Redness of the hair follicle after shaving. Inflammation of the hair follicle: why it happens, treatment of the disease. Medical treatment of folliculitis

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

Concept. Definition

Folliculitis refers to skin diseases and is a form of superficial pyoderma.

Folliculitis is an inflammation of the upper sections of the hair follicles. The inflammation that occurs with folliculitis is infectious. The mechanism of the development of the disease is that first a papule is formed at the mouth of the follicle, then a pustule is formed, which is penetrated by a hair in the center. The next stage is the formation of a crust in the follicle area. If the inflammatory process goes deeper and affects the entire follicle, and not just its upper section, then the disease is called sycosis. The disease has its favorite places of localization, which include parts of the body with an abundance of vellus hair. In this regard, folliculitis most often affects the extensor surfaces of the legs and arms, the scalp.

Epidemiology. Statistical data

Folliculitis is most often found in hot countries where the climate favors the development of inflammatory skin diseases. Also, this disease is more common in socially unfavorable strata of society, which is facilitated by unsanitary living conditions.

Folliculitis is often of a professional nature and is observed in people whose work is associated with constant exposure to reactive agents: gasoline, kerosene, tar, lubricating oils, etc.

Precise statistics are not provided, since in most cases such patients rarely seek medical help, preferring to self-medicate. Most often, patients who develop complications against the background of folliculitis are in the field of view of physicians: phlegmon, abscess or lymphadenitis.

Clinical symptoms of folliculitis

In the initial stage of the disease, there is reddening of the skin in the area of inflamed follicles and moderate soreness. Simply put, pustules form around the hair on the skin. In the absence of timely and adequate treatment, the inflammatory process progresses and causes the formation of an infiltrate in the affected area. The surface of the skin in the area of the inflamed follicle acquires a cone-shaped or spherical shape, has a yellowish color, which is associated with the accumulation of pus. After removal of the pustule cover, pus is determined, after the removal of which, an area of saturated red color is visible.

The number of folliculitis can be different: from 1-2 to huge. In some cases, patients complain of severe itching in the area of folliculitis. In severe cases, when the number of inflamed follicles is very large, the patient may experience an increase in lymph nodes (local).

Features of different types of folliculitis

There are a lot of varieties of folliculitis, and therefore, it is advisable from a practical point of view to consider separately the features of each of them.

Staphylococcal folliculitis. It is typical for areas where bristly hair grows (nasolabial triangle, chin). It occurs mainly in men who shave. In severe cases, when the death of hair follicles occurs, after the end of the inflammatory process, connective tissue scars are formed.

candidal folliculitis. This type of folliculitis occurs, as a rule, under occlusive dressings. The risk of developing folliculitis is increased by topical use of drugs from the group of corticosteroids under dressing. Also, the risk of the disease is higher in bedridden patients and long-term febrile patients.

Herpetic folliculitis. As well as staphylococcal, it is more common in shaving men in the area of the nasolabial triangle and on the chin.

Acne syphilis. This type of folliculitis is a consequence of the disease syphilis. It is characterized by the fact that inflamed follicles acquire a faded red color, in some cases they are arranged in groups. Elimination of this pathology is possible only in the treatment of the underlying disease with specific means.
Pseudomonas folliculitis caused by the pathogen Pseudomonas aeruginosa. This type of folliculitis is also known by another name - "hot bath" folliculitis, since it usually occurs after taking a bath with hot water that has not been sufficiently chlorinated.

Gram-negative folliculitis develops in immunocompromised patients who have been taking antibacterial medications for a long time due to acne. It is characterized by the fact that the patient's condition deteriorates sharply, which is manifested in increased acne. Abscesses may form.

Folliculitis caused by dermatophytes. This infection typically starts from the upper layer of the epidermis, after which the inflammatory process captures the mouths of the follicles, and then the hair shafts. A complication in this case is dermatophytosis of the scalp.

Folliculitis caused by fungi, belonging to the genus Pityrosporum, is typical for tropical and subtropical climates. It is characterized by an itchy rash of a monomorphic nature (papules and pustules), which is located at the mouths of the follicles. In such patients, scratching is found with localization in the area of the shoulders, back, face and neck.

