What is the treatment for nasal folliculitis?

From the Guidelines

Nasal folliculitis can be effectively treated with the application of mupirocin ointment twice daily in the anterior nares for the first 5 days each month, which reduces recurrences by ∼50%. This treatment approach is based on the evidence that the major method of controlling recurrent furunculosis, including nasal folliculitis, is the use of antibacterial agents to eradicate staphylococcal carriage 1.

Key Considerations

• The prevalence of nasal staphylococcal colonization in the general population is 20%–40%, and eradicating this colonization is key to preventing recurrent infections 1.
• For persons with nasal colonization, the use of mupirocin ointment is a recommended approach, with a regimen of twice daily application for the first 5 days each month 1.
• In some cases, oral antibiotics such as clindamycin may be necessary, with a single oral daily dose of 150 mg for 3 months decreasing subsequent infections by ∼80% 1.

Additional Measures

• Gentle cleansing of the affected area twice daily using antibacterial soap or a cleanser containing benzoyl peroxide 2.5-5% may also be beneficial.
• Warm compresses applied to the affected area for 10-15 minutes several times daily can help reduce inflammation and promote drainage.
• It is essential to avoid picking or squeezing the lesions as this can worsen infection and lead to scarring.

Monitoring and Follow-up

• If symptoms don't improve within 3-5 days of treatment, or if you develop fever or spreading redness, seek medical attention as this could indicate a more serious infection.

From the Research

Treatment for Nasal Folliculitis

• The treatment for nasal folliculitis may involve the use of isotretinoin, as demonstrated in a study published in the Journal of the American Academy of Dermatology 2, which showed a rapid and complete clinical response in patients with gram-negative folliculitis.
• Another option for treatment is the use of mupirocin ointment, which has been shown to be effective in eradicating nasal carriage of Staphylococcus aureus 3, 4.
• Topical antibiotics, such as mupirocin, may also be used to treat nasal folliculitis, as they have been shown to be effective in treating various skin infections, including those caused by Staphylococcus aureus 5, 4.
• In some cases, the treatment of nasal folliculitis may be related to the treatment of sinusitis, as sinusitis can be a complication of nasal folliculitis, and antibiotics may be used to treat both conditions 6.

Mechanism of Action

• Isotretinoin has been shown to have a decided advantage over previously reported therapies for gram-negative folliculitis, with a rapid and complete clinical response 2.
• Mupirocin ointment works by reversibly inhibiting isoleucyl-transfer RNA, thereby inhibiting bacterial protein and RNA synthesis, and has been shown to be effective in eradicating nasal carriage of Staphylococcus aureus 3, 4.
• Topical antibiotics, such as mupirocin, have a unique structure and mechanism of action, and have been shown to be effective in treating various skin infections, including those caused by Staphylococcus aureus 5, 4.

Clinical Efficacy

• The use of isotretinoin has been shown to result in a rapid and complete clinical response in patients with gram-negative folliculitis 2.
• Mupirocin ointment has been shown to be effective in eradicating nasal carriage of Staphylococcus aureus, with a statistically significant reduction in S. aureus infection rates 3.
• Topical antibiotics, such as mupirocin, have been shown to be effective in treating various skin infections, including those caused by Staphylococcus aureus, with a significant reduction in infection rates 5, 4.