Brief Answer:
Chronic folliculitis: various measures can be used

Detailed Answer:
Hello,

Welcome and thanks for posting your query to the forum.

I can understand your concern for the problem of chronic folliculitis.

Before I guide you regarding your condition let me guide you for some important points regarding your condition.

To tell you simply - This is a condition of inflammation and infection of the hair root and oil gland attached to it.

To explain it medically, we have hair all over our body which have opening of the oil glands attached to it. By many a factors these hair root and oil gland can become inflamed and infected leading to folliculitis.

The reason for the inflammation and infection of the area is due to the fact that our body harbor multiple types of bacteria on the skin which are known as “Normal flora” of the skin. A bacteria “Staphylococcus aureus” is also a part of that flora, but as soon as there is some break in the skin or trivially also due to bit ups and downs in immunity, the bacteria gets access into the skin and causes the aforesaid process of inflammation and infection. Scalp area has high oil secretion therefore is more prone for such kind of infections.

When it is superficial it heals without any problem, but when it is deep it causes lot of pain and swelling around the area. In general these persist for few weeks and heal without any problem. After a period of time our immunity prevents the further formation and inflammation. The main concern is when it is occurring frequently and regularly.

There are certain important tips regarding your problem:

1. Do not pinch, pop or even try to touch any of the area.

2. Kindly avoid scratching any area of normal skin also, as it leads to minor entry points for the entry of bacteria.

3. Maintain proper hygiene and take two times daily bath.

4. Avoid any kind of stress, even for this condition also as stress is one of the very important factor playing role in our immunity (making it low) so prone for infections. Yoga, meditations and simple walk do help a lot in improving immunity.

For the remedy part follow the things below:

1.Wash your scalp daily. You will say you are already doing it. But my way of application is- it is to be done twice in a single bath. It means when you are washing your scalp apply first time shampoo for washing the hair part only, then rinse it off immediately with water. Reapply the shampoo again immediately, leave it for around 5 minutes, do a good gentle massage by your fingers for around 2 minutes and then wash it off. By doing so for around 7 days you will get good benefit.

2.The other way if you can not do two time wash is apply your shampoo ( diluted with water) for around half an hour before bath like an hair oil. And then rest of the second application and bath as told above. You can reduce the frequency of twice application after 2 weeks and then can optimize it according to your own need.

3.Stick to one good mild shampoo which is suiting your hair, don’t change the shampoos frequently. If you are using any conditioner also then to be used over the strands of hair only and not over the scalp skin. Do not use antibacterial shampoos frequently as can cause lot of dryness of scalp.

4.Do not use any kind of hair oil or any oily or creamy stuff any time on your scalp. People do have a myth that applying hair oil makes hair good- but we dermatologists totally disagree with that. On one side there is no direct or indirect benefit of hair oil, on the other side it actually attract more of dirt and grease over the scalp leading to more proliferation of germs.

5.Comb your hair at least 3-4 times a day and most importantly at night time so that the dust particle and other of dead skin is taken off.

6.Eat a lot of good healthy diet, do mild exercises, reduce your work stress as all these have bit impact on skin so also on scalp skin.

For the folliculitis of existing origin If I were your treating dermatologist then would have suggested you to apply plain antibacterial cream such as fusidic acid or mupirocin (latest is retapamulin) and to take pain killer tablet such as Ibuprofen or paracetamol by mouth for reducing the intensity of pain and redness.

If these are enlarging and painful, then along with above mentioned measures you would require a course of oral antibiotics (best after culture and sensitivity of pus) under medical advice. If at all you take oral antibiotic, then do take proper dose and full course of antibiotics (as improper dosing and schedule leads to antibiotic resistance and then recurrent nature of the situation).

Eat healthy and nutritious food to improve your immunity at its best because is the most important factor in reducing and eliminating any infection from the body.

Hope I have answered your query. If you have any further questions, I will be happy to help.
Wish you good health.

Regards,

Dr Sanjay Kumar Kanodia
MD- Dermatology & Sexually transmitted diseases

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Brief Answer:
Chronic folliculitis: "culture and sensitivity"

Detailed Answer:
Hello,

Welcome again to the forum and thanks for follow up.

