What is Folliculitis? Causes, Symptoms, and Treatment

Folliculitis is an inflammation of the hair follicles, often caused by bacterial, fungal, or viral attacks. This condition leads to symptoms such as itching, mild pain, along with the appearance of red bumps, pustules, or small papules around the hair follicles. This medical condition can manifest on any hair-bearing area of the body, including the scalp, face, back, armpits, legs, and even intimate areas. Although not life-threatening, folliculitis significantly affects aesthetics and can lead to complications such as abscesses, boils, or permanent scarring if not treated promptly and properly.

Causes of folliculitis

What is folliculitis and why does it occur? There are many different causes for this condition, mainly related to infectious agents and environmental factors.

Because of bacteria

Staphylococcus aureus)Staphylococcus aureus) is the leading common agent, invading hair follicles through minor scratches or lesions on the skin surface. This bacterium usually lives on human skin and only causes disease when it has the opportunity to penetrate deep into the hair follicles.

Mushroom picking

Fungal strains can also cause folliculitis, especially in environmental conditions with high humidity, such as when you sweat a lot or are in a prolonged humid environment. For example, Malassezia fungi can cause acne-like folliculitis.

Do virus

Some viruses have also been identified as pathogenic factors. Although less common than bacteria and fungi, some viruses such as Herpes simplex can cause folliculitis, especially in people with weakened immune systems.

Signs of folliculitis

To recognize what folliculitis is, you need to pay attention to the following signs on the skin:

• Appearance of red bumps, papules, or small pustulesat the hair follicle. These bumps may look like acne but are often concentrated around the base of the hair shaft.
• Itchy, aching, or mildly burning sensationon the inflamed skin area. The level of discomfort can range from mild to moderate, affecting daily activities.
• The affected skin can become rough and scalyand there is peeling. The skin may be drier and rougher than usual.
• Hair caningrown, causes irritation and worsens the inflammation. This is one of the distinct signs commonly encountered when skin care is done improperly.
• A pustule ruptures, thendry scabbing. This indicates an ongoing infection and could leave hyperpigmentation or scars if not treated properly.

Favorable factors for disease development

In addition to direct agents, some of the following factors also contribute to an increased risk of developing folliculitis:

• Hot and humid climate:Vietnam has a tropical monsoon climate, which promotes increased perspiration, creating favorable conditions for bacteria and fungi to proliferate and grow on the skin, especially in areas such as the armpits and groin.
• Personal hygiene not ensured:Failure to maintain good hygiene, especially after exercising or strenuous work, or improper hair removal methods (e.g., shaving against the grain, using a dull razor) can damage hair follicles and create conditions for inflammation.
• Thick stratum corneum on the skin:Accumulated dead skin creates an ideal environment for bacteria and fungi to invade. This often occurs in people who do not exfoliate regularly.
• Using unsuitable skincare products:Overusing products containing mineral oil, causing clogged pores, or products with harsh chemicals can damage the skin's natural protective barrier, making it more susceptible to inflammation.
• Weakened immune system:Individuals with diseases such as diabetes, chronic kidney failure, or those taking immunosuppressants have a higher risk of contracting diseases due to their body's reduced ability to fight off pathogens. For example, diabetic patients in Vietnam, estimated to be about 7% of the adult population, often encounter skin problems such as folliculitis.

Potential complications

If not treated promptly and properly, folliculitis can lead to several serious complications:

• Abscess and boil:Inflamed pimples can progress into large boils or clusters of boils, causing severe pain and potentially requiring medical intervention to drain the pus.
• Panniculitis:The infection spreads deeper into the tissue layers beneath the skin, causing swelling, warmth, redness, pain, and may require oral or intravenous antibiotic treatment.
• Hair loss and permanent scarring:If the inflammation is severe and not intervened early, it can cause permanent hair loss in the affected area and lead to the formation of keloid scars or atrophic scars that are difficult to recover, significantly impacting aesthetics.

How to treat folliculitis

Treatment for folliculitis needs to be carried out based on the cause and severity of the condition. Below are some common methods:

Topical treatment

• Topical antibiotics or antifungals:For mild cases caused by bacteria or fungi, doctors may prescribe creams, gels, or solutions containing antibiotics (e.g., clindamycin, erythromycin) or antifungals (e.g., ketoconazole, ciclopirox) to be applied directly to the inflamed skin.
• Skincare products containing AHA/BHA:These products gently exfoliate, unclog pores, and reduce ingrown hairs. However, they should be used as directed to avoid skin irritation.
• Antiseptic solution:Using antiseptic solutions such as diluted povidone-iodine or chlorhexidine can help clean the skin and prevent the spread of infection.

Systemic treatment

• Oral antibiotics or antifungals:In cases of severe, widespread, or unresponsive folliculitis to topical treatment, a doctor may prescribe oral antibiotics or antifungals. For example, doxycycline or itraconazole may be used depending on the causative agent.
• Anti-inflammatory drugs:In some cases, oral corticosteroids may be used for a short period to reduce severe inflammation and itching.

Other methods

• Light therapy:For chronic or recurrent folliculitis, light therapy (such as PUVA therapy) may be considered.
• Permanent hair removal:For cases of recurrent ingrown hairs causing folliculitis, laser or IPL hair removal can be an effective solution to eliminate hair follicles and prevent inflammation. Many dermatology clinics and aesthetic spas in Vietnam offer this service, with costs ranging from a few hundred thousand to several million Vietnamese dong depending on the treated area and technology.
• Surgery:For large abscesses or boils, incision and drainage of pus may be necessary.

Preventing folliculitis

Prevention plays a crucial role in avoiding the contraction or recurrence of folliculitis.

• Cleanse skin:Bathe daily, especially after sweating profusely. Use a mild, non-irritating soap.
• Wear breathable clothing:Choose loose-fitting clothes made from good sweat-absorbent cotton, especially in Vietnam's hot and humid climate.
• Shaving properly:Shave in the direction of hair growth, use a sharp razor and shaving gel to reduce friction. Replace razor blades regularly.
• Periodic exfoliation:Helps remove thick stratum corneum, clearing pores.
• Avoid sharing personal items:Do not share towels or razors with others to avoid infection.
• Keep skin dry:Especially in skin folds, limit the moist environment for bacteria and fungi to thrive.
• Skin care after swimming or sauna:Shower immediately after swimming in a public pool or using a sauna to remove bacteria.

Folliculitis is a common dermatological condition but can be effectively controlled if diagnosed and treated correctly. Understanding what folliculitis is, its causes, symptoms, and risk factors will help you proactively prevent it and seek medical assistance when necessary.

Reference information. Please consult a doctor.