As the term suggests this is a condition of hair follicles. It can occur anywhere on the body except on the palms of the hands and the soles of the feet. This rash can look like red dots but occasionally will have small pustules and sometimes can be quite itchy.
Folliculitis starts when hair follicles get damaged from blockage of the pore. There are many causes and some of the more common ones are topical- such as lotion and makeup, friction from clothing, insect bites, shaving trauma, hair braided to tight and to close to the scalp. The compromised hair shaft can then become infected from certain bacteria, fungus or viruses and start to look like pustular acne.
Some common bacteria causes arise from unclean hot tubs, dirty razors and even mixed with acne from over use of anti-biotic topically that upsets the normal facial flora. The rash can even develop from cold sores (herpes simplex) and will appear around the mouth area.
NON INFECTIVE CAUSES
These are generally less common
- “Ingrown hairs” (PSEUDOFOLLICULITIS BARBAE)
- Impaired immune system ( ESOSINOPHILLIC)
- “Scalp scarring disease (DECALVANS)-more than one hair growing in the shaft. Leads to permanent hair loss and scarring. The cause is unknown.
- Scarring Keloid like lesions on the back of the neck (FOLLICULITIS KELOIDALIS) -usually men with thick curly hair.
- Oil folliculitis- from oil based makeup, exposure in industries with various oil uses such as mechanics, road workers and refinery workers.
- Rare skin cancers
Folliculitis can masquerade like many other conditions. It can appear as fine pin prick red marks, pustules in clusters or isolated, itchy dry patches which can be mistaken for eczema or peri oral dermatitis (POD).
It is important to get a diagnosis before the area is permanently damaged, spreads infection or develops hyperpigmentation.
If the suspicion is folliculitis has developed from a hot tub, the skin will often respond to a good cleanser that is preferably an anti-fungal and anti-bacterial such a Spectrogel. If this doesn’t settle the rash over a few days get a Dermatology opinion. For folliculitis in general, once a proper diagnosis can be made the condition will be treated with antiseptic cleanser, often topical antibiotics and occasional oral antibiotics in severe cases. It will also be important to follow up with persistent cases as these could be viral or fungal problems.
- Shower before and immediately after being in a hot tub with an anti-bacterial cleanser
- Keep shaving equipment clean and sterile. Blades should be dipped in alcohol. This is not easy to do with an electric shaver.
- Avoid lotions with heavy animal oils such as lanolin and emu.
- Avoid oil by product makeups that build up and congest the pores. Water based Jane Iredale is a good option as it does not clog the pores. It allows the skin to breath and doesn’t incubate facial bacteria.
- Protect the skin from industrial oils as much as possible by wearing coveralls, long sleeves and cleaning exposed areas with antiseptic skin cleansers as soon as possible.
At Laser and Skin Care Medspa Dr. Bakken and her team can help you find a solution if you suspect you have this condition. We carry a full complement of necessary products and treatment protocols.