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What Does Folliculitis Decalvans Look Like?
Folliculitis delcavans is a rare chronic ailment that often affects the scalp. It is an inflammatory problem that destroys hair follicles, leaving scars that result in alopecia (hair loss) .
This problem usually appears as red, swollen, and scaly patches on your scalp. Symptoms can range from mild to extreme pain.
There is no cure, but symptoms can be reduced. Treatment varies by person and often includes oral antibiotics and topical treatments that control symptoms and prevent further hair loss. It is not possible to restore lost patches of hair.
This article describes folliculitis delcavans symptoms, causes, treatments, and outlook.
Shampoos for Folliculitis Decalvans
There is a wide range of over-the-counter and prescription shampoos available. Consult your healthcare provider to determine the product that might work best for you.
The outlook for folliculitis decalvans is generally favorable. This condition often responds well to treatment. Results can usually deliver a noticeable cosmetic improvement.
However, folliculitis may return or spread to other body areas even if it is resolved at one site. In some people, the disease may progress slowly over time and continue to flare for months or years.
Though treatments may improve symptoms, dealing with a chronic condition that affects your appearance can be challenging. It can have a negative impact on your quality of life for the following reasons:
- Severe scarring may result in permanent hair loss in the affected sites.
- Regrowth of the hair lost to folliculitis decalvans is rarely possible.
- The side effects of long-term treatments can affect the way you feel.
- For many people, folliculitis decalvans can affect their quality of life.
- Hair transplantation to correct bald patches can't be attempted until the condition has been inactive for several years without treatment. This ensures that the problem does not recur and damage the newly transplanted hair.
If you're feeling overwhelmed by folliculitis decalvans, consider speaking to your healthcare provider or seeking mental health counseling to help you cope with your feelings.
Discussion
Our case studies show that PDT sessions resulted in stabilization of FD and a decrease in symptoms in all 4 patients, with excellent tolerance (VAS, 0-2/10). All patients indicated that the reduction of symptoms resulted in a significant improvement of their quality of life (not assessed with a standardized score). The PDT sessions of the first patient were performed at 37 J/cm 2 , and the PDT sessions of the next 3 patients were performed at 12 J/cm 2 , according to the device available at the time. There was no difference between light irradiation of 12 and 37 J/cm 2 in the effectiveness of treating actinic keratosis. 7 One patient was prescribed adalimumab during PDT sessions, which may have had a synergistic effect against FD.
The reported clinical results of treatment of FD with PDT are variable. 8 , 9 Miguel-Gomez et al 3 reported a prospective series of 10 patients treated by conventional PDT. Nine patients (90%) showed clinical improvement, and 6 patients (60%) had a persistent remission. The main side effect was pain. In contrast, in a study by Burillo-Martinez et al, 10 PDT resulted in no improvement in all 3 patients and an overall worsening of the disease in 1 patient. All patients experienced discomfort that lasted from 1 to 3 days.
Despite encouraging results in the treatment of FD, conventional PDT has 2 main disadvantages compared with textile PDT: variability of light delivery and pain. These 2 parameters are improved by using new light-emitting devices. 7 , 11 , 12 On the basis of our clinical experience, we believe that monthly to weekly sessions are required until the symptoms are controlled. The disease often recurs a few months after the sessions are stopped. 1 To avoid recurrence, regular sessions of PDT could be performed. Furthermore, a well-tolerated illumination device, such as textile PDT, facilitates multiple sessions.
Systemic antibiotic therapy is currently the first-line treatment for FD, but it can increase bacterial resistance. Higher resistance rates of S aureus were shown in a cohort of patients with FD. 13 Photodynamic therapy has antibacterial effects, with no resistance, and provides local immunomodulation, 4 , 14 which could help reduce the use of repeated antibiotic therapies and the risk of bacterial resistance. The bactericidal effect of PDT on S aureus biofilm has been shown in vitro, with more than 99% of bacteria killed after the treatment. 15