Folliculitis and hair removal
Folliculitis is an inflammation of the hair follicles in the skin, very common, caused by infection, obstruction, irritation, or certain dermatological conditions.
Folliculitis is generally caused by a bacterial infection, but it can also be viral, fungal (due to yeasts or moulds), or caused by ingrowing hairs that inflame the follicle. Usually, folliculitis presents as small, raised red spots or whiteheads around the hair follicles from which the hairs emerge. Folliculitis can be superficial or deep, depending on whether it involves the entire hair follicle or only part of it, and whether it spreads to the surrounding dermis. In more severe cases, the lesions can develop into sores that do not heal, pustules filled with pus over which a crust forms, but which, if squeezed or otherwise handled, can lead to scarring and hairless areas. A particular form of folliculitis is that associated with the use of razors or waxing for hair removal. In turn, folliculitis from hair removal can be superficial or deep.
The Pseudofolliculitis barbae It is a superficial razor bump folliculitis caused by the formation of ingrowing hairs, particularly in men with curly hair who shave too closely; it is therefore a foreign body inflammation. However, women who have waxing done in the groin and pubic area (bikini wax) can also experience this problem, which can even leave raised scars in the shape of dark blisters.
Follicles traumatised by ingrown hairs in pseudofolliculitis barbae are more susceptible to Staphylococcus aureus infection and therefore often co-exist with the condition of folliculitis barbae. The diagnosis of pseudofolliculitis barbae is purely clinical; optical magnification can help to see the ingrowing hair. Pseudofolliculitis barbae is suspected when painful, purulent pustules are also present, which can be swabbed to identify Staphylococcus infection. sycosis barbae it is instead a type of folliculitis from deep hair removal in which the infection has spread and has also triggered an autoinflammatory response.
To prevent folliculitis, try to keep your skin clean and moisturised, and avoid shaving too closely or using harsh soaps.
When attempting to shave, whether it's your beard or other body hair, do so gently: only shave in the direction of hair growth (avoid shaving against the grain), or use an electric razor. Always use new, sharp blades, moving slowly, and avoid cutting the hair below skin level by pressing too hard with the razor. Do not use the razor directly on dry skin; instead, use gel or foam. Avoid using soap as it can dry out the skin, and in any case, avoid all products that can irritate the skin before, during, and after shaving.
If you shave excess hair from your legs, groin or underarms in the shower or during a bath, it's best to do it at the end of these so that your skin is softer and the dead skin cells have already been washed away. After shaving, avoid tight or rough clothing. Wash immediately if you have sweated a lot. To try and prevent ingrown hairs, it can be helpful to exfoliate your skin and remove the surface layer of dead skin cells; this can also help to bring already ingrown hairs to the surface. Consider permanent removal of excess hair or from areas where hair tends to become ingrown and cause folliculitis. Laser hair removal.
Folliculitis is usually treated with antibiotics, which can be topical or oral. Warm compresses can also help to soothe the area and promote healing. Severe cases may require minor surgery to drain the infected follicles.
If folliculitis or pseudofolliculitis is already present, you should avoid shaving (in recurrent cases, it may be necessary not to shave for up to three months). For inflammation and itching, a doctor may prescribe a topical corticosteroid cream. In cases of follicular hyperkeratosis, tretinoin or other Vitamin A derivatives may be recommended, always in the form of creams or gels to be applied directly to the skin. If inflammation has caused dark spots (post-inflammatory hyperpigmentations or PIH), the doctor generally recommends treatments with Hydroquinone (compounded cream) or other agents that interfere with the skin's melanin production process. In cases where folliculitis is due to a bacterial infection, antibiotic coverage is indicated, usually against Staphylococcus aureus, but an antibiogram can be performed on the pus that emerges from the skin lesions to select the antibiotic to which the responsible bacterium is most sensitive.
In most cases, for milder forms of folliculitis, the condition will resolve on its own within a few days or weeks without the need for medication, by following the precautions described above. Never squeeze folliculitis pustules, as this is to try and avoid them leading to scars and skin blemishes. If necessary, you can apply cool compresses with gauze to reduce inflammation in the affected areas. It is also very important to always use clean towels until the condition has completely cleared.
