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Facts about the skin from DermNet New Zealand Trust. Topic index: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z


Scalp folliculitis

What is scalp folliculitis?

Scalp folliculitis is an inflammatory disorder of the hair follicles in the scalp. The condition is also known as ‘acne necrotica miliaris’ or ‘Proprionibacterium’ folliculitis.

Scalp folliculitis is characterised by small, very itchy pustules within the scalp, often most troublesome on the frontal hairline. There may be only a small number of lesions or they may be very numerous. They are hard to leave alone because of the itch. They often become sore and crusted.

Scalp folliculitis Scalp folliculitis Scalp folliculitis
Scalp folliculitis

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What is the cause of scalp folliculitis?

The cause of scalp folliculitis is not well understood. It is generally considered to be an inflammatory reaction to components of the hair follicle, particularly the micro-organisms. These include:

What is the treatment for scalp folliculitis?

The scalp affected by folliculitis should be washed with a mild normal shampoo as often as desired. Antidandruff shampoos containing antifungal agents such as ketoconazole or ciclopirox are sometimes helpful. Conditioner can be used if desired.

The following medications may be helpful for scalp folliculitis:

What is acne necrotica?

Acne necrotica is a more severe form of scalp folliculitis also known as ‘acne varioliformis’ or ‘acne frontalis’. In this condition larger follicular spots (papules) become inflamed then develop blackened crusts, finally leaving permanent pox-like scars. Acne necrotica may affect the face, scalp or other areas.

What is perifolliculitis capitis abscedens et suffodiens?

Perifolliculitis capitis abscedens et suffodiens is also known as dissecting cellulitis or folliculitis, or perifolliculitis capitis.

Perifolliculitis capitis abscedens et suffodiens is a rare and severe form of scalp folliculitis sometimes associated with acne conglobata, hidradenitis suppurativa and spinal arthritis (spondyloarthropathy). It most often affects black adult men but may rarely occur in white skinned individuals, females and children.

Large nodules and cysts accompany smaller follicular papules and pustules, from which purulent material can be expressed. Temporary hair loss over the lesions eventually results in permanent scarring and bald patches.

Perifolliculitis capitis abscedens et suffodiens is very resistant to treatment. The severity may be reduced with oral isotretinoin, antibiotics, dapsone and injected or systemic steroids.

Perifolliculitis capitis abscedens et suffodiens Perifolliculitis capitis abscedens et suffodiens Perifolliculitis capitis abscedens et suffodiens
Perifolliculitis capitis abscedens et suffodiens

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Author: Dr Amanda Oakley MB ChB FRACP, Hamilton, New Zealand.

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If you have any concerns with your skin or its treatment, see a dermatologist for advice.