Depilatory folliculitis of smooth skin- This is another type of disease that occurs mainly in hot countries. Middle-aged men are more susceptible to the disease. Also, this type of folliculitis is characterized by the symmetry of the lesion. Inflamed follicles appear evenly on the skin of the lower extremities. After the elimination of folliculitis, characteristic follicular scars remain on the skin.

gonorrheal folliculitis occurs most rarely compared with other types of this disease. The place of its localization is the foreskin in men and the perineum in women. Occurs with long-term and untreated gonorrhea. When examining the contents of the pustules in such patients, gonococci are found in large quantities.

Occupational folliculitis develops in people of certain professions and is associated with exposure to the skin of irritating chemicals. With this type of disease, rashes are usually localized on the back of the hands, as well as on the extensor surfaces of the forearms.

Impetigo Bockhart(impetigo Bockhardt), despite its name, nevertheless belongs to the group of folliculitis. In this case, hemispherical, superficial pustules develop, which can range in size from a poppy seed to a lentil. The pustules are permeated with downy hair, arranged in groups. The reason for the development of this folliculitis is increased sweating and maceration of the skin, which is a consequence of the use of warm compresses.

Tick-borne folliculitis. It develops after a tick bite, lasts longer than other varieties, requires specific treatment of the underlying disease (if the tick is an epidemiological danger).

Eosinophilic folliculitis. It is observed only in an isolated group of patients (HIV-infected).

According to the degree of damage, folliculitis is divided into:

Surface. This type is characterized by small pustules (2-5 mm in diameter). Pustules have a hemispherical or conical shape, in the central part they are penetrated by hair, connected directly with the mouths of the hair funnels. Around the pustules is a small inflammatory rim, painted in pinkish-red color. Pain may be completely absent or minimal. The duration of the disease is 2-3 days, after which the contents of the pustules turn into a brown crust. After rejection of the crust, foci of pigmentation and peeling may remain.
deep folliculitis. This form is characterized by the fact that painful nodules of dense consistency and red color are formed on the skin. The size of the nodules can reach up to 10 mm, the pustule is riddled with hair in the central part. After 3-5 days, the pustule shrinks, resulting in a yellow crust.

According to the number of inflamed follicles, the disease is classified into:

Single folliculitis;

Multiple folliculitis.

Downstream, folliculitis is classified into:

Complicated;

Uncomplicated.

Causes of folliculitis

Exogenous (external) factors

Skin microtrauma;

skin contamination;

Improper application or untimely application of occlusive dressings;

Climatic conditions (high humidity and ambient temperature);

Habit of wearing tight-fitting or tight clothing of synthetic quality;

Endogenous (internal) factors:

Lack of good nutrition;

Liver disease;

Treatment with drugs from the group of immunosuppressants;

The use of glucocorticosteroids locally, especially under an occlusive dressing.

There are also a number of disorders in the body that indirectly contribute to the development of folliculitis. These include:

periodontal disease;

Chronic tonsillitis ;

Chronic pharyngitis;

All these conditions are characterized by the fact that they weaken the immune defense of the body, which becomes unable to provide adequate resistance to skin infections.

Complications of folliculitis

In most cases, folliculitis is mild and does not pose a real threat to human life. In some cases, complications may develop. As a rule, complications develop in the absence of adequate treatment, non-compliance with the rules of personal hygiene and insufficient immune response of the body.

Complications of folliculitis include:

Furuncle (and it, in turn, can lead to the development of lymphadenitis and hydradenitis);

Carbuncle;

Dermatophytosis of the scalp (with folliculitis caused by dermatophytes);

Formation of follicular scars.

In isolated cases, such severe complications against the background of folliculitis as nephritis, meningitis and severe forms of pneumonia are described.

Diagnostics

In the diagnosis of folliculitis, an important role is given to the examination of the patient. The rash with folliculitis is quite characteristic and allows you to reliably establish the diagnosis. Additional examinations allow you to establish the cause that led to the development of the disease.

The nature of the rash
Papules or pustules are characterized by the fact that they are located at the mouths of hair follicles. Around them are defined rims of hyperemia. Most often, inflamed follicles are located close to each other in a chaotic relationship.

