Folliculitis and Skin Abscesses

Folliculitis

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Image provided by Thomas Habif, MD.

Folliculitis is inflammation or infection in a hair follicle (where a hair grows out from your skin). When due to infection, it's a type of very small skin abscess.

• Folliculitis is usually caused by infection with bacteria

• "Hot tub folliculitis" is a type of folliculitis that is caused by certain bacteria that can grow in a hot tub or whirlpool

• Folliculitis looks like a tiny red or white pimple at the base of a hair

• Infected follicles are itchy or slightly painful

• Antibiotic lotion or gel usually cures folliculitis

Most types of folliculitis are caused by bacteria, usually Staphylococcus bacteria (staph infection). Other types of bacteria and fungus can also cause folliculitis.

You usually get folliculitis where your skin is moist or irritated from rubbing, such as the skin that's under sports equipment or on your buttocks. You are more likely to get folliculitis if you are an older adult or have:

• Injuries to your skin

• Obesity

• Diabetes

• A weakened immune system

Sometimes, stiff hairs can reenter the skin (ingrown hairs) after shaving and cause folliculitis that isn't infected

• Tiny red or white pimples in a hair follicle

• The pimples can be itchy or slightly painful

• You may have one or many infected follicles

• If infected follicles get bigger and go deeper, they can become skin abscesses (boils)

Doctors may have you:

• Wash your body with antibacterial soap

• Wet a washcloth with warm salt water and apply it to the folliculitis a few times a day

• Put antibiotic cream on your skin

• Take antibiotics by mouth, if you have a large area of infected follicles

If you regularly get ingrown hairs, doctors may have you:

• Stop shaving for a while

• Take antibiotics, if the follicles are infected

Hot tub folliculitis will go away on its own. Check and fix the chlorine level of the hot tub to prevent other people from getting folliculitis.

Skin abscesses are pockets of pus in your skin. Pus is a thick fluid your body makes when it fights infection. You can also have abscesses inside your body.

• Skin abscesses are caused by a bacterial infection, usually due to Staphylococcus bacteria (staph infection)

• Sometimes, you get the bacteria through a break in the skin or a hair follicle (where the hair grows out)

• Abscesses are painful bumps full of pus

• Doctors will cut the abscess open to drain the pus and sometimes also give you antibiotics

Two specific kinds of skin abscesses are:

• Furuncles (boils): skin abscesses that form around hair follicles

• Carbuncles: more than one furuncle connected together deeper in the skin

Bacteria may spread from a skin abscess and infect other tissue and organs in your body.

Skin Abscess

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If the infection gets into the blood stream, you can have high fever, low blood pressure, and organ failure (sepsis).

Furuncle (Boil)

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Photo provided by Thomas Habif, MD.

You may get skin abscesses over and over again for unknown reasons.

Skin abscesses are caused by a bacterial infection, usually due to Staphylococcus (staph infection). One type of staphylococcus that can cause cellulitis is known as MRSA (methicillin-resistant Staphylococcus aureus). MRSA is resistant to many antibiotics and can be hard to treat.

You are more likely to have a skin abscess if you are an older adult or have:

• Injuries to your skin

• Obesity

• Diabetes

• A weakened immune system

Skin abscesses can be anywhere on your body.

• They are red, swollen bumps that hurt a lot and are very tender to touch

• Furuncles are red, shiny, and usually less than an inch (2.5 centimeters) across

• Abscesses that aren't furuncles can grow up to about 2 or 3 inches (5 to 7 centimeters)

• If not treated, abscesses get bigger, break open, and let the pus out

• You may have a fever and feel sick

If the abscess is small, doctors will have you put mild heat, such as a warm cloth or hot water bottle, on it. If that doesn't work, doctors will:

• Cut the skin abscess open and drain the pus

• Wash out the pus pocket with a salt solution

Doctors may also put gauze in the pocket for 1 to 2 days to keep it open so that it will continue to drain.

Most skin abscesses don't need antibiotics. However, doctors may give you antibiotics if:

• You have many abscesses

• The infection has spread to nearby skin (cellulitis)

• You have a weakened immune system

If you get skin abscesses again and again, doctors will:

• Have you to wash your skin with antiseptic liquid soap

• Give you antibiotics for 1 to 2 months