Folliculitis Decalvans: Symptoms, Causes, Treatment

What are the symptoms of folliculitis decalvans?

Folliculitis decalvans is a type of folliculitis that specifically affects the scalp, leading to hair loss and scarring. The symptoms of folliculitis decalvans can vary but may include:

1. Persistent, painful, or itchy red bumps or pustules on the scalp
2. Hair loss (alopecia) in the affected areas, which may progress over time
3. Scarring of the scalp, which can cause permanent hair loss and bald patches
4. Crusting or oozing of the affected skin
5. Swelling or inflammation of the scalp
6. Tenderness or soreness of the scalp

Folliculitis decalvans is a chronic condition that can worsen over time if not properly treated. It is important to see a healthcare provider for an accurate diagnosis and appropriate treatment if you suspect you have folliculitis decalvans.

What are the causes of folliculitis decalvans?

The exact cause of folliculitis decalvans is not fully understood, but it is believed to be related to a combination of factors, including:

1. Bacterial infections: Similar to other types of folliculitis, folliculitis decalvans may be caused by bacterial infections, particularly by Staphylococcus aureus. The bacteria infect the hair follicles, leading to inflammation, hair loss, and scarring.
2. Immune system dysfunction: Some researchers believe that folliculitis decalvans may be an autoimmune condition, where the body’s immune system mistakenly attacks the hair follicles, leading to inflammation and damage.
3. Genetics: There may be a genetic component to folliculitis decalvans, as it tends to run in families. Certain genetic factors may make some individuals more susceptible to developing the condition.
4. Other factors: Other factors, such as hormonal imbalances, skin trauma, or underlying skin conditions, may also contribute to the development of folliculitis decalvans.

It’s important to note that folliculitis decalvans is a relatively rare condition, and more research is needed to fully understand its causes and risk factors.

How is the diagnosis of folliculitis decalvans made?

The diagnosis of folliculitis decalvans is typically made based on a combination of a physical examination, medical history, and sometimes additional tests. Here’s how it’s typically diagnosed:

1. Physical examination: Your healthcare provider will examine your scalp and look for signs of folliculitis, such as redness, pustules, and hair loss. They may also ask about your symptoms and medical history.
2. Skin biopsy: A skin biopsy may be performed to confirm the diagnosis. During a skin biopsy, a small sample of skin is removed and examined under a microscope. This can help determine if there is inflammation and scarring of the hair follicles, which is characteristic of folliculitis decalvans.
3. Cultural tests: In some cases, a culture of the affected skin may be taken to identify the specific bacteria or other microorganisms causing the infection. This can help guide treatment decisions.
4. Blood tests: Blood tests may be done to rule out other conditions that can cause similar symptoms, such as autoimmune disorders.
5. Dermoscopy: Dermoscopy is a non-invasive technique that allows healthcare providers to examine the skin in detail. It can be useful in diagnosing folliculitis decalvans by revealing specific patterns of inflammation and scarring in the hair follicles.

It’s important to see a healthcare provider for an accurate diagnosis if you suspect you have folliculitis decalvans. Treatment can help manage symptoms and prevent further hair loss and scarring.

What is the treatment for folliculitis decalvans?

The treatment for folliculitis decalvans aims to reduce inflammation, control infection, and prevent further hair loss and scarring. Treatment options may include:

1. Antibiotics: Oral or topical antibiotics, such as clindamycin or rifampicin, may be prescribed to help control bacterial infection and reduce inflammation.
2. Corticosteroids: Topical or injectable corticosteroids may be used to reduce inflammation and ease symptoms. These medications are often used in combination with antibiotics.
3. Retinoids: Topical retinoids, such as tretinoin, may be prescribed to help unclog hair follicles and reduce inflammation.
4. Anti-inflammatory medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be used to reduce pain and inflammation.
5. Immunosuppressive medications: In some cases, medications that suppress the immune system, such as corticosteroids or methotrexate, may be prescribed to help reduce inflammation and prevent further damage to the hair follicles.
6. Phototherapy: Light therapy, or phototherapy, may be used to help reduce inflammation and stimulate hair regrowth in some cases.
7. Surgical options: In severe cases of folliculitis decalvans with extensive scarring and hair loss, surgical options such as hair transplantation or scalp reduction surgery may be considered to improve the appearance of the scalp.

It’s important to work closely with a healthcare provider to develop a treatment plan that is tailored to your specific needs and to monitor the condition closely for any signs of progression or recurrence. Folliculitis decalvans is a chronic condition, and long-term management may be necessary to control symptoms and prevent complications.