Folliculitis: Causes and Treatments for Red, Swollen Hair Follicles

Follicular erythema

Hello Doctor: I have been using a razor to shave my leg hair due to excessive hair growth.
Previously, I only experienced hair trapped under the skin, but recently the hair follicles on my legs suddenly became red and swollen, and then blisters formed.
Eventually, when I squeezed them, pus came out.
What could this be a symptom of?

A-Xuan, 10~19 year old female. Ask Date: 2022/06/13

Dr. Wu Yuxin reply Dermatology

If there is a hair trapped under the skin, it could be a case of pseudofolliculitis or simply a common folliculitis.

Reply Date: 2022/06/13

More Info

Folliculitis is a common skin condition that occurs when hair follicles become inflamed, often due to infection, irritation, or blockage. The symptoms you are experiencing, such as redness, swelling, and the presence of pus-filled blisters, are indicative of folliculitis. This condition can be caused by various factors, including bacterial infections, fungal infections, irritation from shaving or waxing, and even certain skin conditions like acne or eczema.

1. Causes of Folliculitis:
- Bacterial Infection: The most common cause of folliculitis is a bacterial infection, particularly by Staphylococcus aureus. This bacterium can enter the hair follicle through small cuts or abrasions, leading to inflammation and pus formation.

- Fungal Infection: Fungal infections, such as those caused by yeast, can also lead to folliculitis. This is more common in warm, moist environments.

- Irritation: Frequent shaving, especially with dull blades or without proper lubrication, can irritate the hair follicles, leading to inflammation.

- Blockage: Excess oil, dead skin cells, and other debris can clog hair follicles, causing them to become inflamed.

- Underlying Conditions: Certain skin conditions, such as acne or eczema, can predispose individuals to folliculitis.

2. Symptoms:
- Red, swollen bumps around hair follicles.

- Pus-filled blisters that may burst and ooze.

- Itching or tenderness in the affected area.

- In severe cases, the infection can spread, leading to more extensive skin involvement.

3. Self-Care and Treatment:
- Avoid Irritation: If shaving is the cause, consider using an electric razor or ensuring that you use a sharp blade and shaving cream to minimize irritation.

- Warm Compresses: Applying warm compresses to the affected area can help soothe discomfort and promote drainage of any pus-filled blisters.

- Topical Antibiotics: Over-the-counter topical antibiotics, such as bacitracin or mupirocin, can be applied to the affected area to help combat bacterial infections.

- Antifungal Creams: If a fungal infection is suspected, antifungal creams may be necessary.

- Avoid Picking: It is crucial to avoid picking at the bumps or blisters, as this can worsen the infection and lead to scarring.

4. When to See a Doctor:
- If the symptoms persist or worsen despite home treatment.

- If you develop a fever or the area becomes increasingly painful, which may indicate a more serious infection.

- If you experience recurrent episodes of folliculitis, as this may require further investigation to identify underlying causes.

5. Preventive Measures:
- Maintain good hygiene by regularly cleansing the skin and avoiding tight clothing that can irritate the hair follicles.

- Use non-comedogenic products that do not clog pores.

- If you are prone to folliculitis, consider alternative hair removal methods that are less irritating to the skin.

In summary, folliculitis is a manageable condition, but it is essential to identify the underlying cause to prevent recurrence. If you are unsure about the diagnosis or if your symptoms do not improve, it is advisable to consult a healthcare professional for a thorough evaluation and tailored treatment plan.

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