From the Guidelines
Superficial folliculitis is a common skin infection characterized by inflammation of the hair follicles, typically caused by Staphylococcus aureus 1.
Key Characteristics
- Inflammation is more superficial compared to furuncles or carbuncles, with pus limited to the epidermis 1
- Usually occurs on hairy skin 1
Treatment
- Treatment involves topical or oral antibiotics, such as mupirocin 2% ointment applied twice daily for 7-10 days or cephalexin 250-500mg orally every 6 hours for 7-10 days
- In mild cases, over-the-counter antibacterial washes containing chlorhexidine or benzoyl peroxide may be sufficient, used twice daily for 7-10 days Some studies suggest that Gram-positive bacteria, particularly Streptococcus aureus, are the primary cause of superficial skin infections, including folliculitis 1.
Important Considerations
- Incision and drainage is not typically necessary for superficial folliculitis, as it is usually limited to the epidermis 1
- Antibiotic therapy should be targeted against Gram-positive bacteria, including Staphylococcus aureus 1
From the Research
Definition of Superficial Folliculitis
- Superficial folliculitis is an inflammatory reaction in the superficial aspect of the hair follicle, involving the follicular opening or the perifollicular hair follicles 2.
- It is an infection of hair follicles, mostly caused by Staphylococcus aureus 3.
- The condition can manifest as 1mm-wide vesicles, pustules, or papulopustules in acute cases, while hyperkeratosis and keratotic plug formations are indicative of a chronic process 2.
Characteristics and Causes
- Superficial folliculitis can be caused by infectious agents such as bacteria, fungi, or viruses, as well as inflammatory conditions like rosacea, acneiform eruption, and Ofuji syndrome 4.
- The presence of superficial pustules does not always imply an infectious origin, as there are many noninfectious types of folliculitis 2.
- The pilosebaceous unit of the follicle is divided into three compartments: the infundibulum, the isthmus, and the inferior segment, which forms the basis for evaluating the clinical manifestations of folliculitis 2.
Treatment Options
- Topical benzoyl peroxide is a first-line nonantibiotic treatment for simple folliculitis 3.
- Mupirocin and clindamycin are topical antibiotic options, while oral cephalexin or dicloxacillin can be used for treatment-resistant cases 3.
- Azelaic acid 15% foam has been shown to be a useful treatment or adjunctive therapy for folliculitis, reducing lesional erythema, inflammatory papule size, and overall folliculitis assessment 5.
- Mupirocin 2% ointment has also been proven to be effective and safe in the treatment of primary and secondary skin infections, including folliculitis 6.