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What Causes Folliculitis Decalvans?
For most people, this doesn't cause a problem. The bacterium occurs naturally on your skin.
Folliculitis decalvans may occur due to a hypersensitivity reaction to "superantigens." Superantigens are a class of toxins produced by bacteria and viruses that trigger an intense response in people who have a compromised or defective immune system. This response may be hereditary because folliculitis decalvans is known to occur more frequently among members of the same family.
Despite its appearance, folliculitis decalvans is not skin cancer. Though it is linked with a specific bacterium and often improves with antibiotics, the problem is not considered contagious.
Common Triggers for Folliculitis Decalvans
Folliculitis may be triggered when the hair follicle becomes damaged or blocked. This can occur when the follicle rubs against clothing or shaving, leaving the damaged hair follicle susceptible to infection.
The cause of folliculitis decalvans is not understood. The following circumstances have been identified as possible triggers, though they have not been proved as causes:
- Abnormal immune response to Staphylococcus aureus
- Males, usually in their 40s and 50s
- Family history of the condition
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)
Human Ethics
Consent was obtained or waived by all participants in this study
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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.
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