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Types

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Several different forms of folliculitis are described:

  • infectious causes
    • bacteria Yeasts Fungi Virus Parasites Environmental folliculitis Folliculitis due to skin diseases Other forms (1)
      • Staphylococcal folliculitis
        • most common form of bacterial folliculitis (1)

      • Hot tub folliculitis
        • can present as red spots and pustules on the trunk
        • due to an infection with Pseudomonas aeruginosa from improperly sanitised hot tubs or spas
        • caused by Pseudomonas aeruginosa contamination of undertreated water in saunas or whirlpools (2)

      • Gram negative folliculitis
        • rare pustular facial eruption, usually following antibiotic treatment of acne
        • gram-negative pathogens including Klebsiella, Enterobacter, and Proteus species may replace the gram-positive flora on facial skin, nasal mucous membranes, and neighbouring areas, causing gram-negative folliculitis and boils (3)
      • Pityrosporum folliculitis
        • presents as an itchy acne-like rash on the back and chest of young adults
        • most commonly, it is caused by Pityrosporum ovale (also called Malassezia).
      • Tinea capitis or ringworm of the scalp is a fungal infection involving the hair follicles of the scalp
        • generally, it presents as scaling and hair loss, but may cause more severe inflammation or folliculitis in some people.
      • Herpes simplex virus or cold sore virus
        • occasionally cancause folliculitis
        • most commonly it affects men who experience recurrent localised facial herpes simplex infections and shave with a razor.
      • Demodex folliculitis
        • presentation similar to rosacea
        • caused by the hair follicle mite demodex
        • occurs on the faces of people whose immune system has been suppressed, usually with medication.
      • Mechanical folliculitis
        • caused by chronic frictional factors
        • occurs frequently in men or women who shave their faces or legs with a razor, particularly if they do so against the direction of the hairs
        • occasionally, it may also be associated with the wearing of tight pants or obesity.
      • Occlusion folliculitis
        • caused by blockages of the follicles as a result of exposure to topical products such adhesives, oil, moisturisers, greases and ointments that cause swelling of the skin of the hair follicle opening
      • Chemical folliculitis
        • caused by exposure to certain topical products such as coal tars and the overuse of topical medications such as corticosteroids
          • particularly on the facial region, leading to swelling and obstruction of the follicular opening.
      • Buttock folliculitis
        • a common problem in both men and women
        • may be a form or localised acne
        • can be an acute condition with painful pustules requiring oral antibiotics
        • can also be chronic and require topical maintenance products to manage the condition.
      • Drug-induced folliculitis
        • presents as uniform red spots and pustules
        • more common in people prone to acne
        • occurs within two weeks of taking certain medications such as oral corticosteroids, androgenic hormones, epidermal growth factor receptor inhibitors, lithium and some other anticonvulsants
      • Pseudofolliculitis barbae
        • a type of chronic inflammation seen in the beard area of men who shave
        • mostly commonly affects men with darker skin types and tightly curled hair.
        • as the cut hair grows, the curliness leads to the sharp point digging into the skin causing a mechanical inflammation.
      • Irritant folliculitis
        • occurs on the lower legs of women who shave, wax, pluck or use electrolysis for hair removal.
      • Eosinophilic folliculitis
        • an itchy bumpy or pustular rash that most commonly affects the head and neck but other body sites may also be involved
        • unknown cause
        • in some cases may be related to immune suppression, either due to medications or medical conditions such as malignancy or HIV. Rarely, it occurs in infants

Reference:

  1. Gunatheesan S. Folliculitis. www.dermcoll.edu.au/atoz/ folliculitis/ (accessed 10/3/2021).
  2. Zacherle BJ et al.Hot tub folliculitis: a clinical syndrome. Western Journal of Medicine 1982;137(3):191-4.
  3. Boni R et al.Treatment of gram-negative folliculitis in patients with acne. American Journal of Clinical Dermatology 2003;4(4):273-6.

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