Folliculitis and skin abscess

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What is it about ?

Folliculitis is inflammation of one or more hair follicles. Hair follicles are tiny pockets in the top layer of the skin (epidermis), from which body hair and hair grows. They have small blood vessels, nerves and sebaceous glands, which secrete sebum. The sebum preserves the suppleness of the hairs and the hair and prevents their drying out.

Folliculitis occurs in different ways. The skin can for example be damaged by shaving, rubbing tight clothes, waxing, etc. The use of chemicals such as soaps, ointments and oils may also clog the sebaceous glands. The skin is then irritated and more susceptible to infections.

Infections are usually caused by the bacteria known as Staphylococcus aureus. When the focus of infection spreads from the hair follicle to the surrounding skin and subcutaneous tissue, a skin abscess or boil forms. When several boils appear in the same place, it is called anthrax. Skin abscesses are more common in people with weakened immune systems, such as diabetes, AIDS and undernutrition.

How to recognize them?

Inflamed follicles look like small, red, painful nodules on the skin where a hair grows. A skin abscess is larger and presents the 4 classic signs of inflammation: local heat, redness, pain and swelling.

At first it looks like a hard ball. When it fills with pus, it softens and a white, yellow or green tip (swirl) appears in the center. It can puncture spontaneously and let the pus drain. Then the skin cells die and a black plug or scab (necrosis) forms. Often it heals spontaneously, leaving a small scar.

How is the diagnosis made?

The appearance is very characteristic. The diagnosis is therefore easy to establish. In people who have recurrent folliculitis or skin abscesses, the doctor will send a sample of the pus to the lab for culture. A blood test will also be done to check for a possible underlying disease such as diabetes.

What can you do ?

The most important thing is to have good personal hygiene. Wash yourself with soap and water and rinse your skin well. Don’t go overboard with cosmetics. They can clog hair follicles and sebaceous glands.

If you injure yourself while waxing or shaving, disinfect the wounds well with chlorhexidine or povidone iodine. Avoid puncturing the pimple or abscess. You would only remove superficial pus, but drive deeper residue even further. It is best to pull on the skin so that the pus and dead tissue will come to the surface.

What can your doctor do?

In the event of folliculitis or small abscesses, the doctor will prescribe a disinfectant and / or an antibiotic cream to be applied locally. Larger abscesses should be incised. Severe cases of folliculitis accompanied by large abscesses, abscesses in the face, or underlying illnesses such as diabetes require treatment with antibiotics.

Want to know more?

Source

Foreign clinical practice guide ‘Skin abscess and folliculitis’ (2000), updated on 23.05.2017 and adapted to the Belgian context on 01.07.2017 – ebpracticenet

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