaving. It is recommended to use creams, soaps, or gels as lubricants to prevent the skin from getting hurt. Remember, don't share shaving tools with other people. Do not use tight clothing to avoid friction between the skin and clothing, and wash and dry rubber gloves before using them again.

Generally, folliculitis is not contagious, but folliculitis due to Staphylococcus aureus can spread to other people. This risk can be reduced by washing clothes, towels, and sheets with hot water, and not sharing razors.



References

References

  1. Laureano, AC. et al. (2014). Facial Bacterial Infections: Folliculitis. Clinics in Dermatology,
  2. American Academy of Dermatology. Acne-Like Breakouts could be Folliculitis.

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Health and clinical interests include all aspects of infectious diseases

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