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Folliculitis

Folliculitis means inflammation of the hair follicles. It is usually due to infection with bacteria or fungi or occlusion and can occur anywhere on the scalp or hair-bearing parts of the body.

The clinical appearance is of red bumps or pustules which can become sore.

If there is pus your doctor takes a swab to see what is the causal organism and prescribes appropriate treatment.

The most common causal bacteria is Staphylococcus aureus which can be caught from another infected individual and can be treated with an antibacterial wash, an antibiotic cream or oral antibiotics.

The most common yeast to cause folliculitis is Malassezia furfur which can also cause a scaly discoloured rash on the trunk called Pityriasis Versicolor.  When Malassezia furfur causes folliculitis it is usually on the upper trunk of a healthy adult and can be treated with an antifungal body wash and topical or oral antifungals.

Occlusion of the follicle opening with greasy creams can also lead to folliculitis and in this case, it is a Sterile Folliculitis ie: the swab grows not pathogens. Change to lighter more water-based lotion if a moisturiser is needed.

Other causes of folliculitis which may be sterile are in-grown hairs after waxing the legs and bikini area. Laser hair removal to permanently remove the hair is a solution.

 In-grown hairs in the beard area are called Pseudofolliculitis Barbae and are treated by applying emollient shaving cream and doing a less close shave to minimise irritation with an antibiotic cream if infected.

Buttock folliculitis is common and may be bacterial or with sterile pustules. A bacterial infection is treated with an antibacterial wash and topical antibiotic cream.

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