Folliculitis Decalvans: Symptoms and Treatment – Healthgrades

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Folliculitis decalvans is a chronic disease that leads to painful inflammation of hair follicles followed by baldness. Research suggests that Staphylococcus aureus and an inappropriate immune response contribute to the development of this disorder. As the disorder progresses, the inflamed hair follicles fill with pus and crust over. Scar tissue replaces the hair follicles, and hair no longer grows in these areas.
This article will discuss the causes, risk factors, and treatment options for folliculitis decalvans. It will also discuss possible complications.
Folliculitis decalvans is a progressive condition that leads to round or oval patches of baldness. “Folliculitis” means inflammation of hair follicles and “decalvans” comes from the Latin word for “bald.”
With folliculitis decalvans, inflamed hair follicles swell and fill with pus. When the follicles scar over, they can no longer support hair growth. Alopecia, or sudden hair loss, then begins. The resulting bald areas slowly become larger as more follicles die.
While folliculitis decalvans usually affects the scalp area, it can affect any part of your body where hair grows, including:
Folliculitis decalvans is a rare disorder. It accounts for around 9% of cases of alopecia that are caused by scarring. 
Read more about alopecia here.

Research shows that young and middle-aged adults are most likely to develop folliculitis decalvans.
Symptoms of folliculitis decalvans include:
Folliculitis is a common skin condition that is triggered by bacterial, viral, or fungal infections. Symptoms include:
Unlike folliculitis decalvans, many cases of folliculitis are harmless and may go away without treatment. If you have symptoms of folliculitis for more than a week, talk with your doctor or a dermatologist for advice on treatment.
Read more about folliculitis here.
Contact a doctor or dermatologist for a diagnosis if you have any of the following symptoms:
They can help identify any underlying cause and suggest appropriate treatment options.
Researchers are still not sure what causes folliculitis decalvans. Studies suggest that an immune response triggered by infection from Staphylococcus aureus bacteria may be the cause.
Research also suggests that structural abnormalities in the hair follicle or inflammation may contribute to the disorder.
Anyone can develop folliculitis decalvans. However, the following groups may be slightly more at risk:
There are various treatments for folliculitis decalvans. However, research shows that in many cases, the disorder is chronic and can reappear after treatment.
Your doctor may recommend using topical antibiotics alone or in combination with topical corticosteroids.
Oral antibiotics that penetrate the hair follicle can help to stop the disorder from spreading. However, you must continue taking these medications to prevent a relapse. These medications include:
Photodynamic therapy involves treating damaged cells with light.
A 2019 review looked at a small study using red light photodynamic therapy to treat folliculitis decalvans. It noted that the therapy improved the condition in 9 out of 10 people treated. 6 out of the 10 experienced remission.
You may be able to increase the effectiveness of medications your doctor prescribes by taking the following steps:
To diagnose folliculitis decalvans, your doctor will start by taking your medical history. They will then examine your scalp, skin, and hair for rashes and scarring.
In some cases, your doctor may take a skin biopsy and send it to a laboratory for testing.
Current treatment options may help prevent hair follicles from becoming infected. However, research shows that even after pus-filled follicles disappear, alopecia can continue to spread.
Some research suggests that folliculitis decalvans could lead to squamous cell carcinoma, but more recent studies show that this is extremely rare.
Folliculitis decalvans is a chronic disorder where hair follicles become infected, leading to scarring and permanent hair loss.
Although treating folliculitis decalvans can be challenging, a dermatologist can provide you with several effective treatment options.

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