Folliculitis

Folliculitis

Localized inflammation of a hair follicle. The condition may be caused by infections, injury or irritation and is generally found on the face, neck, breast and buttocks. The damaged follicles are then infected with the bacteria Staphylococcus (staph).

The condition may be caused by staph aureus,  yeast or fungi.  If the condition spreads or becomes persistent swab cultures may need to be taken.

Lymphedema patients are more susceptible to skin infections and are strongly advised against hot tubs because of the possibility of contracting Pseudomona folliculitis. This is a resistant gram-negative bacterial infection with serious complications. Barber's itch is a staph infection of the hair follicles in the beard area of the face, usually the upper lip.  Shaving makes it worse.  Tinea barbae is similar to barber's itch, but the infection is caused by a fungus.


Pseudofolliculitis barbae is a disorder that occurs mainly in black men.  If curly beard hairs are cut too short, they may curve back into the skin and cause inflammation.

Clinical:

Pus in the hair follicle
Irritated and red follicles
Damaged hair (possibly in growing back into the follicle)

Complications:

While we tend to think of folliculitis as a minor and superficial infection, it is important to remember that with a lymphedema limb that is immunocompromised, the folliculitis could develop into a more severe infection.  Complications include cellulitis, forunculosis (This condition occurs when a number of boils develop under your skin. Boils usually start as small red bumps but become larger and more painful as they fill with pus), scarring, destruction of the hair follicle.  Untreated and/or severe/deep folliculitis could result in sepsis and bacteremia.

Treatment:

Topical antibiotics which may include bacitracin, polymyxin B sulfate (Polysporin), clindamycin, erythromycin, or mupirocin (Bactroban). You may also use an antiseptic cleanser, such as povidone-iodine (for example, Betadine) or chlorhexidine.
Oral antibiotics based on the seriousness (deeper or more severe infections) of the folliculitis or on the underlying medical condition of the patient. If caused by a bacteria, your doctor may prescribe dicloxacillin, erythromycin, or cephalexin (such as Keflex). Ciprofloxacin (Cipro) and ofloxacin (such as Floxin) are used for certain types of bacteria.

Fungus based folliculitis is treated with antifungal oral medications which include You will need to take antifungal pills, such as fluconazole (Diflucan), griseofulvin (Fulvicin-U/F or Gris-PEG, for example), itraconazole (Sporanox), or terbinafine (Lamisil).

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