Tuesday, October 12, 2010

What is Folliculitis?

For those who have had this condition, I will not go too detailed about the basics. For those who don't know, I will go into it enough to provide an understanding of the infection and how it to treat, and hopefully put it into permanent remission.

More after the jump

I use remission, because if you adopt bad habits again, those that got you this in the first place, it can always come back. Just like a cold.

What is Folliculitis?

It's a real nasty bugger of an infection that occurs when the hair follicles become infection with a bacteria or a fungus. It can also be, in very rare cases, the demodex mite or a virus.

The most common cause is staph or the fungus called malassezia (Pityrosporum folliculitis). But the most persistant cases are usually gram negative bacterias, such as E.Coli, Enterobacter aerogenes, Klebsiella or Proteus.

When the follicule becomes plugged or damaged, due to anything whether it be friction from clothing, other nearby skin infections, cosmetic use, or even an insect bite, it can become infected. Once it becomes infection, given the right environment, it will spread to other follicles to become full flown folliculitis.

So what is the difference between folliculitis and acne? Well, folliculitis is a more persistant beast, and if you look closely, the "acne", is always centered around a hair follicle. In other words, the hair follicle will be in the middle of the zit, and if you pull it out, say with tweezers, pus will come out.

If you google image pictures of "folliculitis", you will see what I am talking about.

Folliculitis is usually superficial, and goes away in a matter of 10 days without antibiotics or topical treatment, and if it does, than it is usually:

1.) Hot Tub Folliculitis: Usually caused by Pseudomonas aeruginosa found in hot tubs
2.) Barber's Itch: When you have a bad shave, and you get alot of ingrown hairs, they become infected with staph. Usually, if you lay off the infection and do not irritate if further, and cease shaving till it clears, it will usually clear on it's own in a few days.
If you get folliculitis only when you shave, then I suggest quitting, growing your beard out till the infection clears, then adopting an beard trimmer. Don't even consider a close shave such as an electric razor, just go straight to the beard trimmer. Let your skin heal, leave your hair alone.

But if you have chronic folliculitis, you probably have either:

Chronic staph folliculitis
Gram Negative Folliculitis (as stated above, an infection with gram negative bacteria, very hard to kill)

If it is on your scalp, it is called Folliculitis Declavans.


If you get folliculitis, depending on the severity and how you got it, this is what you should do.

1.) Go to the doctor and demand a culture and sensitivity test. Find out what is causing it, either bacteria or fungus, and find out what it is sensitive too. Many doctors will not want to do this, but tell them to suck it up. You are the patient and you are getting paid. I cannot tell you how many doctors have shrugged off a culture and sensitivity test when I asked, and to think of how long I let that go for, I could have nipped in in the butt earlier had I been more persistant with my rights as a patient.

2.) Based on the results and the severity:
*Determine if you need an antibiotic orally and/or topically. I say this because sometimes, in some conditions, minor enough, the skin will heal itself in a matter of days, usually 7-10.

If it is minor, stop using all harsh skin products. Wash with water only and allow your skin to heal. You can also use a diluted form of tea tree oil, I'd recommend mixing tea tree and jojoba oil, as tea tree oil is a very potent anti-bacterial. Or, better yet, order this relatively cheap stuff called H2Ocean. It's a piercing aftercare spray that is made of sea salt and lysozyme, a natural enzyme found in raw milk of mammals and your own saliva, that kills bacteria, virus, and fungi without compromising your skins natural defense barriers and natural healthy flora.

In fact, skip the tea tree oil, and just go to H2Ocean. It is better not to compromise your skins natural acid mantle or natural bacteria with an oil that can potentially irritate in some cases.

H2Ocean has a sister product, called OceanZyme that is used to heal diabetic wounds. But Oceanzyme is 45 bucks, while H2Ocean is 7.50. On the amazon link I provided you can read numerous glowing reviews for H2Ocean.

 *Adopt a healthy diet immediately. Drop all grains, sugars, omega 6 oils, and processed dairy. Switch to yams, sweet potatoes, grass fed meats, grass fed butter, coconut oil, cooked green veggies, raw milk and raw milk kefir, raw saurkraut, etc. But DO NOT UNDEREAT. Your body needs fuel right now to fight this infection. If you cannot get raw dairy, and you not have any issues at all with pasturized dairy (that means even the slightest digestive issue), then go grab some Lifeaway Kefir and drink that stuff like water. But I would usually advise to stay away, as most people have some, however minor, issues with pasturized dairy if they listen to their body closely.

Also consider taking an Astragalus supplement, it is reported to help clear minor infections by boosting immunity. It's also pretty cheap.
*Get some sunshine if weather and geographic location permits. This can be vital for some. It can be very healing and beneficial. Aim for 40 minutes or more of UNPROTECTED exposure on the infected area. Do not burn though, so if you are prone to burning after 30 minutes, then only stay out for 30 minutes.

*Get Tea Tree Oil, Bactroban, or Sino Fresh (proven to kill MRSA in the nares) and apply 3 times a day for a week in the nares to kill hidden staph and bacteria that lingers and survives in the nose, even after antibiotic use.

