You may have heard them described as hot tub rash, razor bumps and barber's itch, but they're all different faces of folliculitis, an infection of the hair follicles caused by bacteria, viruses, fungi and even an inflammation from ingrown hairs. And it's often as ugly as that sounds.
Folliculitis can occur anywhere you have hair follicles, which is everywhere except the palms of your hands and the soles of your feet. The infection may be classified as either superficial or deep, based on how much of the hair follicle it involves. Deep folliculitis is usually more severe, and severe infections can cause permanent hair loss and scarring.
There are four types of deep folliculitis:
· Sycosis barbae, a staphylococcal infection and irritation of the hair follicles in the beard region; it may be associated with other superficial bacterial infections such as impetigo or furunculosis. Symptoms include burning, itching, and pain, with formation of small papules and pustules that drain, form crusts, and leave scars when they heal.
· Boils and carbuncles, which occur when hair follicles become deeply infected with staph bacteria. Small boils usually heal without scarring. A large boil may leave a scar.
· Gram-negative folliculitis, which sometimes develops if after you have received long-term antibiotic therapy for acne. Antibiotics alter the normal balance of bacteria in the nose.
· Eosinophilic folliculitis, which mainly affects people with HIV/AIDS. The exact cause is not known, but it may involve the a yeast-like fungus responsible for some less severe folliculitis.
Symptoms of folliculitis include:
· Clusters of small red bumps or white-headed pimples that develop around hair follicles
· Pus-filled blisters that break open and crust over
· Red and inflamed skin
· Itchy or burning skin
· Tenderness or pain
· A large swollen bump or mass
The symptoms may pass after a few days. If they do not, see a doctor. Your doctor is likely to diagnose folliculitis by merely examining your skin and reviewing your clinical history. Once diagnosed, the usual course of action is a regimen of antibiotics to control the infection. Mild cases merit the cream mupirocin, while oral antibiotics will likely be prescribed for more severe or recurrent cases. Fungus-based infections will be dealt with via specific anti-fungal meds.
If the usual treatments don't clear up your infection, your doctor may take a sample of your infected skin to send to a lab for analysis. Other treatments available to counter folliculitis include:
· Photodynamic (Light) therapy, accompanied by a medicated cream;
· Laser hair removal, in extreme cases;
· Minor surgery, in instances of large boils or carbuncles.