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WHAT IS FOLLICULITIS?


Folliculitis is an acute infectious process which affects the upper portion of the hair follicle, or the structure from which the hair originates, and consists of four parts called the infundibulum, the isthmus, the region soprabulbare and the bulb. On human skin there are an average of about 5 million hair follicles.

Folliculitis is manifested by the presence of pustules and small nodules, erosions, small crusts or ingrown hairs. Generally folliculitis affects the infundibulum, but its involvement may extend the entire length of the follicles. The symptoms of folliculitis with extended depth can be severe, you may have gathered substantial puss, tenderness, local adenopathy and even experience a fever.

The treatment of a deep folliculitis must be rapid, but also especially suitable, otherwise it could result in scarring and a relatively extended suffering period. Examples of deep folliculitis are folliculitis decalvans, necrotic acne, sycosis pyogenic and boils. Deep folliculitis is often very painful and surgery in the form of having the boil or carbuncle lanced is often the best method of treating the discomfort. The drawback however is that the scar may then be subject to repeated infections in the future.

There are several forms of folliculitis; among the most common include folliculitis by bacteria (Staphylococcus aureus, Pseudomonas Aeuroginosa, etc), Eosinophilic folliculitis, folliculitis decalvans and folliculitis from fungi (Candida, Pityrosporum, dermatophytes, etc).

Folliculitis caused by bacteria is the form that is most commonly seen in westerners. The bacteria most frequently involved in folliculitis is the Stapylococcous aureus bacterium, but several other bacteria may be causing the problem, besides the two mentioned above these include Escherichia coli, Serratia marescens, Klebsiella and Proteus mirabilis.

Bacterial folliculitis can occur due to hair removal treatments or even after shaving. It may be caused by repeated mechanical and chemical damage to the skin, or may be due to alterations in the balance of bacteria and lipid skin, resulting in deformation of the hair shaft.

The Gram-negative type of folliculitis may occur in patients undergoing prolonged antibacterial treatments for the treatment of acne. Gram-negative folliculitis may be present in those subjects suffering from acne in which the treatment with tetracyclines (antibiotics) has not been successful.

Eosinophilic folliculitis is a form of folliculitis of unknown cause that can affect people of all ages, there are three types: the adult eosinophilic folliculitis, eosinophilic folliculitis of the infant and the eosinophilic folliculitis in AIDS patients. In over half the cases of folliculitis eosinophilic, there is a peripheral blood eosinophilia (this means that the bacteria leaches into the bloodstream but is captured by the immune system).

Decalvans Folliculitis is another folliculitis condition. Luckily decalvans is not particularly common and the appearance of alopecia is a form of healing. In other words, when you start getting better, you start losing hair. Folliculitis decalvans affects both sexes, but males have it occur with more frequency. Generally decalvans folliculitis occurs in adulthood. Initially there is an inflammation of the hair follicles with small pustules. Later the bacteria will destroy the hair follicle and result in hair loss. There is then the formation of scar spots (round or oval in shapes) with small pustules.

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