From the Guidelines
Folliculitis in toddlers can be effectively managed with gentle cleansing, topical antibiotics, and oral antibiotics in moderate cases, as recommended by recent guidelines 1. The diagnosis of folliculitis is typically based on clinical presentation, with small red bumps or pustules around hair follicles, and can be confirmed with Gram-stain and culture of lesions 1.
Treatment Options
- For mild cases, apply over-the-counter antibiotic ointment like Bacitracin or Neosporin to affected areas 2-3 times daily for 7-10 days.
- For moderate cases, topical antibiotics like mupirocin (Bactroban) or oral antibiotics such as cephalexin (Keflex) dosed by weight may be prescribed if the infection is widespread or not improving 1.
- Warm compresses for 15 minutes several times daily can help drain pustules.
Prevention and Management
- Prevent recurrence by maintaining good hygiene, using fresh towels and washcloths, and changing your toddler's clothes daily.
- Keep the area clean and dry, and avoid tight clothing that can irritate the skin.
- Seek medical attention if the folliculitis worsens, spreads, is accompanied by fever, or doesn't improve within a week of home treatment. The most recent and highest quality study 1 prioritizes the assessment of the necrotizing or non-necrotizing character of the infection, anatomical extension, characteristics of the infection, and clinical conditions of the patient to classify patients with soft-tissue infections, including folliculitis.
From the Research
Diagnosis of Folliculitis in Toddlers
- The diagnosis of folliculitis is typically based on history and clinical appearance, and may involve direct microscopy of a potassium hydroxide preparation or culture to confirm the presence of a fungal or bacterial infection 2.
- In some cases, folliculitis may be caused by an infestation of Demodex folliculorum, which can be detected by standardized skin surface biopsy or examination of epilated eyelashes 3.
Treatment of Folliculitis in Toddlers
- Treatment of folliculitis depends on the underlying cause, and may involve topical or oral antibiotics, antifungals, or other medications 4, 2, 5.
- For bacterial folliculitis, treatment may include antibiotics such as cephalexin, minocycline, or doxycycline, and may also involve the use of topical antibacterials such as benzoyl peroxide 4, 5.
- For fungal folliculitis, treatment may include antifungal medications such as ketoconazole, which has been shown to be effective in treating seborrhoeic dermatitis and other fungal infections 6.
- In cases of Demodex folliculorum infestation, treatment may include oral ivermectin or combined ivermectin-metronidazole therapy, which has been shown to be effective in reducing the mite count and improving clinical symptoms 3.