The cause of folliculitis is often unclear, but perspiration, trauma, rubbing, and clogging of the skin are known to enhance infection. Pathogens can be bacteria, fungi, viruses, or parasites. Bacterial folliculitis is usually caused by Staphylococcus aureus, but occasionally Pseudomonas aeruginosa (hot tub folliculitis) or other organisms have been reported. Hot tub folliculitis occurs as a result of inadequate chemical treatment of the water. Acne is a non-infectious form of folliculitis.
Symptoms of folliculitis are mild pain, itching, or irritation. Signs of folliculitis are superficial pustules or inflammatory nodules around the hair follicle. Infected hairs are easily shed or removed, but new hair follicles tend to grow. The growth of hard hairs into the skin can cause chronic inflammation or mild irritation, which can be similar to bacterial folliculitis.
The primary skin symptoms of folliculitis are pustules and inflammation around the hair follicles. Microbiological tests are not routinely indicated.
Since most folliculitis is caused by S. Aureus, clindamycin 1% lotion or gel can be applied for 7 to 10 days. Alternatively, 5% benzoyl peroxide bath can be used in the shower for 5 to 7 days. Extensive skin lesions can be treated with systemic drugs (eg, cephalexin 250 to 500 mg 3-4 times/day for 10 days). If these measures persist, or folliculitis recurs, the pustules should be Gram stained and cultured to rule out infection with Gram-negative bacteria or methicillin-resistant Staphylococcus aureus S. Aureus (MRSA). ), And nasal culture to rule out nasal staphylococcus infection. A fungal examination of the hair shaft should be performed to rule out fungal folliculitis
Hot tub folliculitis usually goes away on its own without treatment. However, chlorination of the tub is necessary to prevent recurrence and to protect others from infection.
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Folliculitis can have many causes and tends to be irritated by sweat, trauma, friction, and blockage of the skin.
Bacterial folliculitis is usually caused by Staphylococcus aureus, but sometimes by Pseudomonas aeruginosa (hot tub folliculitis).
Treat staphylococcal folliculitis with clindamycin 1% lotion or gel.
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