Folliculitis: Causes, Symptoms, and Treatment Options

Q: Folliculitis: Causes, Symptoms, and Treatment Options

Dear Ann： The symptoms you described are commonly known as a pilar cyst, medically referred to as an epidermoid cyst. <br>This usually occurs after skin injury (such as squeezing a pimple or scratching), causing a portion of the epidermis to be encapsulated by new skin, resulting

Is it folliculitis?

Doctor, I have a follicle under my armpit that seems to have a small opening.
I can see a white substance at the follicle's opening, and when I squeeze it, I can expel more of this white material, which feels like it won't stop.
I'm hesitant to continue squeezing.
Currently, it doesn't appear red or swollen.
Could this be a bacterial infection, or is it possibly tissue fluid from the follicle? How should I handle this? I'm wondering if it might be related to the fact that I previously plucked some underarm hair.
At that time, one or two hairs also had the same white substance at the follicle.
Could this indicate that I have a bacterial infection?

ann, 20~29 year old female. Ask Date: 2007/12/21

Dr. Zhang Zhibo reply Dermatology

Dear Ann: The symptoms you described are commonly known as a pilar cyst, medically referred to as an epidermoid cyst.
This usually occurs after skin injury (such as squeezing a pimple or scratching), causing a portion of the epidermis to be encapsulated by new skin, resulting in a new subcutaneous tumor.
I often liken it to a garbage bag filled with trash buried underground, which can sometimes ferment and produce gas (resulting in a fluid that feels watery when touched on the skin).
Over time, it can form a hard lump similar to a fossil.
If you squeeze it, a white, chalky substance with an unpleasant odor may emerge (this is a product of the epidermis: bacteria + sebum).
The treatment method must involve surgically removing the capsule surrounding the white substance completely; otherwise, it is likely to recur easily!

Reply Date: 2007/12/21

More Info

Folliculitis is an inflammation of the hair follicles, which can occur in various areas of the body, including the armpits. It is characterized by small, red bumps or white-headed pimples around hair follicles. In your case, the presence of a small opening with a white substance that can be expressed suggests that you may be experiencing a mild form of folliculitis, possibly due to irritation or infection.

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

2. Fungal Infection: In some cases, fungal infections can also lead to folliculitis, especially in warm, moist environments.

3. Irritation: Shaving, waxing, or plucking hair can irritate the hair follicles, leading to inflammation. If you recently plucked your underarm hair, this could have contributed to the condition.

4. Occlusion: Wearing tight clothing or using heavy creams can block hair follicles, leading to folliculitis.

5. Other Factors: Conditions such as diabetes, immune system disorders, or certain medications can increase the risk of developing folliculitis.

Symptoms
The symptoms of folliculitis can vary but typically include:
- Small red bumps or white-headed pimples around hair follicles.

- Itching or tenderness in the affected area.

- In some cases, the area may become swollen or painful.

Since you mentioned that there is no redness or swelling, it may indicate that the inflammation is mild or that it is in the early stages.

Treatment Options
1. Warm Compresses: Applying a warm compress to the affected area can help soothe irritation and promote drainage if there is pus.

2. Topical Antibiotics: If a bacterial infection is suspected, over-the-counter topical antibiotics like bacitracin or mupirocin may be effective.

3. Avoiding Irritants: Avoid shaving or waxing the area until it has healed. If you must shave, use a clean razor and consider using shaving cream to minimize irritation.

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

5. Oral Antibiotics: In cases of severe or persistent folliculitis, a healthcare provider may prescribe oral antibiotics.

6. Hygiene: Maintaining good hygiene and keeping the area clean and dry can help prevent further irritation or infection.

When to Seek Medical Attention
If the condition worsens, becomes painful, or shows signs of spreading (such as increased redness, swelling, or fever), it is essential to consult a healthcare provider. They may perform a culture to identify the specific bacteria or fungus involved and prescribe appropriate treatment.

Conclusion
In summary, the white substance you are observing could be pus from an inflamed hair follicle, possibly due to a bacterial infection or irritation from hair removal. It is advisable to avoid squeezing or picking at the area to prevent further irritation or infection. If symptoms persist or worsen, seeking medical advice is recommended to ensure proper diagnosis and treatment.

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