Folliculitis is usually a mild infection affecting the hair follicles. It is caused by bacteria or fungi attacking the area of the skin that surrounds the follicle. It is normally not a serious problem and it will heal by itself pretty fast, so it shouldn't concern you too much. It only becomes a real worry when the infection keeps returning. In such a case, the condition can transform into the so-called deep folliculitis, which might cause permanent scarring.

Folliculitis usually looks like a tiny swollen area surrounding the base of a hair follicle, with a white head because of the pus inside. In most cases, simple hygiene measures are enough to get rid of the problem. Simply cleaning the area with soap will allow the body's immune system to defeat the infection in just a few days. In such cases, there is no real skin damage, the wound is healed quickly and there are no scars.

A more severe condition is deep folliculitis. In this case, the infection attacks the root of the follicle, deep under the skin, not just the superficial area visible on the surface. Because this infection is more serious, it can cause itching and even pain, along with an urge to scratch that is hard to control.

Basic hygiene will not be enough to cure deep folliculitis and a dedicated treatment is required. Usually, external creams or ointments are applied on the surface. These destroy the pathogen that causes the infection, which can be either a bacteria or a fungus. If the problem persists or the infection is very strong, a treatment with antibiotics pills can be prescribed. These reach the blood and can fight the infection from within.

The worst case scenario is when the infection keeps spreading out of control. In this case, a laser treatment is required, which will have very serious consequences. The laser kills the bacteria causing the infection and prevents additional scars but the hair follicle and its root also die. This is a permanent problem, since new hair will not emerge in the affected area.

The infection can attack hair follicles located anywhere on the body. For some reason, it usually affects the scalp of both males and females, rarely occurring in other areas like the arms or legs. Males are also vulnerable to this condition on the beard follicles, but it is usually not severe.

Why does folliculitis occur?

Several pathogens can cause folliculitis but the bacterium Staphylococcus aureus (S. aureus) is responsible for most infections. This germ is widespread and lives in every person's nose, without causing any harm at all. The condition can also be caused by other agents, mostly bacteria.

There are a number of factors that can increase the risk of folliculitis. The infection is most likely to occur when follicles are blocked or hurt by contact or shaving. Big amounts of sweat, due to intense heat or the disease named hyperhidrosis, can also increase the risk. The infection can also be triggered sometimes by the usage of steroid creams on the face. Folliculitis affects most often the beard of men but it can also appear on the buttocks, arms, armpits or legs.

Types of folliculitis

While folliculitis normally appears in a few areas, the disease can affect any area of the skin, as long as it has hair on it. The few areas without hair, like the lips or the palms, can't be infected. The disease can be split into several types.

The most common variety affects the beard of males and is named sycosis barbae. It is a long-term infection that can usually be found in the moustache area and is quite hard to eliminate. The problem is that the area is constantly damaged by shaving, which causes irritation and fuels the infection. The skin can be covered with itchy crusts and pustules in the follicles. Some people avoid shaving to get rid of the disease and end up with a beard.

The hot tub folliculitis infects people who enjoy using the hot tub, just like the name implies. A bacterium named Pseudomonas spp. thrives in the hot water. This is the reason why chlorine is usually added to the water, in order to purify it. The presence of this bacteria in the water can eventually lead to an infection. Properly cleaning the hot tub will prevent the risk of disease, which is usually harmless anyway. The chance of infection is not reduced even if you take a shower right after the hot tub.

Gram-negative folliculitis is caused by several types of bacteria that are not staphylococci. The name of the disease comes from a lab stain used to differentiate these bacteria types. The infection happens after using antibiotics for a long time, usually to treat acne.

There is also the pseudo-folliculitis, which is not actually the disease but can look very similar. Little swollen areas appear at the bases of follicles but they are not filled with pus. The real cause is hair growing under the skin, which can lead to infections or permanent scars. People with curly hair or African heritage are more vulnerable to this condition.

What is the treatment for folliculitis?

All types of folliculitis share the same basic treatment. The first steps are to make sure that you don't make the infections worse. Avoid irritating the area further and do not shave against the hair growth direction. The infection can disappear in a few days if you stop shaving completely. Avoid sweating in the area and don't wear tight clothes that might trigger it. The skin will heal a lot faster if a low temperature is maintained and it is not covered by anything. Sharing clothes, razors or towels is a bad idea, since it can spread the disease. The skin will heal faster if treated with Elma 11Hair and Scalp Revitalizer.