3.) If your infection doesn't heal itself in 10 days, or show any improvement whatsoever with either leaving it (and your skin) alone, then it is time to consider antibiotics.

Now, you must really think about antibiotics. Because they can dig deeper holes. They most certainly did for me.

If you do not kill the bacteria the first time around, then it will come back, along with stronger bacteria. Antibiotics kill off all your good flora and along stronger ones to dominate and infection. And they will.

If you must go the antibiotic route, I suggest you order Dr. Ohhira's Probiotic. It can be found on iHerb for cheaper than in stores. I have read many cases where patients who took Ohhiras during antibiotics not only not having the horrible side effects, but also reporting complete success with their antibiotic treatment. These came from people with chronic staph infections.

You can also go to straight to Ohhira's without antibiotics and see if it works for you. I would go as far to say that you should order the Ohhira's and take it anyway. Most of us are very deficient in proper gut flora, and Ohhira's is one of the best out there for supplying that. Take the loading dose at first, which is 5 in the morning, 5 at night for 6 days on an empty stomach, then switch to 2 a day, 1 in the morning and 1 at night on an empty stomach. So make sure to order 2 when you order. Yes it is pricey, but so are antibiotics, even with health insurance.

Give the above treatments 2-3 weeks to work completely. If there is little to no result, then it is time to look at other options will I will go over in the next few posts. This is just basic information for those who perhaps have just come down with the infection or are in the early stages. Or those who have had this for a while without serious antibiotic therapy. Hell, even those who have had serious antibiotic therapy, the above might work too. It made the world of the difference for me, and as very few spots remain, and my folliculitis gets weaker every day with Ohirra's Probiotic, leaving my skin alone, intermittent sun exposure and a healthy, anti-inflammatory diet.

More treatments will be posted later.


  1. great article.. i found your blog as i noticed traffic coming to my website: sinusfresh.com

    your article is timely for me as i have this folliculitis problem sometimes. i use diet and sinofresh sold on my site to fight the infection. sinofresh kills it on contact.

    you should consider being an affiliate for my site, make some money off the traffic.

  2. I just cam across this blog. Thanks man for doing this. I've had this folliculitis boil problem in the moustache/beard area for about 2 years. I was prescribed 2% erythromycin antibiotic to use along with panoxyl soap a year ago. So far, its been 70% effective, but if I skip on either I feel the inflammation coming on. According to my derm doctor, there's no known cure, but I think I might follow your steps.

  3. Hello Guys,
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  4. This comment has been removed by the author.

  5. I'm glad that you found a regimen that works for you, but as a biologist I would like to point out some misinformation in your article so that other sufferers don't get confused.

    First off, folliculitis can be caused by either bacteria OR yeast (which is a fungus, and not a type of bacteria; it's a completely different organism, just like plants vs animals). Both yeast and bacteria are living in a balance on your skin. So when you get folliculitis, it is not actually an infection. It is actually an overgrowth of either the bacteria or the yeast, which means there is now an imbalance. It is important to know whether it is yeast or bacteria that is causing the flare-ups, because if you treat the wrong type then you are exacerbating the other organism, because you are contributing to the imbalance that's already taking place on your skin.

    Antibiotics ONLY KILL BACTERIA, AND DO NOT KILL YEAST. Therefore you should not tell people to take antibiotics, or any other bacteria-killing agent, if they have folliculitis caused by yeast. It will only make it worse. This is key. Antibiotics do not kill viruses either, by the way. Only bacteria. This seems to be a point of confusion in your writings.

    Another point of confusion you bring up is about probiotics. You recommend taking them if you "can't get/can't afford" antibiotics. These are 2 different things. Actually they are OPPOSITE things. ANTI-biotics kill bacteria. PRO-biotic encourage bacteria. Hence the names. So these are actually treatments that accomplish opposite things. Taking probiotics is not an alternative to taking antibiotics.

    However, if you are on very strong antibiotics, you may be killing "good" bacteria in your gut and in this case it's a good bet to take probiotics (even those in yogurt can help), to keep the "good" kind in your gut from dying off. Killing too much bacteria=upsetting the bacteria/yeast balance (in skin, gut, mouth, and sex organs)= yeast takes over. This is why many women get yeast infections when they are on strong antibiotics.

    The best thing to do, whether you want to treat your folliculitis at home or with medications, is to get a diagnosis of what's actually causing your skin issue. The doctor may be able to tell by looking at it, but the only definitive diagnosis is to get a biopsy where a lab can tell you what exactly is growing on your skin.

    If it is true folliculitis (there are other rashes and skin issues that look similar anyways), then you need to know whether to treat/manage the yeast overgrowth or the bacterial overgrowth. If you don't know this underlying cause, then you don't know what to treat. Even if you're seeing improvement by guessing, or by mixing different treatments for each possible cause, you may be wasting time and effort (and money) by using some treatments that are harmful and just setting you back. You may also be recommending the incorrect treatments to people who have a different type of folliculitis than you, and that may actually worsen their condition.

    Not trying to talk down to you or anything, as it's clear that you are only trying to help. But your understanding of how skin follicles work, including the flora living in them is not correct. So if you are going to recommend a bunch of medical options to other people, without having gone to medical school for Dermatology, then you need to know exactly what you're talking about.