Scalp folliculitis is a common skin condition that causes inflammation of the hair follicles on the scalp. It can lead to itchy, red, pimple-like bumps forming around the base of the hair shaft. Understanding what scalp folliculitis looks like can help you identify it and seek proper treatment.
What are the symptoms of scalp folliculitis?
The main symptoms of scalp folliculitis include:
- Small red bumps around hair follicles
- Pus-filled pimples
- Itchy scalp
- Tender or painful scalp
- Crusting around the base of hair follicles
- Hair loss in severe or chronic cases
The bumps can range in size from pinpoint to several millimeters wide. They tend to be most pronounced around the hairline, back of the scalp, and along the part line. The surrounding skin may appear red and inflamed.
What causes scalp folliculitis?
There are a few potential causes of scalp folliculitis:
- Bacterial infection – The most common cause is an infection with bacteria, especially Staphylococcus aureus. The bacteria invade and inflame the hair follicles.
- Fungal infection – Fungal organisms like Malassezia can infect the scalp and hair follicles leading to folliculitis.
- Clogged hair follicles – Anything that clogs up the follicles, such as oil, skin cells, hair products, or sweat can cause swelling and inflammation.
- Irritation – Chronic rubbing, friction, or scratching of the scalp can damage follicles and make them prone to infection.
- Skin conditions – Scalp psoriasis, seborrheic dermatitis, acne, and other skin diseases can trigger folliculitis.
- Immune deficiency – People with weakened immune systems are more vulnerable to folliculitis.
Who is at risk for developing scalp folliculitis?
You may be more likely to get scalp folliculitis if you:
- Have a history of skin conditions like acne, psoriasis, or dermatitis
- Frequently use hair products like gels, mousses, or pomades
- Regularly wear tight hats, helmets, or headgear
- Have an underlying illness like diabetes or cancer
- Have a weakened immune system
- Are obese or overweight
- Are going through hormonal changes like puberty or menopause
What are the different types of scalp folliculitis?
There are a few variants of scalp folliculitis:
- Acute folliculitis – Sudden onset of pus-filled pimples that resolve within 2-3 weeks.
- Chronic folliculitis – Persistent, recurrent bouts of pustules and bumps that last over 3 weeks.
- Pseudofolliculitis barbae – Occurs after shaving and affects curly bearded men. Leads to razor bumps.
- Eosinophilic pustular folliculitis – Rare condition causing itchy pustular lesions in people with cancers, HIV/AIDS, or autoimmune disorders.
How is scalp folliculitis diagnosed?
Scalp folliculitis is often diagnosed just by examining the appearance of the bumps and listening to your symptoms. However, your doctor may also:
- Take a sample of the pus to identify the type of germ causing infection
- Examine plucked hairs under a microscope
- Perform a skin biopsy to inspect the hair follicles
- Order blood tests if an underlying condition is suspected
It’s important to see a dermatologist if you have severe, widespread, or recurrent folliculitis to rule out other possible skin disorders.
What does mild scalp folliculitis look like?
Mild cases of scalp folliculitis cause scattered pimples and small red bumps concentrated around a few hair follicles. There may be some minor itching or irritation but not much pain. The skin won’t appear too red or swollen. This limited folliculitis often clears up on its own or with basic home treatment.
Images of mild scalp folliculitis:
What does moderate scalp folliculitis look like?
Moderate scalp folliculitis involves more pronounced inflammation and bumps scattered widely across the scalp. There will likely be some itching and tenderness. You may notice some flakes or crusting around the hair follicles. The bumps contain visible pus and fluid. Redness and swelling spreads beyond each lesion. Treating moderate folliculitis often requiresprescription medication.
Images of moderate scalp folliculitis:
What does severe scalp folliculitis look like?
With severe scalp folliculitis, there is inflammation across large areas of the scalp. The lesions are densely clustered with significant pus, oozing, and crusting. Pain and itching are more pronounced. There may be signs of hair loss, scarring, and skin discoloration from long-standing inflammation. Severe cases often warrant oral antibiotic treatment or steroid injections.
Images of severe scalp folliculitis:
How to treat scalp folliculitis
Treatment for scalp folliculitis may include:
- Antibacterial shampoos and washes
- Antibiotic pills or creams
- Steroid injections for severe cases
- Oral antifungal medicine for fungal folliculitis
- Isotretinoin for severe acne-related folliculitis
- Avoiding triggers like greasy products, tight hats, and friction
Properly treating the underlying cause is key to stopping recurrence of the folliculitis bumps.
When to see a doctor
Consult a dermatologist promptly if you have:
- Severely inflamed or painful lesions
- Folliculitis that keeps recurring
- Signs of infection spreading beyond the hair follicles
- Hair loss along with scalp folliculitis
- Fever, immune deficiency, or other systemic symptoms
- No improvement with over-the-counter medication
Getting proper treatment can help minimize scarring hair loss and other complications of scalp folliculitis.
Conclusion
Scalp folliculitis can range from mild red bumps to widespread pus-filled pimples with crusting and hair loss depending on severity. Recognizing the characteristic signs and symptoms of folliculitis is key to differentiating it from other possible skin conditions. Prompt diagnosis allows timely treatment to control the inflammation and prevent any permanent damage to the scalp and hair follicles.