What Is Folliculitis and What Does it Have to do With Hair Transplants?
Hot tubs, close shaves, and hair restoration surgery all have something in common: they can lead to folliculitis. When hair follicles become inflamed or infected, the result is those annoying little pimple-like bumps that pop up on your skin.
Though the majority of cases are more annoying than dangerous, untreated folliculitis can evolve into bigger problems.
What Is Folliculitis or an Infected Hair Follicle?
One of the most common conditions affecting skin, folliculitis occurs when hair follicles get rubbed, blocked or infected causing a small red bump to form around a hair. It can be anywhere on your body, but it is most common on the scalp, beard/neck, torso and legs.
Also called razor bumps, barber’s itch, hot tub rash, heat rash or shaving rash; folliculitis can cause symptoms beyond just unsightly red bumps. These may include:
- Bumps with whiteheads
- Pus-filled bumps that can break open and crust over
- Painful skin
- Dark spots and scars
What Causes Folliculitis?
Folliculitis is technically the general term for any problem that causes an inflammation or infection of your hair follicle.
When it is infectious, folliculitis is most often caused by Staphylococcus aureus (Staph). Though “staph” is sometimes associated with life-threatening infections, this is actually a very common bacterium with 30% of the general population regularly carrying it, according to the CDC.
However, folliculitis can also be caused by other factors including:
- Ingrown hairs
- Occlusive Clothing, Helmets or Straps
- Excess sweat
- Hormones (anabolic steroids)
Undergoing a hair transplant or hair restoration surgery can also cause folliculitis; Usually occurring between the first couple of weeks post-procedure up to about six months. A few bumps here are there is normal, but more than that should be reported to your doctor immediately. Through the process of the hair transplant, grafted hairs are placed into small holes in the balding areas. These initial grafts, or newly emerging hairs, can become ingrown. Typically, this is minor and the ingrown hair follicles will clear up on their own without any negative effects on the grafts. However, if you experience excessive bumps, pustules, pain, redness, or see more than five infected follicles at a time, call your doctor because left unchecked, folliculitis definitely will decrease the final growth of your transplant.
When it comes to shaving, every time you run the blade over your skin, it opens up and irritates follicles. It also introduces dirt, and bacteria living on your razor into your skin. Shaving very close, especially in patients with very coarse or afro-centric hair often leads to folliculitis in the beard & neck area. Also, repeatedly shaving over the same area increases the chances of developing folliculitis.
Hot tubs are known for a particular type of folliculitis caused by Pseudomonas aeruginosa bacteria. This comes from not maintaining proper chemicals in the hot water and allowing this bacteria to over grow. Keeping your chemicals in check will prevent this.
How Can I Treat an Infected Hair Follicle?
First of all, don’t pick! Picking at your skin only makes things worse and increases the chance for scarring.
Treatment starts with proper skin care. Carefully clean the area twice a day with an antibacterial soap or medicated shampoo (such as zinc pyrithione). Do not use a loofa, clean fingertips are your best cleansing tool, and always use a clean towel or washcloth.
Over the counter acne remedies can be helpful. Acne washes or gels contain salicylic acid or benzoyl peroxide which help unclog follicles, kill bacteria and reduce inflammation. Avoid products that are oily or greasy, as they will worsen follicle blockages.
For the majority of people, the condition resolves with simple skin care. However, sometimes cases are stubborn. If the irritated area is growing, keeps reoccurring, causes excessive pain, or looks infected, see a Board Certified Dermatologist.
A Dermatologist can usually diagnose the problem instantly simply by examining you, or they may do a quick swab test to verify an underlying infection. Depending on the severity, they may prescribe oral or topical medications, which include antibiotics, antifungals or steroids.
How Can I Prevent Folliculitis?
If bacteria, dirt, sweat, occlusive clothing, friction, poorly maintained water, hormones and other blockages usually cause the problem, avoiding these culprits is the key when it comes to preventing future bumps.
To prevent folliculitis from shaving, always use a clean razor blade and shave IN THE DIRECTION of the hair NOT AGAINST it. Avoid shaving too close or more often than necessary to minimize chances of follicle irritation.
Avoid tight clothes that trap sweat, heat, and other particles close to your skin. You should change clothes as soon as possible after a workout. Also, ensure that all clothes and towels are properly washed after each use.
Folliculitis is rarely contagious but it should go without saying that sharing sweaty or dirty clothes and sporting gear should also be avoided. When participating in contact sports like football or wrestling, it can be helpful to keep antibacterial wipes or OTC acne pads in your bag to wipe the gear and/or your body before and after use.
Even if your folliculitis is mild and resolves quickly, it’s important to prevent reoccurrences. Small infections can become serious, leading to abscesses or other more serious infections. Also, folliculitis where you have “terminal hair” like the scalp and beard areas can eventually cause scarring and hair loss.
At the Limmer Hair Transplant Center we are concerned about all aspects of your hair care. We want your hair restoration results to be their very best and preventing and treating folliculitis can be part of that. Any inflammation of the scalp is not good for native or transplanted hair so recognizing and treating it are important for healthy hair growth.