Leczenie łysienia związanego z łysieniem mieszkowym

Treatment for Folliculitis Decalvans

Treatment for folliculitis decalvans varies by individual in its effectiveness. The goal of treatment is to encourage disease remission (no symptoms). Most therapies can be administered at home, though some may require outpatient visits to a healthcare provider.

For most people, treatment involves a combination of topical solutions and/or oral antibiotics. It is a lengthy process because this condition can return after a course of successful therapy and trigger a recurrence of symptoms.

There is no specific treatment approved for folliculitis decalvans, so there is a wide range of approaches. The following therapies are the most common:

Antibiotics

Systemic antibiotics are regarded as the first-line treatment for folliculitis decalvans because they can eradicate Staphylococcus aureus. Though these treatments can be effective, symptoms often relapse after the interruption of therapy. Antibiotic resistance is also a concern with long-term use.

The following antibiotics are the most common:

  • Oral tetracyclines :
  • Minocin, Solodyn, others ( minocycline )
  • Vibramycin -D, Efracea ( doxycycline )
  • Adoxa, Declomycin , others (tetracycline)
  • Tetralysal ( lymecycline )
  • Rifadin, Rimactane ( rifampicin ) with or without Cleocin ( clindamycin ) (oral)
  • First-generation cephalosporins:
  • cephalexin oral
  • Velosef ( cephradine oral)
  • Duricef ( cefadroxil oral)
  • Ancef ( cefazolin ) (intravenous and intramuscular)

Corticosteroids

Corticosteroids can help manage symptoms of itching, pain, and inflammation. They are also effective in treating the scar tissue common with folliculitis decalvans.

  • Topical products (creams, gels, and ointments applied over the surface of the affected area)
  • Intralesional injection (injection into a lesion)
  • Systemic treatments (administered orally or intravenously for treatment throughout your body)

Summary

Folliculitis delcavans is a rare ailment that causes red, swollen patches on your scalp. The patches destroy your hair follicles, causing scars and permanent hair loss at the affected sites.

While there is no known cause, the problem is linked to a bad response to Staphylococcus A. bacteria. It is believed that the bacteria trigger an extreme immune response that causes symptoms.

Treatments can reduce symptoms and slow the damage to hair follicles. The nature and chronic course of this problem can also have a negative impact on those who have it. Enduring long-term treatment only to have the problem recur can be difficult. This can also have an impact on your self-image and affect your quality of life.

Working with your healthcare provider and a counselor can help you manage the mind and body aspects of this problem. Despite its long course, the outlook is good for most cases.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. NYU Langone Health. Types of hair loss.
  2. British Association of Dermatologists. Folliculitis decalvans.
  3. Fabris MR, Melo CP, Melo DF. Folliculitis decalvans: the use of dermatoscopy as an auxiliary tool in clinical diagnosis. An Bras Dermatol. 2013,Sep-Oct,88(5):814-6. doi: 10.1590/abd1806-4841.20132129
  4. Penn Medicine. Folliculitis.
  5. The Primary Care Dermatology Society. Folliculitis decalvans.
  6. Rakowska A. A 36-year-old man with inflammatory lesions and crusts on the scalp. In: Waśkiel-Burnat A, Sadoughifar R, Lotti TM, Rudnicka L, eds. Clinical Cases in Scalp Disorders. Springer International Publishing, 2022:43-46.
  7. Coondoo A, Phiske M, Verma S, Lahiri K. Side-effects of topical steroids: A long overdue revisit. Indian Dermatol Online J. 2014,5(4):416-425. doi:10.4103/2229-5178.142483
  8. Pimenta R, Borges-Costa J. Successful treatment with fusidic acid in a patient with folliculitis decalvans. Acta Dermatovenerol Croat. 2019,27(1):49-50. doi:
  9. Le Calvé C, Abi-Rached H, Vicentini C, et al. Treatment of folliculitis decalvans by photodynamic therapy using a new light-emitting device: a case series of 4 patients. JAAD Case Rep. 2021,17:69-72. doi:10.1016/j.jdcr.2021.09.026
  10. Pindado-Ortega C, Saceda-Corralo D, Miguel-Gómez L, et al. Impact of folliculitis decalvans on quality of life and subjective perception of disease. Skin Appendage Disord. 2018,4(1):34-36. doi:10.1159/000478053

Case presentation

A 20-year-old male from central India presented to the outpatient department of a tertiary care hospital with multiple painful pustules covering the crown and occipital areas of his scalp (Figure ​ (Figure1). 1 ). The patient had no history of pruritus, hidradenitis suppurativa, acne, or scalp injuries. Multiple nodulocystic lesions and patches of hair loss over the occipital and crown region were noted during the clinical examination.

Figure 1

Multiple nodulocystic lesions are present on the occipital and crown area of the scalp (black arrows).

All laboratory tests, such as the fasting lipid profile, thyroid profile, liver function test, renal function test, total blood count, and other indicators of inflammation, were within normal ranges. No fungal growth was seen in the fungal culture. Methicillin-sensitive S. aureus was found in moderate amounts in the swabs taken from the intact pustules. Methicillin-sensitive S. aureus was also detected in pustule scalp bacterial cultures (Figures ​ (Figures2, 2 , ​ ,3 3 ).

Figure 2

Round (1-3 mm), golden-yellow colonies of Staphylococcus aureus on blood agar.

Figure 3

Yellow-colored colonies of Staphylococcus aureus on mannitol salt agar (MSA).

A diagnosis of FD was made for the patient based on the clinical presentation, examination, and culture results. The patient was prescribed topical ozenoxacin 2% lotion twice daily for one month and oral doxycycline 100 mg BD. At one-month follow-up, the patient showed a recession of nodulocystic lesions with reticular patches of alopecia and hair regrowth (Figure ​ (Figure4 4 ).

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.

Other possible causes for your hair loss

A dermatologist may rule out other causes of hair loss, such as:

  • hormonal conditions related to pregnancy, menopause, and elevated androgen levels
  • a recent acute illness, such as the flu or an infection
  • underactive thyroid (hypothyroidism)
  • radiation exposure
  • cancer treatments
  • certain medications, such as birth control pills, anabolic steroids, and blood thinners
  • ringworm
  • chronic stress
  • stress from a recent traumatic event
  • malnutrition (especially iron and protein deficiencies)
  • vitamin A overdose
  • weight loss
  • eating disorders
  • poor haircare
  • tight hairstyles

Once other causes for your hair loss are ruled out, a dermatologist might recommend a biopsy and culture. This procedure involves taking a small sample of your scalp or your skin and sending it to a lab for testing. A blood test may also be ordered to help rule out any other underlying issues, such as thyroid disease.

  • medical history
  • physical exam
  • possible biopsy
  • blood test
  • skin culture

There is currently no cure for FD. The main goals of treatment are to reduce inflammation and prevent the condition from getting worse. Because FD is a rare condition, most treatment studies have been small, with no overwhelming consensus about the most effective option.

Some treatments are more effective for certain people than they are for others. You may need to pursue a variety of treatment options or a combination of two or more approaches to manage your symptoms. Among the more widely used treatments are:

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