Folliculitis is a bacterial infection of the superficial layers of the skin involving the hair follicles. Bacteria gain entry to the deep hair follicles and produce an infection. The hair follicle is filled with bacteria and pus cells (a microscopic abscess), causing irritation of the surrounding tissue, often experienced as itching. Folliculitis always has some sort of cause, most commonly those below.

Hot tub (bathing trunk) folliculitis

This is a special case of follicle infection caused by prolonged soaking in a hot tub which has not been adequately chlorinated and harbors Pseudomonas, a bacterium that thrives in warm water (and smelly old tennis shoes, too). The rash appears as an itchy eruption only in the areas of the body covered by the bathing suit. Apparently, poor water circulation under the bathing suit, coupled with the dilation of the hair follicles due to the warmth of the water, leads to penetration of the follicles by the germ. No treatment is normally necessary, unless one or more of the microabscesses develops into a larger abscess.

Leg and axillary shaving

Girls in particular are prone to folliculitis caused by shaving with a razor contaminated with bacteria from the previous shaving session. The unavoidable microscopic nicks and cuts allow the innoculation of bacteria into the skin around the follicle (as well as producing infected shaving cuts as well). This can be largely prevented by soaking the razor in rubbing alcohol between shaves, and treated by antibacterial soaking of the legs if the problem arises. As with any folliculitis, there is a risk that microabscesses can enlarge and require medical attention.

Facial shaving

Male teens old enough to shave (and of course adult men) can develop a similar folliculitis of the face, sycosis barbae, usually caused by Staphylococcus and related to microscopic nicking and contamination of the tiny mounds of skin about the hair follicles. It begins as an itchy red rash and may progress to impetigo of the face. See your physician about this one.

Diaper wearing

We also see this type of infection in babies and toddlers still in diapers. Apparently the friction of the diaper against the skin in the presence of Staph. or Strep. bacteria can lead to a follicular eruption. In the age of MRSA, this is a particular concern, as tiny follicular abscesses can lead to more serious abscess formation.

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