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Forum Name: Dermatology Topics

Question: folliculitis problems


 der_chad - Mon Jun 27, 2005 1:53 pm

Hello there,

I have folliculitis that is recurring for a really long time now. It is mainly on my upper arms, shoulders, back and scalp. Occasionally on my chest and thighs.

This has been going on for a while now and my doctor just recommended to use mild or no soap and try to keep eveything dry.

Any tips?

-Chad
 stephanie0107 - Mon Jun 27, 2005 6:45 pm

deleted
 Dr. Anthony Solomon - Mon Jun 27, 2005 6:57 pm

If the condition has been accurately diagnosed, I would differ in my treatment plan.

The most common offending organism in folliculitis is Staphylococcus aureus.
These bacteria usually colonize the nose and are eventually disseminated onto the skin. Most lesions are located on the trunk and extremities, but bacterial folliculitis of the scalp is most common in dark-skinned patients. Low serum iron has been associated with chronic folliculitis, so estimation is necessary. Culture of the lesions and of the nose establishes the diagnosis and may indicate the appropriate antibiotic choice.

This is the treatment plan for chronic folliculitis that I would suggest. Names of appropriate medications have not been stated for ethical reasons.

1. an appropriate oral antibiotic as directed by culture for at least 14 days
2. an appropriate antibacterial ointment into each nostril and around the perianal skin daily for one month.
3. cleansing the skin daily for one month with an appropriate cleansing solution
4. both nose picking and skin scratching to be discouraged
5. if the iron level is low, it should be supplemented
6. repeated cultures may be necessary if the response to treatment is poor.


Dr Anthony Solomon
Consultant Physician, Tropical & Genitourinary Medicine
 der_chad - Tue Jun 28, 2005 11:46 am

HI there,

My GP just had a VERY fast look at some of the spots on my chest and said "that is just a little folliculitis, don´t use soap that drys out your skin and wear loose clothes."

I have to say, I always think my GP is a bit of a hippie, always suggesting 'alternative' remedies as the first step for everything. I keep going to him though since he really is a nice friendly guy and speaks excellent english. (I live in a small town in Germany and it is hard to find an english speaking GP)

Is there any tests I can request to confrim the diagnosis? or would I be better to seek out a dermatologist.

I recently was on a mild antibiotic for a different illness, and I have to say that my folliculitis did clear up while I was taking it. However 2 weeks or so after finishing it, the pimples were back.#
 Dr. Anthony Solomon - Sun Jul 03, 2005 6:18 am

The first line of action would be to have the diagnosis confirmed by a dermatologist.
The specialist will then decide if you require the tests I have mentioned. Are you generally in good health? Are there any high risk factors that I should know about? I cannot view your medical history because of problems with the profile page.

It is good to have a friendly GP with whom you can communicate easily. Tell him you want a dermatologist's opinion due to the chronicity of your skin problem. I am positive that he will not hesitate to refer you to one in your vicinity.

Dr Anthony Solomon

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