Folliculitis

Folliculitis is a skin condition caused by the infection of hair follicles. Hair follicle is a small sac out of which hair grows. When small pus-filled bumps develop at the base of a hair, often in clusters, it is said to be Folliculitis. It can occur anywhere on the skin or scalp. However, Folliculitis typically occurs at the sites that are prone to friction. Shaving and friction from tight clothes are the most common culprits that damage the hair follicles. Poor hygiene, obesity, skin injuries, wounds, excessive sweating, weak immune system are also some of the causes that damage the hair follicles.

These impaired follicles thrive a bacteria called Staphylococcus (staph) and lead to an infection. Beard area of men, arms, legs, armpits and buttocks are the most common areas affected by Folliculitis. Though Folliculitis is primarily a bacterial infection, it can even be caused by virus (herpes simplex virus), fungi (tinea capitis), or yeast. Barber's itch is a staph infection of the hair follicles in the beard area of the face. It worsens on shaving. Tinea barbae is similar to barber's itch, but the infection is caused by a fungus.

Deep-seated and chronic lesions are called sycosis. Hot tub Folliculitis refers to pustules and lesions that result from bathing in a contaminated hot tub or public swimming pool.

Symptoms

Folliculitis presents itself with symptoms such as itchy, white, pus-filled bumps in clusters, surrounded by red inflamed skin associated with tenderness and pain. There is whitish blood-tinged discharge from the boils. Tenderness and pain might be experienced. Mere observation of symptoms is often enough for the doctor to diagnose Folliculitis. However a biopsy may be ordered in case of severe infection.

Treatment

Mild form of Folliculitis does not need treatment and usually clears off with self care practices. Washing the area with medicated lotions, maintaining hygiene and applying hot compress over the affected region helps relieve the symptoms of Folliculitis. Natural products like Aloe Vera gel, Neem (Azadirachta indica) juice and coconut oil are highly effective in treating Folliculitis.

In case of severe infection, doctor may prescribe topical anti bacterial creams and washes containing benzoyl peroxide (Clearasil, Proactiv), chlorhexidine (Hibiclens), Phisoderm and may also treat with oral antibiotics such as tetracycline or minocycline.

Pruritus

Pruritus is a skin disease associated with conditions pertaining to autoimmune disorders and other advanced complications like liver cirrhosis. Pruritus cases vary from mild to complex as the symptoms associated with the condition generally aggravate with age. Untreated pruritus can be a big hindrance to an individual's normal life as it interferes with sleep patterns leading to irritability and stress. In some cases the causative agent for this disease is the Hepatitis C virus which accounts in 20% of the population.

Pruritus occurs mostly in the wrist and ankles as a scratch. The intensity of the itch facilitates other factors such as eczema, impetigo and induced urticaria. The immune response releases histamines causing allergic reactions. The association of pruritus with allergic reactions is identified by the presence of serotonin. The serotonin release caused because of pruritus occurs in case of preexisting medical conditions such as polycythemia, lymphoma and cholestasis.

The identification and diagnosis of pruritus is closely associated with the evaluation of dermatological condition of the patient. Progressive pruritus is noticed with contact dermatitis, urticaria, scabies, pediculous infections of the genital region, folliculitis and xerotic eczema.The factors associated with the respective causes along with pruritus are fomites, dust, bites, chemicals and photosensitivity. Atopic dermatitis induces aggressive form of pruritus. The intense forms of atopic dermatitis associated pruritus usually occur in pregnant women, infants and veterans. Systemic causes of pruritus involve preexisting conditions such as Hodgkin's lymphoma, HIV, scleroderma, multiple myeloma, chronic renal failure and many other conditions.

Pruritus diagnosis involves meticulous procedures in examining the exact history of the patient to rule out other forms of allergic reactions. The information pertaining to the patient history includes several factors such as travel zones, food and occupation. Differentiation of non-septic and septic forms is done to identify systemic involvement of the disease. Secondary infections and malignancies associated have to be identified. Specific sites are identified on the skin reaction to respective drug therapy is carefully monitored.

Pruritus treatment

Avoid stress which delays the healing process. Topical creams are prescribed for allergic forms of pruritus. Skin cleansing is an important step. It is predominantly done to prevent secondary infections and conditions such as psoriasis. Patients who have history of sunburn and sensitivity to extreme temperatures need to relieve the stress upon immune system that reacts immediately to such conditions. Hydration of the skin helps in the restoration of the skin cells to facilitate the process of healing. Change of diet and lifestyle is prescribed to patients who are sensitive foods such as nuts, seafood etc. Patients with a history of contact dermatitis are advised to use skin safe deodorants, shampoos and bubble bath solutions. Oral antihistamines are recommended to ease the immune system's reactivity. Hot water bath and tight clothing are to be avoided in case of pruritus as it may aggravate the condition. Topical creams containing corticosteroids are recommended during the onset of a pruritic reaction. In case of secondary infections associated with pruritus, antibiotics are given.