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What Is The Cause And Treatment For Chronic Folliculitis Of The Scalp?

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Posted on Fri, 5 Sep 2014
Question: My problem started in August last year and I had boils on my head and it got gradually worse. I saw my doctor who prescribed antibiotics and it started to improve but then the condition became aggressive and also on had boils on my my face. I tried various antibiotics and it does not help. I think it's foliculitous carbuncle. But I do not know for certain and also what is the cure?

So my question is what precise test can be done to identify the cause first?
doctor
Answered by Dr. Geetika Paul (1 hour later)
Brief Answer:
Chronic folliculitis, need to be investigated

Detailed Answer:
Hi

I understand your concern regarding your skin problem and I hope I am able to help you in the same.
Now from the description, it looks like you are suffering from chronic folliculitis of the scalp.
As you have mentioned already that you have been taking various antibiotics with some relief
Chronic folliculitis of the scalp is a common skin problem . Rather than taking random antibiotics whenever the problem flares up, a better approach would be to do a pus culture and sensitivity testing from the lesions whenever they develop.
This will give us a fair idea of the exact cause of the development of this problem. Also it will help in deciding the exact antibiotics which would be useful in your case
Even a skin biopsy from the active lesion would be diagnostic.
This is basically the approach that we follow in our patients with this problem.
I would advise you to discuss this with your treating doctor.
Also I am sure you must be aware that you should avoid the use of any hair oils as much as possible.
You can use an antiseptic shampoo with betadine to wash hair atleast twice a week.

Hope it helps

Dr Geetika XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Geetika Paul (14 hours later)
How effective is the treatment once the bacteria is identified as you suggested?
doctor
Answered by Dr. Geetika Paul (1 hour later)
Brief Answer:
Culture and sensitivity testing will help you

Detailed Answer:
When a pus culture and sensitivity is done, it tells us about the causative organism and it also tells us about the antibiotics which would be useful in treating the infection by that particular organism.
So by this method, a direct therapy can be given to the patient and the results are mostly very good.

Dr Geetika XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Geetika Paul (4 hours later)
I am trying to get this testing done privately. Is there a medical test term used for this type of test?

Bevause the laboratory i contacted want to know exactly what testing i need.
doctor
Answered by Dr. Geetika Paul (5 minutes later)
Brief Answer:
Better to see a doctor first

Detailed Answer:
Hi again

Well XXXXXXX you might need to consult a doctor or preferably a dermatologist since this test requires a pus discharge from your active lesions which only a doctor will be able to take.
So I would rather suggest that you can see your local doctor and discuss regarding the need for this test. It is called pus culture and sensitivity testing for antibiotics.
Also I have advised you this based only upon the information that you have provided. A direct examination of the affected area is always important for confirmation of the diagnosis.


Dr Geetika XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Geetika Paul (12 minutes later)
Thank you. In terms of what you suggest this seens to me that it will help deal with the symptoms but not identify the underline root cause and deal with it that way.

What are you thoughts on this?
doctor
Answered by Dr. Geetika Paul (3 hours later)
Brief Answer:
Culture test helps to find, treat real cause

Detailed Answer:
Hi again

No.I think you have not really understood the use of the advised test.
It will help in finding out the root cause of your problem and will suggest the medicines which will help in healing your problem.
When we give antibiotics to a patient according to the test report, it prevents giving the patient any useless or less effective medicines. We can guide our treatment approach according to the real cause, thereby giving the patient the most effective medicine.

Dr Geetika XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Geetika Paul (11 hours later)
I think maybe i am not being clear in my previous question. I want to find out why i had folliculitous in the first place. For example could it have been caused by hormone inbalance? How do i find the answer to this question please?
doctor
Answered by Dr. Geetika Paul (5 hours later)
Brief Answer:
Altered normal skin flora causing the disease

Detailed Answer:
Hi again

I understand that your concern regarding this problem is genuine since it has been a recurrent and chronic problem.
There can be many reasons for such a presentation as is seen in your case.
It might be difficult to reach an exact cause but such a problem basically occurs due to an alteration in the normal flora(normal skin organisms) of the scalp.
It can occur due to many conditions like an immunocompromised state like in diabetics,patients on steroids,patients with a chronic illness like liver or kidney problems,people who tend to oil their scalp too much,patients with any itchy scalp condition causing recurrent trauma to scalp skin and many other causes.
I would like to know if you have ever got a fasting glucose analysis done.
If not, it would be good to rule out diabetes.
When the normal scalp skin flora is altered, colonization by other disease causing organisms occurs .So finding out the exact disease causing organism and its treatment is very important.
I hope this will give you some understanding of the disease and you might be able to discuss the issue better with your treating doctor.

Dr Geetika Paul
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Geetika Paul (5 hours later)
No i have not done a fasting gluccose analysis. I will also follow this up with my doctor. Thank you for all your help
doctor
Answered by Dr. Geetika Paul (10 minutes later)
Brief Answer:
Best of health

Detailed Answer:
You are most welcome XXXXXXX

Wishing you speedy recovery

You can always follow up in case of any problem

Dr Geetika XXXXXXX
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Geetika Paul

Dermatologist

Practicing since :2008

Answered : 2606 Questions

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What Is The Cause And Treatment For Chronic Folliculitis Of The Scalp?

Brief Answer: Chronic folliculitis, need to be investigated Detailed Answer: Hi I understand your concern regarding your skin problem and I hope I am able to help you in the same. Now from the description, it looks like you are suffering from chronic folliculitis of the scalp. As you have mentioned already that you have been taking various antibiotics with some relief Chronic folliculitis of the scalp is a common skin problem . Rather than taking random antibiotics whenever the problem flares up, a better approach would be to do a pus culture and sensitivity testing from the lesions whenever they develop. This will give us a fair idea of the exact cause of the development of this problem. Also it will help in deciding the exact antibiotics which would be useful in your case Even a skin biopsy from the active lesion would be diagnostic. This is basically the approach that we follow in our patients with this problem. I would advise you to discuss this with your treating doctor. Also I am sure you must be aware that you should avoid the use of any hair oils as much as possible. You can use an antiseptic shampoo with betadine to wash hair atleast twice a week. Hope it helps Dr Geetika XXXXXXX