To make a diagnosis, the collection of anamnesis (information about the onset of the disease, predisposing and antecedent factors) also plays a role.

To establish the nature of the disease, a microscopic analysis of a Gram smear, bacteriological culture of the contents of the pustules is carried out. In some cases, a skin biopsy may be performed.

A blood test is also mandatory to determine the level of sugar in the blood in order to exclude undiagnosed diabetes mellitus, which can also be the cause of the disease.

Differential Diagnosis

If folliculitis is suspected, the doctor needs to make a differential diagnosis with other skin diseases that have similar manifestations. In this case, the task is not easy, since there are a lot of diseases with a similar course. These include:

Inflammation of the hair follicles of a non-infectious nature;

Rosacea;

Acne vulgaris;

Exposure to chemicals (chlorine);

Drug toxicoderma (lithium, corticosteroids, bromine preparations);

Kirle disease.

Follicular keratosis;

Diffuse neurodermatitis;

ingrown hairs;

Avitaminosis C and A;

Devergie disease;

Lichen planus (follicular form);

Discoid lupus erythematosus;

Necrotic acne;

Scurvy;

Grover's disease.

Treatment

In the initial form of the disease, fairly simple but effective methods of treating folliculitis are used. The treatment of pustules is carried out with 2% camphor or salicylic alcohol, 2% solution of brilliant green, fucorcin or a solution of methylene blue. Remember, only 1% and 2% salicylic alcohol can be used, high concentrations are excluded. Salicylic acid is part of the creams, gels and lotions of the Klerasil series specially created for the skin.

In cases where the folliculitis is deep and the accumulation of pus is significant, it is recommended to open the pustules, remove the pus, followed by treatment with one of the listed solutions.

Chronic recurrent forms of folliculitis require the appointment of stronger medications. In these cases, prescribe drugs from the group of sulfonamides, antibiotics. With this form, immunostimulating therapy is also indicated.

From non-drug therapy for folliculitis, irradiation with ultraviolet rays has proven itself well. Suberythemal doses are administered every other day or daily. The general course is 6-10 exposures.

If folliculitis has developed against the background of diabetes, then a corrective diet is additionally prescribed. With the normalization of carbohydrate metabolism, the risk of recurrence of the disease is greatly reduced.

Consider the treatment of special cases of folliculitis

Staphylococcal folliculitis

Topically prescribed mupirocin ointment 2 times a day. Inside appoint cephalexin, dicloxacillin, erythromycin or methicillin. The antibiotic is selected on the basis of a certain sensitivity of the organism to antibacterial agents.

Pseudomonas folliculitis
In severe cases, ciprofloxacin is prescribed.

Folliculitis caused by gram-negative bacteria
Antibiotics should be discontinued. Local therapy with benzoyl peroxide is prescribed.

Fungal folliculitis
Locally specific antifungal agents are prescribed. Inside it is recommended to take itracanosole, terbinafine, fluconazole.

Herpetic folliculitis
Assign inside the drug acyclovir.

In the treatment of folliculitis, a huge role is given to folk methods of treatment that have successfully proven themselves and are recognized by official medicine.
Consider some of the most common and effective traditional medicine recipes.

A decoction of viburnum and wild rose
The decoction contains: viburnum berries - 200 grams, rose hips - 200 grams, dried nettles - 100 grams. Here we also add the shell of nuts, always green - 10 grams, fresh home-made cottage cheese -50 grams a, bee honey - 50 grams, water - 2 cups.
How to prepare a healing infusion? We take ripened and washed viburnum berries, as well as wild rose, combine them with nettles and nut shells. Pour the dry mixture with boiling water and send it to languish for 10 minutes on a minimum fire. After that, the mixture should be infused for 24 hours, then we filter it. We have prepared the basis for future applications. When we start treatment, we make a mixture of fresh cottage cheese with honey and add two tablespoons of decoction to them. We put a mixture of vorog with viburnum decoction on the affected area of \u200b\u200bthe skin 3 times a day for 20 minutes.

