Hair follicle infections are normally mild skin conditions that most people experience at some point in life. They can affect any part of your body where hair grows, but your scalp is most commonly affected (e.g. scalp folliculitis), as your hair makes a good breeding ground for bacteria and other germs [1].
While most hair follicle infections resolve themselves with home care, in some cases, they can spread and become more severe, requiring medical attention [2]. This article will tell you all you need to know about recognising and treating these conditions, such as:
Hair follicles are tubular structures located inside your skin and scalp, making up the root of your strands [3]. When germs multiply within the follicle, it can lead to an overgrowth of bacteria, viruses or fungi which may cause a hair follicle infection [4].
As your immune system fights these germs, you may develop the telltale signs of infection, such as inflammation, redness, pain and sometimes pustules or abscesses [2][1].
Hair follicle infections are most often associated with folliculitis [5] since this is the most common type. However, you can also develop other more serious infections that involve your follicles, such as acne, boils or carbuncles (skin abscesses) [6].
There are many ways that you can get a hair follicle infection, but most of them are caused by bacteria, viruses, fungi or parasites [7]. Here are some of the main ways these germs can infect your hair follicles:
Whatever may have caused your hair follicle infection, it is good to be able to recognise and treat it as soon as possible, to prevent it from spreading and avoiding potential complications.
Symptoms can vary from one such condition to another, depending on the microbe that caused them. However, most of them manifest in a similar fashion. Here are the most common symptoms of the main types of hair follicle infections.
This common skin condition can occur in any area of your body that is covered with hair. Some types of folliculitis are noninfectious (e.g. facial hair inflammation from razor burns [8] or ingrown hairs), but they can become infected if scratched or rubbed with dirty hands. However, there are also several kinds of infectious folliculitis, depending on the microorganism that has caused it [7][8]:
Symptoms: Small, zit-like bumps or pustules which appear around your hair roots, surrounded by redness and inflammation. These can form yellow crusts or scabs that are painful and/or itchy. In some people, they can cause a burning sensation on the scalp.
If your folliculitis is viral in nature, it can manifest with plaques instead of pustules. Temporary hair shedding can occur at and around the infection site.
There are several factors that can cause acne, such as skin oiliness, hormonal activity, or dietary choices. However, it usually occurs when bacteria or fungi grow excessively within pores or hair follicles that have become clogged with dirt, hair product buildup or sebum.
Acne can appear on your face, body or scalp, but it’s most likely to affect areas that are prone to sebum buildup, as the germs feed on the natural oil. Thus, the scalp can be a good place for it to thrive [12].
Symptoms: Multiple small pustules (pimples) or papules (reddish bumps), surrounded by redness and inflammation, which can cause discomfort. In severe cases, painful cysts or nodules (lumps) can also appear under the skin, making your scalp hurt when you move your hair.
A boil occurs when a type of bacteria (usually Staphylococcus aureus) or fungus infects a hair follicle and its nearby tissue. Boils are pus-filled bumps (abscesses) that are larger than pimples or folliculitis pustules and can occur anywhere on the body where hair is present, including the scalp [13]. If the infection extends to several hair follicles in the same area, it can form a cluster of boils, called a carbuncle [14][2].
While most such infections only develop once and heal with home care or antibiotics, in 10% of cases [5], boils become recurrent. More rarely, the abscesses can become chronic, especially if the bacteria causing them (e.g. Methicillin-resistant Staphylococcus aureus – MRSA) is resistant to commonly used antibiotics.
Symptoms: A red, sometimes warm, dome-shaped lump filled with pus. It can range from the size of a small marble to that of a golf ball and it is painful and very tender to the touch. If a carbuncle develops, there will be several adjacent lumps, with a cauliflower-like appearance. On rare occasions, you may develop fever, fatigue, and malaise.
Mild hair follicle infections often heal on their own, with appropriate home care. However, more serious ones that do not improve after a few days will often require treatment. Here are some good ways to care for your infected follicles.
Sometimes, an infection at your hair roots will only manifest as a few bumps or pimples which can be painful or itchy but don’t require medical attention. If you experience mild scalp acne or folliculitis, try these remedies to help it heal faster [11]:
If your symptoms don’t improve in a few days, the infection appears to spread, or you are feeling unwell (fever, lightheadedness, nausea), contact your GP for medical attention.
