Folliculitis

Folliculitis can either be mild and short-lived, or a severe, chronic (long-term) issue. Due to the variation in severity, it can sometimes lead to the misconception that folliculitis is nothing more than a passing inconvenience, which can be frustrating to those who have a more severe form.

As a result of the chronic, uncomfortable and sometimes unpredictable nature of the more persistent version of the condition, many patients find that it negatively impacts their quality of life and self-confidence. For these reasons, it is common for patients suffering with chronic folliculitis – especially in its more severe forms – to also experience psychological issues, such as depression and anxiety.

For many individuals, living with chronic folliculitis can be upsetting and traumatic, so it may be helpful to seek support from groups or organisations that can provide additional resources. There are also communities on social media, where individuals with chronic folliculitis share their stories to help support others with the condition.

Most cases of folliculitis are mild, and will resolve in 7-10 days, but patients with recurring folliculitis (either short-lived or chronic) can usually be treated by their GP, and most pharmacies will be able to advise about over-the-counter treatments for pseudo-folliculitis.

While the majority of folliculitis cases are not contagious, if doctors have identified a patient as carrying the S. aureus germ (a bacterium in the nose), it means there is a risk that the infection could be transferred to other people. This risk can be minimised by taking normal hygiene measures, and laundering clothing, bed linens and towels on a hot wash.

Folliculitis usually occurs at sites where the hair follicles have been damaged by friction (rubbing), or shaving, or where the follicle is blocked. Excessive sweating, also known as hyperhidrosis, can increase the risk of folliculitis. In some people, using a steroid cream on the face can also trigger folliculitis.

The most common area affected by folliculitis is the beard area of men, although women with facial hair can also develop the condition in the same area. Other common sites are the arms, legs, armpits and buttocks.

Other types of folliculitis have different causes, such as:

• Hot tub folliculitis – This is caused by the bacteria that thrive in warm, moist conditions of jacuzzis and hot tubs.
• Gram-negative folliculitis – Different bacteria than staphylococci are involved in this condition.

Pseudo-folliculitis, or ingrown hairs are hairs that have switched direction when growing, curled around and then grown back into the skin. Anyone can develop them, but they are more common in people who have very curly or coarse hair, as curly hair is more likely to bend back and re-enter the skin.

The risk of ingrown hairs increases after they’ve been shaved or cut, and they may also occur when dead skin cells block the normal hair growth. Other conditions such as furuncles and carbuncles can also involve the hair follicles, and both are the result of bacteria, typically the S. aureus germ.

A furuncle is a skin infection that involves the hair follicle and its surrounding skin, and when clusters of furuncles join together under the surface of the skin, they form what is known as a carbuncle. Carbuncles and furuncles are typically much bigger and more painful than pustules caused by folliculitis.