Chamomile decoction
Chamomile is a magical remedy for inflammation. Wash it with a decoction prepared in accordance with the instructions on the pharmacy box at least three times a day. The same decoction can be used to lubricate any other areas of the skin that show signs of folliculitis. Chamomile will remove inflammation from the skin and dry it.

hot towel
To prevent staphylococcal folliculitis, use the old and proven folk method, it will help prevent the onset of the disease. After shaving, apply a moistened hot towel to your face for just a minute.

Dandelion officinalis
This herbal infusion is drunk inside. It is prepared from the roots, along with the leaves.
Pour two, without top, teaspoons of small and well-dried leaves with one glass of boiling water and boil for 10 minutes. We filter the broth and take 4 times a day, 50 ml each.

prickly
We use prickly pear as an effective external folk remedy. We take 50 g of the root and cook in half a liter of water for 30 minutes. Remove the broth from the heat and continue to insist for one hour, do not forget to filter. It is used by patients for compresses, baths and soothing dressings.

Cleavers
Here, we use flowers, that is, the aerial part of the plant, as raw materials. With dried powder from the plant, sprinkle the sore spot under the medical bandage.

Fragrant woodruff
Everything is very simple here, fresh, freshly prepared slurry of leaves is applied locally under a medical bandage to the site of the abscess. We change the bandage 2 times a day.

prickly tartar
This plant is also called thistle. As in the previous recipe, we use it locally, make a fresh gruel from the leaves of the plant and apply it to the affected area.

Burdock
We drink the decoction inside. To do this, boil the chopped burdock root (1 tablespoon) in 500 ml of water for 10 minutes, leave for 1 hour, filter. It is taken 50 ml 2 times a day.

Forecast

With folliculitis, the prognosis is considered favorable. With a significant depth of the lesion, foci of pigmentation may remain after the crust falls off. Complicated folliculitis is rare, but they are successfully treated by doctors.

Under favorable conditions, the pustule dries up into a crust, which soon falls off, the infiltrate gradually resolves and after 6-7 days only pigmentation or, with a significant depth of the lesion, a scar remains at the site of the former folliculitis.

Preventive measures

Preventive measures are reduced to a set of hygiene measures, timely and proper care of hair and skin. In addition, each person should monitor the general level of health, since the factors contributing to this disease can be eliminated or prevented.
Stay healthy!

Inflammation that affects the hair follicles in the form of painful blisters filled with purulent fluid is called folliculitis. Foci can be detected in any area of the body, except for the mucous membranes, palms, feet, and several areas on the face where follicles are absent by default.

Causes of folliculitis

Inflammation of the hair follicles can develop on its own, when infected with a fungal infection, under the influence of a virus, or for other reasons. But most often, pathology accompanies the underlying disease in the form of a complication. Dermatoses are the most common skin lesions that cause inflammation of the hair follicles. Often, problems with the skin also occur with a long course of diabetes or anemia.

Other situations in which a person may find single or multiple rashes of a characteristic type:

long stays in the heat or in a stuffy enclosed space;
non-compliance with basic hygiene standards;
constant wearing of a headgear that does not allow air to pass through, or clothes made of synthetics;
enhanced hyperhidrosis;
minor cuts, abrasions, followed by the introduction of an infectious agent.

In women, inflammation of the hair follicles is often diagnosed after long courses of contraceptives, when wearing tight, synthetic underwear, after poor-quality hair dyeing with cheap dyes or depilation.

Symptoms of the disease

There are three degrees of damage to the bulb located in the epidermis:

osteofolliculitis;
folliculitis;
sycosis.

In the first case, only the surface area of the follicle is damaged, in the second, if treatment is not started, the inflammation goes inside the follicular cavity. The third degree, the most severe, occurs when the bulb is completely damaged.

In order to prevent the dynamic development of the disease, one should know the first symptoms of the disease and signs of deterioration during the transition of folliculosis to the next stage:

individual inflammation in the form of elements of a pink rash;
gradually the rash spreads around the initial focus, increasing in size and acquiring a specific appearance - a purulent vesicle with a hair in the center of the formation;
in place of the bursting bubble, a transparent-colored scab immediately appears;
in rare cases, high temperature indicators are noted;
the place of localization of the pustules itches, and when the pustules mature, it hurts;
there are cases of focal alopecia in areas of sycosis.