My suggestion of combing the hair is after the healing of boils on normal scalp and not in the present situation. So it is not an immediate measure but an act to prevent the deposition of dirt and environmental impurities present in air.

Folliculitis is a problem which can occur at any site where the hairs are present. For the boils on cheeks and jaw line you have to take care of heat, humidity and strict policy of "no application of any creamy or oily stuff on face".

Additional part is not pinch and pop any existing lesion. Because this si the most important cause of entry of bacteria in the skin.

In my patients I generally go for "culture and sensitivity of pus" to know the exact bacteria and its sensitive antibiotic. A proper full course of dose treats the condition fully. You can discuss the same with your treating doctor.

There is no prohibition of food in my experience. I have not found any major contribution of food in causation of folliculitis. In some cases sweets & spicy food are considered to be contributory so you can try avoiding them. If for almonds in particular I suggest to take peeled almonds after overnight soaking.

Do not worry Chronic folliculitis is though bothersome but very well treatable condition with proper care and management.

I hope these informations will help you. If you have any further questions, I will be happy to help.
Wish you good health.

Regards,

Dr Sanjay Kumar Kanodia
MD- Dermatology & Sexually transmitted diseases

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Brief Answer:
folliculitis can affect any hairy area.

Detailed Answer:
Hello,

Welcome again and thanks a lot for sharing all your concerns.

Folliculitis and boils are same spectrum of entity. Boils are nothing but folliculitis with pus accumulation.

We can find boils or folliculitis at every of that area where there is presence of hair whether fine or coarse.

I have already suggested you measures to prevent these. Additionally I suggest you to not use any cosmetic item including ay cream or oil or an massage on face.

In my opinion culture and sensitivity of the area is quite important to know the exact bacteria and its sensitive antibiotic so that proper full course it can be taken for remission of the problem.

I hope these informations will help you. If you have any further questions, I will be happy to help.
Wish you good health.

Regards,

Dr Sanjay Kumar Kanodia
MD- Dermatology & Sexually transmitted diseases

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Brief Answer:
Hygiene + Antibiotics + Vitamin A ester

Detailed Answer:
Hello,

Welcome to the forum again.

I can understand the part of folliculitis occurring again and again.

I have already told you to take care of the things in our previous discussions. I am again enumerating the things:

- I suggest my patients to apply any antibacterial cream containing "fucidin" or "mupirocin" two times a day in a very thin layer so that it should not be visible to naked eye. I now a days prefer for “retapamulin” which is a latest antibacterial cream.

- In your kind of cases I prefer to give a sensitive antibiotic to the bacteria. As in your case it is erythromycin- so a complete course of antibiotic should be taken to eradicate the propensity of bacteria causing folliculitis.

-Do not scratch or even try to touch the area unnecessarily. This is the most important part in your treatment. Due to touching or scratching or pinching the area, there can be more spread of infection to the surrounding area and so further aggravation of the problem.

- You can do cold water or bit warm water compresses to reduce any discomfort and for soothing. Do not try to do hot water compress as can lead to more pain.

- Stay away from hot and humid climate.

- Do not wear any synthetic undergarments coming in contact with the affected area. So wear cotton undergarments to be changed two times in a day.

- Keep proper hygiene by trimming the hair with a trimmer (not shaving or hair removal creams as these itself irritates the hair and skin).

For the part of shampoo I prefer an antibacterial shampoo such as “betadine Ad wash” on regular basis. It contains an antibacterial compound “betadine” in it.
An additional measure is to reduce the proliferation of glands by reducing the oil activity of teh glands secreting more oil. In my patients I prefer a vitamin A ester such as “Isotretinoin” for around 3-6 months in proper dosage. You can talk to your treating dermatologist for the same.

Stress is very important part in reducing our immunity, which in turn cause proliferation of infection. So kindly relax and reduce your stress also!!

I hope you will take good care of yourself. Eat a lot of nutritious food in form of fruits, green vegetables and good protein intake will help you in good recovery of the situation.

Feel free to ask any further queries,
With best wishes of early recovery of the problem"

Regards,

Dr Sanjay Kumar Kanodia
(MD- Dermatology & STD)

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