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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.
Folliculitis Decalvans: What You Should Know
Inflammation in your hair follicles that leads to patchy hair loss is known as folliculitis decalvans. It may also involve itching, redness, blister-like pimples, and sores.
It’s typical to shed between 50 and 100 hairs a day. However, noticeably thinning hair, baldness, and skin irritation may warrant an investigation.
Hair loss (alopecia) is a relatively common condition, according to the American Academy of Dermatology. Short-term conditions, such as pregnancy, may cause temporary hair loss. But long-term hair loss that leads to bald patches may stem from an underlying medical condition. Folliculitis decalvans (FD) is one of the possibilities.
FD stems from widespread inflammation within the hair follicles. This causes the follicles to lose hair and stop producing new ones. It can also lead to other inflammatory symptoms.
Learn more about FD and how you can manage this condition. While there’s no cure, treatment can prevent further balding, sores, and scarring.
Inflammation in the hair follicles eventually leads to a variety of noticeable symptoms. FD may cause itching, inflammation, tenderness, tight feeling scalp, and, rarely, you may have no symptoms at all. Unlike genetic hair loss in which you might only experience hair thinning, FD also includes inflammatory symptoms.
Over time, you may notice the following signs on the scalp:
- redness
- swelling
- pustules (blister-like pimples that contain pus)
- scars
- tufting of hairs
- scaling
- crusting
- sores
Hair loss from this condition often occurs in irregular patches.
Alopecia is perhaps most noticeable on the scalp because that’s the area of the body with the most hair. However, alopecia can occur in the following areas:
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:
Symptoms of Folliculitis Decalvans
Symptoms of folliculitis decalvans can differ by individual. Some people have this problem without pain.
Symptoms are usually confined to the scalp. Rarely, the problem can affect other areas of hair such as the beard area, pubic area, armpits, and legs.
Common symptoms of folliculitis decalvans include the following:
- Inflammation (swelling) and redness
- Pustules around hair follicles
- Scaly areas, scabs, or crusts
- Pus-filled spots
- Itchiness
- Pain
- Scalp inflammation
- Bleeding
- Yellow pustular discharge
- Growth of several hairs from the same hair follicle, creating tufts that resemble the bristles of a toothbrush
- Bald patches at later stages
- Scarring
- Hair loss
Successful Management of Folliculitis Decalvans
This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Folliculitis decalvans (FD) is a rare disease that causes inflammation on the scalp, leading to scarring alopecia. It commonly affects young and middle-aged men and is characterized by pustules, papules, scarring, hemorrhagic crusts, and erosions. The exact cause of FD is not fully understood, but it is believed that Staphylococcus aureus may play a role in its development. The condition is thought to be influenced by a combination of genetic, allergic, infectious, and immunological factors. This report describes a 20-year-old male patient who experienced painful pustules on his scalp for six months. The pustules first appeared on the occipital region and then spread to the crown. The patient was diagnosed with FD after a thorough clinical and pus culture examination. Treatment involved a month-long prescription of doxycycline (100 mg BD) and topical ozenoxacin (2%), which led to successful remission of the lesions.
Keywords: staphylococcus aureus, antibiotics therapy, oral doxycycline, scalp nodule, cicatricial alopecia