Inflammation of the hair follicles on the head in children occurs as an accompaniment of dermatitis (especially seborrhea), as well as in connection with general diseases that lead to a sharp decrease in immunity.

Foci localization

Since inflammation of the hair follicles is a transient phenomenon, the appearance of a rash is most often associated with the use of other people's hygiene items. As a rule, the scalp suffers, but the appearance of alarming signs in the groin, on the upper and lower extremities, in the armpits is not excluded.

The appearance of symptoms of the disease in the pubic region and armpits is often complicated by an increase in nearby lymph nodes, and after healing of abscesses that are in the stage of deep damage, scars or ulcers remain in their place. The same period is marked by partial alopecia.

On the legs and armpits, the bulbs are damaged as a result of rough, traumatic shaving with a machine or after depilation. Folliculitis on the hands is often diagnosed in men working in unsanitary conditions (at a construction site, at a garbage disposal), or women who use low-quality detergents (washing, cleaning) without gloves.

Medical treatment of folliculitis

Inflammation of the hair follicles is treated at home with drugs prescribed by a dermatologist. The schedule of the therapy regimen is preceded by the diagnosis and establishment of the cause of the disease.

Drugs prescribed for the treatment of folliculitis:

local antibacterial drugs: "Gentamicin", "Levomekol";
antiseptics: 3% hydrogen peroxide, Zelenka, Miramistin, Fukortsin;
local antifungal agents: "Nizoral", "Mycozoral";
antiallergic tablets: "Zodak", "Suprastin".

Regardless of the causative agent of the disease, with any degree of damage, the usual zinc ointment is successfully applied, applied in the form of applications to the affected area.

Treatment of recurrent or advanced forms

Antibiotics are prescribed if the disease is already detected at the stage of sycosis, that is, there are multiple lesions with purulent formations of varying degrees of maturation. In this case, in parallel with the main treatment, sulfonamides and drugs that increase immune defense are prescribed.

When self-applying local remedies to areas with ripe or opened pustules, you should not press on the affected area or try to open the formations yourself. This action is carried out only under sterile conditions in the treatment room.

Physiotherapy

Hardware folliculitis therapy is provided to the patient as part of additional services and is one of the most effective methods for treating inflammation of the hair follicles. From the point of view of safety and the speed of the positive effect, exposure to ultraviolet irradiation to a depth of up to 10 mm of the affected area has proven itself best.

The duration of the course is negotiated on an individual basis, but does not exceed ten procedures. The frequency of exposures is also regulated only by the severity of the patient's condition and his susceptibility to treatment.

Folk methods

Folk health remedies cannot replace the main therapy, but they are successfully used as a concomitant treatment of folliculitis due to the high concentration of tannins, astringents, natural antiseptics and stabilizers of regenerative processes in many herbal preparations. Doctors support additional treatment with folk methods using the following active ingredients that make up decoctions and tinctures:

common dandelion;
burdock roots (burdock);
chamomile;
nettles;
onion;
cranberries.

All of the above herbal ingredients are prepared in a weak degree of concentration - for oral administration - and in a highly concentrated form - for external use.

Prognosis and complications

If the disease is not stopped in the first two weeks after the onset of the first symptoms, or the means used by the patient do not correspond to the goal of treatment, complications such as:

dermatophytosis;
lymphadenitis;
carbuncle;
abscess.

The prognosis of recovery in the development of complications depends on the direction that the disease has taken, and can mean a severe outcome, even death. Children under one year of age are at particular risk, therefore, treatment of this category of patients occurs only in stationary conditions.

Prevention of folliculitis

You can prevent skin pathology by simply adhering to basic hygiene standards and completely curing all diseases associated with the penetration of infections and viruses. If a person with folliculosis is surrounded by relatives or colleagues, you should wash your hands more often and treat your hands with antiseptics and be sure to contact a dermatologist at the first suspicion of the disease.

may develop with prickly heat, excessive sweating due to wearing too warm clothes or synthetic ("non-breathable") underwear in hot weather. This is facilitated by scratching the skin and introducing infectious microflora into macerated tissues.

