Follicullitis is a bacterial infection and inflammation of the hair follicle. It heals without scarring and is a very common condition. There are many variants of folliculitis. Superficial pustular folliculitis or follicular impetigo of bokhart is a small fragile dome shaped pustule occurs at follicular orifices. Scalp, beard , axilla , extremities and buttocks in adults are the sites involved. The organism causing it is mostly Staphylococcus aureus. It appears in crops and heals in few days.
Deep folliculitis or Sycosis barbae is Staphyloccocal infection and inflammation and pustular infection involving whole length of follicle. Beard area and upper lip are the usual sites of appearance. Recurrence is common. It appears as a red small swelling with or without pus centered on a hair.
Sometimes this condition lasts for long durations becoming chronic folliculitis. It is seen especially in young Indian males and involves front aspect of both lower legs and may extend up to the thigh. This condition is difficult to treat and lasts for several years and results in permanent atrophy of involved sites.
Folliculitis is a condition that a dermatologist diagnoses clinically. Sometimes certain tests like Gram’s stain, KOH mount, Culture and sensitivity of the organism from the pus maybe needed.
It is treated with antibiotics that are both applied or taken orally.
Furuncle is an extension of folliculitis or maybe be considered a similar hair follicle infection. This is an acute infection of hair follicle by the same organism S. aureus. In this condition the inflammation and infection spreads from the follicle to the area surrounding the hair as well. It is larger, more painful and heals after discharge of the pus inside. It heals mostly leaving a dark mark and rarely with a scar. A ring of scaling around this usually indicates the process of healing.
Carbuncle is another bacterial infection caused by the same organism. It is a deep infection of a group of contiguous follicles with inflammatory changes. A cluster of coalescing furuncles with separate heads that are connected under skin surface form a carbuncle. The most common sites are the nape of neck , back and thigh. It appears like a sieve with multiple openings draining pus. Obesity, prolonged steroid intake, Diabetes and malnutrition are the risk factors for developing a carbuncle. It has to be incised and all the pus should be drained as treatment along with antibiotics.
Sometimes recurrent furunculosis happens in some due to persistents. aureus in some areas of the body like nose, groin, underarms and around the anus. In such cases prolonged antibiotics orally and application in these areas is needed along with proper hygiene.
Following proper cleansing measures prevents development of this kind of bacterial infections.