Makindo Medical Notes

Folliculitis is a common inflammatory condition affecting the hair follicles, resulting in localized pustules or papules. It is typically caused by infection (bacterial, fungal, or viral), mechanical irritation, or occlusion of follicles. Early identification and treatment are key to preventing complications.

Types of Folliculitis

Clinical Features

• Small, red papules or pustules around hair follicles
• Pruritus or mild pain in the affected area
• Pustules may break open, forming crusts
• Commonly affected areas: scalp, beard area (barber’s itch), chest, back, and buttocks
• Possible systemic symptoms in severe or widespread infections (e.g., fever)

Diagnosis

• Clinical Examination: Typical appearance of pustules and inflammation around hair follicles.
• Bacterial Cultures: Swabbing for culture and sensitivity if infection is suspected or recurrent.
• KOH Test: For suspected fungal folliculitis (e.g., Pityrosporum folliculitis).
• Skin Biopsy: May be required for deeper or non-resolving folliculitis to rule out other causes (e.g., folliculitis decalvans).

Treatment and Management

• Topical Therapy: Topical antibiotics (e.g., mupirocin, clindamycin) or antiseptics (e.g., benzoyl peroxide) for mild cases.
• Oral Antibiotics: For moderate to severe bacterial folliculitis or cases that are widespread.
• Antifungals: Topical or oral antifungal agents for fungal causes (e.g., Pityrosporum folliculitis).
• Antivirals: Oral antivirals for viral folliculitis, such as herpes-associated cases.
• Hygiene and Prevention: Regular cleaning of the skin, avoiding tight clothing, and maintaining proper hygiene in settings like gyms or hot tubs.

Note: Chronic or recurrent folliculitis may require long-term therapy and lifestyle modifications. Consider referral to a dermatologist for severe, treatment-resistant cases.