The disease often occurs in HIV-infected, which is due to their lack of immunity and weak resistance of the body to infections.

Folliculitis in the groin: causes

Folliculitis in the groin is a common occurrence in diabetes. The reason for this is the increased predisposition of the skin to purulent-necrotic lesions due to endocrine disorders. This, in turn, is caused by diabetic angiopathy - circulatory disorders in tissues, including in the groin area.

Pathology can occur with allergies, which are accompanied by itching and scratching of the skin caused by it. With scabies the disease develops quite often. This is due to severe itching and associated scratching of the skin, which very often leads to microbial infection and, as a result, to inflammatory damage to the hair follicles.

The same thing happens with pubic pediculosis.

The latter disease is caused by the ingestion of fungal microorganisms on the skin. Their reproduction causes itching of the skin, its swelling, hyperemia. In this connection, scratching occurs, tissues become infected with microbes and the hair follicle becomes inflamed. With inguinal erythrasma caused by pseudomycotic microbes, a similar clinical picture develops. This is a pronounced skin itching, redness, swelling, peeling, the formation of clearly defined rounded lesions on the skin, devoid of hair.

Folliculitis in the groin may occur in violation of hygiene. Pathology develops due to excessive reproduction of pathogenic or conditionally pathogenic microflora.

The barrier function of the skin is reduced, which leads to an infectious and inflammatory lesion of the hair follicle. Due to its frequent occurrence after exposure to hot water, folliculitis is also called "hot bath disease".

How to distinguish folliculitis in the groin from herpes

With herpetic lesions of the skin, vesicular elements are formed on it in the form of bubbles filled with a light yellow transparent liquid.

Their presence is almost unmistakable proof of the herpetic origin of the pathology.

Folliculitis is not accompanied by the appearance of a vesicular rash. Most often occurs alone. A herpetic rash is often grouped and consists of several loose elements located close to each other.

How to distinguish folliculitis in the groin from a boil

Furuncle is a deeper and more extensive purulent-inflammatory process. Since not only the hair follicle is involved in it. But also the sebaceous gland adjacent to it with loose connective tissue.

This difference also leads to differences in clinical presentation. Folliculitis is much easier than a boil. It comes with less pain. The amount of purulent discharge in this case is also much less than with the formation of a boil.

How to distinguish folliculitis in the groin from eczema

Inflammation of the surface layer of the skin is accompanied only by itching and flaking, skin hyperemia, but in this case no pustules are formed. In the first case, a localized purulent-necrotic element is necessarily visualized on the skin.

The disease often occurs during pregnancy. Due to the weakening of the body's immune defense against the background of natural dyshormonal phenomena.

The likelihood of developing pathology may increase with sexual infections, due to a decrease in general and local tissue immunity.

Folliculitis in the groin: which doctor to contact

Treatment of this pathology is carried out by a dermatologist or dermatovenereologist. If the disease is accompanied by sexual infections, consultation of a dermatovenereologist, urologist or gynecologist is necessary.

What tests to pass with folliculitis in the groin

To compile a general diagnostic picture, you may need:

general and biochemical blood tests,
general urine analysis,
microscopy of the urogenital smear,
sowing a smear for bacteria from the pathological focus and the genitourinary tract,
PCR smear, urine, blood,
serological examination using ELISA.

What complications are possible if no treatment is attempted?

Folliculitis can develop into furunculosis, carbuncle, abscess. In severe cases - phlegmon and general blood poisoning - sepsis. Complications often occur with a weak state of immunity and the absence or incorrectly prescribed treatment. With insufficient immunity, in addition to a severe course and the possible development of complications, frequent relapses are likely. They occur when the general immune defense is weakened and the local barrier function of the skin is reduced. External ointments are used to suppress the activity of microbial flora in tissues, as well as relieve skin itching and inflammation.

What antibiotics to drink?

This should be decided by the attending physician based on the results of laboratory tests and based on the severity of the clinical picture of the disease.

When folliculitis appears in the groin, contact competent dermatovenereologists.