DID YOU KNOW? Most hair loss caused by follicle infection is reversible -- but only if you act quickly to treat the infection before hair follicles die.
A hair follicle infection is something you would never think about, that is, until it happens to you. When you see the telltale red pimples or pustules at your hairline or feel the pain and inflammation of a large boil on your scalp, you have a hair follicle infection. You may even notice hair loss that occurs at the site of the inflammation, which can further be susceptible to a secondary bacterial or fungal infection occurring. This is an issue that needs to be treated by a dermatologist, not a hair loss treatment specialist.
“The most important thing,” advises Dr. Valerie Callender, M.D., board-certified dermatologist and director of the Callender Skin & Laser Center in the Washington, D.C., area, “is to get to a dermatologist as soon as possible to get a culture taken of the inflamed follicles. You need to determine the cause and whether there is any bacterial or fungal secondary infection in order to treat it successfully and keep affected hair follicles healthy.”
How did this hair follicle infection happen?
Anything that causes inflammation or irritation of a hair follicle that presents as inflammations, redness, pimples, pustules, itching or a rash on your scalp is called simple folliculitis, Dr. Callender states. “The most common form of folliculitis I see in my practice is traction alopecia which is caused by traction, or wearing hairstyles that are too tight; the second most common irritation is from allergic and sensitive reactions to chemicals in hair products such as chemical relaxers and even fragrances in shampoos and conditioners or styling products containing alcohol.”
She explains that the inflammation easily forms a boil (technically called a furuncle), which swells up the entire hair follicle and the skin around it. Once this happens, skin’s protective barrier is weakened, leading to secondary infection caused by bacteria or fungus and possibly also leading to multiple boils in one location (called a carbuncle.) A boil, or group of boils, can disrupt the hair growth cycle, causing hair loss; if left untreated, it can cause irreparable hair loss because of damage to the hair follicle. Sometimes the boil and secondary infection can be caused by a scratch, by a bug bite or by the use of unsterile instruments in a hair salon; in children very often the culprit is tinea capitis, or ringworm, which can transfer to adults.
How are hair follicle infections treated?
If you see or feel itchy or painful inflammations, pimples or pustules around, under or on your scalp, head to your dermatologist immediately. The simple, direct course of treatment is to discontinue using any tight hairstyles or offending products and to apply hydrocortisone and an antibiotic ointment topically to the area. It is recommended that cells from the inflamed area be cultured to determine whether any secondary infection from bacteria or fungus is present, which would then require you to take an oral antibiotic or antifungal medication, as well. You may have to change your hairstyle and your product regimens indefinitely in order to reverse any hair loss and successfully remove the source of the inflammation.
Hair follicle health alert: MRSA
“It’s very important to get any large boil on your scalp (or anywhere on your body, for that matter) cultured so you can determine the severity and type of secondary infection that may be present,” Dr. Callender cautions. “We have actually been finding MRSA (methicillin-resistant Staphylococcus aureus) in many recent boil cultures, and it is important to catch this type of infection as soon as possible and before it spreads.” The culture tells your doctor what type of bacterium or fungus is present and what medications it is resistant to.
