Holistic Solution to get rid of Folliculitis
Hidradenitis suppurativa (HS) is recurrent inflammation of the apocrine sweat glands, particularly those of the axilla, genital, and perianal areas. It can result in obstruction and rupture of the duct and secondary infection. The lesions generally drain spontaneously, with formation of multiple sinus tracts and with hypertrophic scarring. Although not initially infected, the lesions frequently become secondarily infected. Often, patients with HS also are afflicted with acne, pilonidal cysts, and chronic scalp folliculitis thus, giving rise to the term follicular occlusion tetrad.
In many instances, infections of the epidermis and deimis extend and can become subcutaneous infections and even reach the fascia and or muscle. For example, erysipelas (Figure 60-3) can become a subcutaneous cellulitis and thereafter a streptococcal necrotizing fasciitis. Similarly, folliculitis can readily become a subcutaneous abscess or a carbuncle that can extend to the fascia. Cellulitis also can frequently extend to the subcutaneous tissues (Figure 60-4). Anaerobic cellulitis is
Various disorders affect pilosebaceous units, although these diseases are rarely life threatening. Three types of skin cysts exist epidermoid cysts result from squamous metaplasia of a damaged sebaceous gland, while trichilemmal cysts and steatocys-toma are both genetically determined structural aberrations of the pilosebaceous duct. Accumulation of material in the follicular lumen results in distension of the follicle, leading to the formation of noninflamed lesions that are typical of acne, which is the most common follicular disease. In terminal follicles, plugging of the pilosebaceous duct may occur and result in keratosis pilaris. Inflammation around follicles is often seen at the skin surface, for example in folliculitis or acne. In folliculitis, there is extensive colonization of the follicular lumen by microflora.
Localized skin infections may involve hair follicles (i.e., folliculitis) and spread deeper to cause boils (i.e., furuncles). More serious, deeper infections result when the furuncles coalesce to form carbuncles. Impetigo, the S, aureus skin infection that involves the epidermis, is typified by the production of vesicles that rupture and crust over. Regardless of the initial site of infection, the invasive nature of this organism always presents a threat for deeper tissue invasion, bacteremia, and
Several different techniques may be used, according to the characteristics of the individual patient (Table 2). Shaving does not increase the rate of hair growth, as erroneously thought by many patients, but it leaves an unpleasant sharp stubble. Therefore, other procedures are generally preferred. Waxing and plucking may be effective, but there is the risk of folliculitis and in-grown hairs. Furthermore, skin irritation may sometimes induce a paradoxical increase in local hair growth. In addition, these complications may subsequently make more difficult the removal of hairs by electrolysis. For these reasons, several authors strongly discourage their use, in particular in women with clinically significant degrees of hirsutism.
Folliculitis, furunculosis, and carbundes are localized abscesses either in or around hair follicles. These infections are distinguishable from one another based on size and the extent of involvement in subcutaneous tissues. Table 60-2 summarizes each infection's respective clinical features. For the most part, these infections are predpitated by blockage of the hair follide with skin oils (sebum), or minor trauma resulting from friction such as that caused by clothes rubbing the skin. Staphylococcus aureus is the most common etiologic agent for all three infections. Members of the family Enterobacteria-ceae can also cause folliculitis, albeit much less commonly. Also, outbreaks of folliculitis caused by Pseudomonas aeruginosa and associated with the use of whirlpools, swimming pools, and hot tubs have been reported.9
Coal tar preparations have been used for many years in the management of AD. Although topical corticosteroids have generally replaced the routine use of these kera-tolytic agents, they are still effective in the management of chronic, lichenified skin lesions that respond poorly to corticosteroids. The mechanism by which coal tar preparations work is unknown, but clinical evidence has shown that they have both antiinflammatory and antipruritic effects. These preparations are will tolerated, but prolonged use may lead to folliculitis and photosensitivity. Shampoos containing tars are especially useful in the patient with scalp involvement (i.e., as in both AD and seborrhea).
Eflornithine is an irreversible inhibitor of ornithine decarboxylase. This enzyme catalyzes the conversion of ornithine to polyamines, which are involved in the regulation of cell growth and differentiation in several tissues. The enzyme is modulated by androgens and takes part in the physiology of hair growth, regulating the proliferation of matrix cells in the hair follicle. Studies have indicated that blockade of this enzyme activity in hair follicles slows hair growth, and the drug has recently been licensed for topical treatment of facial hirsutism. Percutaneous absorption of the drug is negligible. In short-term clinical studies, eflornithine 11.5-15 cream was better than placebo in reducing hair growth in women with unwanted facial hair, as demonstrated by objective and subjective methods (11). However, hair growth returned to pretreatment rates within a few weeks after stopping treatment. Mild irritation and folliculitis may affect the skin with treatment. Anecdotal evidence...