What are these Conditions?

Folliculitis is a bacterial infection of the hair follicle that causes formation of a pustule - a collection of pus beneath the outer skin layer. The infection can be superficial or deep.

Folliculitis may also lead to the development of furuncles (furunculosis), commonly known as boils, or carbuncles (carbunculosis). The prognosis depends on the severity of the infection and on the person’s physical condition and ability to resist infection.

What Causes them?

The most common cause of folliculitis, boils, or carbunculosis is a bacterium called Staphylococcus aureus. Factors that increase a person’s risk of developing these conditions include an infected wound, poor hygiene, debilitation, diabetes, cosmetics that clog pores, tight clothes, friction, exposure to chemicals, and treatment of skin lesions with tar or with occlusive therapy, using steroids. Boils often follow folliculitis that’s exacerbated by irritation, pressure, friction, or perspiration. Persistent infection and boils may lead to carbunculosis.

What are their Symptoms?

Pustules of folliculitis usually appear on the scalp, arms, and legs in children; on the face of bearded men; and on the eyelids. Deep folliculitis may be painful.

Folliculitis may progress to hard, painful boils, which commonly develop on the neck, face, underarms, and buttocks. These boils enlarge for several days and then rupture, discharging pus and necrotic material. After they rupture, pain subsides, but redness and swelling may persist for days or weeks.

Carbunculosis is marked by extremely painful, deep abscesses that drain through many openings onto the skin surface, usually around several hair follicles. Fever and malaise may accompany these lesions.

How are they Diagnosed?

The presence of characteristic skin lesions confirms folliculitis, boils, or carbunculosis. A wound culture performed in a lab reveals the infecting organism. In carbunculosis, the person’s history reveals preexistent boils. A complete blood count may show an elevated number of white blood cells.

How are they Treated?

Treatment of folliculitis consists of cleaning the infected area thoroughly with soap and water; applying warm, wet compresses to promote drainage from the lesions; topical antibiotics, such as Bactroban ointment; and in extensive infection, systemic antibiotics (E-Mycin or Dynapen). Boils may also require incision and drainage of ripe lesions after application of warm, wet compresses, and topical antibiotics after drainage. Carbunculosis is treated with systemic antibiotics.