What is folliculitis?
Folliculitis is an inflammation and infection of the hair follicle caused by bacteria that live on the skin’s surface such as Staphylococcus aureus. We know that bacteria and sometimes fungus are introduced into the follicle, where they reproduce. Men and women who shave are most at risk, so folliculitis is somewhat common. Most often, it appears as pus bumps on the legs and bikini areas of women and the beard area of men. Folliculitis is more common among women when the weather gets warm and they start shaving more often. Hot tub folliculitis is contracted from hot tub water contaminated with a gram-negative bacteria called Pseudomonas aeruginosa.
How can folliculitis be prevented?
Discontinuing shaving is often helpful. So, for men who frequently develop folliculitis, a good option might be growing a beard. Razor bumps, also known as pseudofolliculitis barbae, which is an inflammatory reaction due to ingrown hairs, produces a painful bump. A curly hair grows out of the hair follicle and then turns and pierces the skin. An infection from S. aureus can then develop within the bump. This also improves when men grow a beard.
If people do choose to shave, shaving in a downward fashion, as opposed to against the hair growth, can help. Shaving with a sharp razor so you only need one pass reduces risk. Sometimes using shaving creams that contain benzol peroxide or antibacterial agents can also help.
How is folliculitis treated?
Hot tub folliculitis usually goes away without treatment if you avoid contaminated hot tubs. Regular folliculitis is treated with topical and/or oral antibiotics for one to two weeks. Over-the-counter antibiotics such as Neosporin can have a mild antibacterial effect.
What is cellulitis?
Cellulitis is a bacterial infection of the skin that is much less common than folliculitis. Like folliculitis, it’s usually caused by either Streptococcus or Staphylococcus that live on the skin. Usually, there’s some type of inciting event, such as an injury or a wound, which leads to the infection. Sometimes even a significant scratch will introduce the bacteria beneath the surface of the skin, where it multiplies.
What are the symptoms?
The skin becomes red, hot, tender and swollen, and the surface may resemble the skin of an orange peel. Patients sometimes develop a fever or nausea. Symptoms usually develop within 24 hours of the injury. If cellulitis spreads to the face or the hands, it can impinge on important structures. For example, in the hands, swelling can compress nerves and tendons, so you wouldn’t be able to use your fingers. On the face, cellulitis can be catastrophic if it involves the eye. With severe infection, you can sometimes see a red streak across the affected area that represents an infection of the lymphatic system. (The lymphatic system gets involved because cells that fight infection exit the area via the lymph system.)
Who is most at risk?
There are some people who seem more prone to cellulitis, particularly those with diabetes. People with diabetes, who are more likely to develop leg ulcers, are at higher risk because bacteria can be introduced beneath the surface of the skin in the area of the ulcer. Cellulitis can also follow surgeries because surgical wounds can create an entryway for the bacteria.
How is cellulitis treated?
Warm compresses or soaks, and pain relievers, which can also reduce fever, can help. We would also treat with oral antibiotics for about 10 days, although intravenous antibiotics are sometimes necessary.
What is impetigo?
Impetigo is a bacterial skin infection caused, again, by S. aureus or Streptococcus. It’s generally seen in children, although it can occur in adults. Usually, you will see what’s described as a honeycomb, which is a yellow, sticky type of crusting. It can be painful, though you don’t usually have a fever. There’s a variety that presents with blisters that’s called bullous impetigo. Rather than cause a honey-colored crust, this type of impetigo leads to bumps with fluid inside that oozes. |