If your infection is too serious to be treated with home care alone, it is best to see your GP or a dermatologist to get the right treatment. Depending on the severity of the condition and the type of microorganism causing it, these may include [7][1][13]:
A one-time course of medication is usually enough to cure most hair follicle infections (although more complicated forms may require long-term treatment to heal properly).
If you have deeper infection pockets, such as boils, carbuncles or abscesses, they may need to be surgically drained before medication is administered. The wound needs to be disinfected so it can heal from the inside out [15].
This prevents the infection from spreading further into your body and (rarely) causing potentially life-threatening health problems such as severe forms of cellulitis or sepsis.
It is a good idea to see a doctor if your symptoms are not improving or are actively worsening after a few days of self-care. While most cases are mild and resolve themselves with little or no intervention, some of these infections can become severe. Certain types of bacteria are aggressive and spread quickly in hair-covered areas that are often warm and damp.
If you are not sure whether your infection is spreading, draw a circle on your skin outside the edges of the redness surrounding it. If the red area becomes wider than the circle, your infection may be progressing. However, you can’t always see when it is getting worse, as it could be boring deeper into your skin without showing outward signs.
Contact healthcare services right away if you also experience symptoms such as [16][15]:
While these cases are rare, untreated infections can spread to your vital organs or lead to a potentially life-threatening condition such as severe cellulitis or sepsis [17]. That is why getting medical attention in a timely fashion can be extremely important.
While not all hair follicle infections are easily preventable, there are several things you can do to lower your chances of developing one. Here are some of the most common:
Yes. Since they manifest with inflammation, moderate and severe forms of hair follicle infections can cause hair loss in the affected area. If they are itchy, vigorous scratching can also lead to hair breakage. In most cases, this is temporary and you should be able to see new hair growth in a few weeks or months after the infection resolves.
However, if left untreated, the infection can spread deeper into your tissues, permanently damaging your hair follicles and triggering scarring alopecia at the affected site [18]. This is particularly unfortunate when the infection is located on your scalp, as it can lead to irreversible and largely untreatable hair loss. Boils, carbuncles and abscesses can have this effect if not addressed in time, as can severe forms of infectious folliculitis.
If you are concerned about the hair loss potential of an infection on your scalp, or if you’ve healed from one and your hair has not grown back, it is best to see a trichologist. Our dedicated specialists are here to help, so book a consultation with us at your earliest convenience. We’ll ensure your condition is diagnosed and treated quickly to minimise your discomfort and promote rapid healing.
Our hair doctors will assess your scalp for any hair follicle damage and prescribe the best treatment for acute, chronic or recurrent scalp infections. And if your hair needs a little extra help to regrow after you’ve healed, they can also recommend the best hair loss treatment for women, or the most effective hair loss treatment for men.
If you still have questions regarding the most common hair follicle infections, find your answers below.
Initially, folliculitis may look like a tender rash on your scalp or skin, showing redness and a few small bumps. Soon, the number of bumps may increase and they may develop small white pustules. Within a few days, the pustules will start to crust and form scabs. The pain, and tenderness will start to subside, but some itchiness may persist.
After about 7-10 days [11] the crusts will start falling off and the redness and inflammation will clear, completing the healing process. However, you may still have some darker-coloured marks left over for a while where the pustules used to be.
Yes. While it is a rare occurrence (it happens in under 1% of patients [11]), hair transplant infection is a known risk of this procedure. When it does occur, hair transplant folliculitis usually develops as a result of deficient aftercare.
However, poorly dissected hair grafts, poor graft placement and subpar safety and hygiene practices during surgery can also lead to this outcome. This is why it is a good idea to have this procedure done in a reputable hair transplant clinic you can trust.
While some hair transplants on scar tissue can be successful, this is not a general rule. One study shows that hair restoration surgery was effectively performed on scar tissue following an MRSA infection, but that does not necessarily mean it will work for everyone with a similar type of alopecia [10].
The best thing you can do is to see a trichologist to help you determine if you would make a good candidate for a hair transplant.
If you identify signs of folliculitis or another type of infection in the first few days after your hair transplant, contact your surgeon immediately. They will be able to assess the situation, confirm the presence of infection and recommend the best treatment and home care advice to prevent the infection from harming your sensitive hair grafts.
Simply fill in your details in the form below and we'll get in touch with you shortly.
Δ
