Folliculitis is the infection of hair follicles. This can occur anywhere on the skin or scalp. Usually there is some itch, sometimes a little soreness. Folliculitis looks like acne pimples or non-healing, crusty sores.
An acute eruption or one present for only a short time is usually due to Staph bacteria (impetigo of Bockhart). This is treated with oral cephalexin, dicloxacillin or similar oral antibiotic. Topical antibiotics creams or lotions can also be used. Bactroban ointment should be applied into the front of the nose for several days to prevent a carrier state. While this may seem like it makes no sense, the inside front area of the nostrils is often a place where bacteria can survive a course of oral antibiotics. Later, they spread back to the skin to cause a relapse.
Chronic or recurring folliculitis is less likely to clear with just antibiotics. Often this is on the legs of women, but it can occur in any areas of shaving, waxing, hair plucking or friction. These need to be stopped for at least 3 months to allow the hair to grow in healthy. If shaving is resumed, one should shave with the grain of the hair; it won't FEEL quite as smooth, but it will LOOK a whole lot better.
An antibiotic such as tetracycline or minocycline can be given for 4 to 6 weeks. Unless the skin is sensitive, drying, antiseptic lotions should be used on the affected areas such as Xerac-AC (aluminum chlorhydrate solution), Cleocin-T solution or Benzaclin gel. In some cases, the infection with unusual bacteria may be picked up from a dirty hot tub or scrubbing brush.
For those with sensitive skin, friction and rubbing must be avoided. Avoid Lycra workout clothes, and tight fitting rough fabrics like blue jeans in the affected area. Apply a non-greasy moisturizer such as Lac-hydrin cream (ammonium lactate 12%) plus mild prescription cortisone cream to the area if there is an associated atopic dermatitis (eczema).
Resistant and recurrent cases, especially on the legs may clear with hair removal laser treatments. This may be expensive and require several treatments, but is helpful when other treatments fail.
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