What Causes Folliculitis?
Folliculitis is characterized by inflammation of hair follicles. This
can be due to an infection by viruses, fungi, bacteria, or parasites.
Skin irritation caused by chemicals and friction, say, by shaving
against the direction of hair growth, can also cause this condition. So
can certain moisturizers or ointments that block hair follicles,
medication such as corticosteroids, and skin disorders like lichen
planus and folliculitis decalvans. Compromised immunity is a trigger
too.
Are you troubled by pustules, pimples, or an itchy rash? You may have
folliculitis, a condition in which your hair follicles become inflamed.
Folliculitis can develop in any area where you have hair, including your
back, chest, buttocks, legs, and arms. Let’s take a look at some factors that can cause this common problem.
6 Possible Causes Of Folliculitis
1. Infection
Various viruses, fungi, bacteria, and parasites can infect you and cause folliculitis.
Bacteria
The Staphylococcus aureus bacteria are usually responsible for bacterial
folliculitis. The bacteria can infect hairy areas like the beard in a
condition called folliculitis barbae. This is more common among men who
shave, with contaminated shaving equipment leading to infection. Also,
reinfection is not uncommon, particularly among men who have conditions
like hay fever, sinusitis, or nasal discharge. This happens when
bacteria that live in the nose infect hair follicles.
A variety of folliculitis known as hot tub folliculitis, which usually
develops on the trunk, is caused by Pseudomonas aeruginosa. These
bacteria are usually found in spas or hot tubs that have not been
properly sanitized.
A rare kind of folliculitis known as gram-negative folliculitis, caused
by gram negative bacteria which affect the face, usually develops after
antibiotics are used to treat acne.
Viruses
The herpes simplex virus, which causes herpes or cold sores, can
sometimes cause folliculitis too. It is usually seen in men who suffer
from recurrent facial herpes infections and who use razors.
Herpes zoster, the virus that causes shingles, can also cause folliculitis.
Another virus known as Molluscum contagiosum, which is commonly found in
children, can cause this condition. You usually see papules clustered
around a body fold in this case.
Fungi
Yeasts, which are a kind of fungi, can cause folliculitis. The most
common yeast that causes folliculitis is known as Malassezia, causing an
acne-like itch rash on the chest or back of young adults. Meanwhile,
another yeast called Candida albicans causes the development of
folliculitis in the folds of your skin or beard.
Ringworm of the scalp (Tinea capitis), which is the result of a fungal
infection, generally causes hair loss and scaly skin. Sometimes, it can
lead to folliculitis too.
Parasites
Infestation by parasites like Demodex and Sarcoptes scabiei can result
in folliculitis. Demodex generally infests the scalp or face of elderly
people or people whose immune system has been weakened. Sarcoptes
scabiei is responsible for causing scabies.
2. A Close Shave
If beard hair is cut too short, it can curl back and enter your skin,
causing inflammation. This condition usually affects the beards of men
with curly hair. This is similar to folliculitis barbae but without the
infection and is, therefore, called pseudofolliculitis barbae.
3. Skin Irritation
Some substances and practices can irritate and damage hair follicles, block them, and cause folliculitis.
Friction
Irritation of the skin due to friction can lead to folliculitis. This is
generally seen in women or men who shave their legs or faces using a
razor, especially if the shave goes against the direction of hair
growth. This kind of folliculitis is also associated with wearing tight
clothes or being obese.
Blocked Pores
Topical application of products like moisturizers, oils, and ointments
can block the hair follicle opening and lead to folliculitis. Some
products may also cause your skin to swell. This may block the follicle
opening and lead to inflammation.
Reaction To Chemicals
Topical products containing coal tar and other chemicals can irritate
your skin and cause folliculitis. Some topical medicines like
corticosteroids can also cause swelling and obstruct your follicular
opening, particularly when used on the face.
4. Medication
Many medicines can induce folliculitis too. Some examples include oral
corticosteroids, epidermal growth factor receptor inhibitors, androgenic
hormones, and lithium.
5. Weakened Immunity
A weakened immune system can leave you more susceptible to folliculitis.
A particular kind of folliculitis known as eosinophilic folliculitis is
a rare and recurrent skin disorder that specifically arises in people
whose immune system has been compromised, say those with HIV or cancer.
6. Skin Conditions
Various skin conditions can cause folliculitis. Some of them include:
Lichen Planus
A skin condition characterized by an itchy non-infectious rash that can
affect various body parts like arms, trunk, legs, genitals, mouth, nails
etc.
Discoid Lupus Erythematosus
A chronic skin condition that results in sores, scarring, and
inflammation. It generally develops on the ears, face, and scalp though
other body parts can be affected too.
Folliculitis Decalvans
A chronic inflammatory skin condition that develops on the scalp, though
other areas like beards, armpits, legs etc. can sometimes be affected
too. Itchiness, scarring, and hair loss can be indicative of this
condition.
Acne Nuchae Keloidalis
An inflammatory condition that develops when the hair on your nape or
the back of your head grows into the skin, irritates the follicles, and
leads to inflammation. This condition is more commonly seen in people
with dark skin and curly hair.
Unknown Causes
In some cases of folliculitis, a cause cannot be identified – for
instance, buttock folliculitis commonly affects the buttocks in men as
well as women. Although this is thought to have a bacterial origin, the
specific offender is yet unknown.
What Can You Do About Folliculitis?
The treatment for folliculitis depends on its cause. Antibiotics may be
prescribed for conditions caused by bacteria while antifungal medication
can be helpful if it’s caused by fungi. You can also try applying a
moist hot compress to drain affected follicles. Reduce or avoid chances
of skin friction by wearing comfortable clothes and not shaving.