How to treat folliculitis scabs?

Written by Liu Gang
Dermatology
Updated on September 04, 2024
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When scabbing occurs in folliculitis, it generally indicates that the follicle has almost completely healed, and no special treatment is necessary. However, some cases of folliculitis, especially severe ones, may still have underlying inflammation despite the surface being covered with a scab. In such cases, you can disinfect with iodine and then remove the scab to further clean out any pus or blood underneath. Generally speaking, folliculitis is relatively easy to treat with oral and topical anti-inflammatory medications. In severe cases, lancing or surgically opening the follicle to drain pus might be necessary. After recovery, it is important to regulate one's diet and lifestyle habits, avoid spicy and irritating foods, and not stay up late.

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What are the symptoms of folliculitis?

Folliculitis is a common purulent inflammatory skin disease, usually caused by bacterial infection. The symptoms of folliculitis initially manifest as small red papules which, after several days or weeks, develop small pustules at the center with a surrounding erythema forming pustules. These dry out or rupture later to form yellow crusts. Generally, there are no scars left after the crust peels off.

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Is chicken skin keratosis pilaris?

Chicken skin, scientifically known as keratosis pilaris, is a chronic keratinizing skin disease of the hair follicles, not folliculitis. Keratosis pilaris has a high prevalence rate, often beginning in childhood and becoming significantly worse during adolescence. The condition may be related to genetics, vitamin A deficiency, and metabolic disorders. It commonly occurs on the upper arms, near the shoulders, and on the extensor sides of the thighs. Chicken skin appears as a distinctive rough texture on the skin, with follicular papules ranging from the size of a pinhead to a grain, matching the color of the skin, and not merging. Generally, this condition does not require treatment as it primarily affects only the aesthetic appearance of the skin. However, topical treatments such as tretinoin cream and urea cream can be used, and in severe cases, oral vitamin A, vitamin E, or retinoid medications may be prescribed. (Use medications under medical supervision.)

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Can you drink alcohol with folliculitis?

Folliculitis generally requires abstaining from alcohol, as well as spicy foods like chili peppers, lamb, and seafood. These should be avoided as much as possible because folliculitis is related to consuming spicy and irritating foods, frequently staying up late, and similar habits. Therefore, during the treatment or recovery phase, it is advisable to strictly avoid these, as well as avoiding staying up late, stress, and anxiety. It is also recommended to avoid public baths and swimming pools. Folliculitis is commonly treated with some oral and topical anti-inflammatory medications which can completely cure it. If individual lesions are particularly prominent or painful, local disinfection can be performed, and the pus and blood can be drained by piercing with a needle. For larger, more stubborn folliculitis that does not subside over time, surgical removal may be recommended.

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Written by Liu Jing
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What should I do about folliculitis?

Folliculitis refers to an inflammatory change in the skin appendages, which is quite common and can occur on the scalp as well as in areas of abundant sebum secretion such as the face, chest, and back. It is more prevalent in males, with symptoms generally more severe than in females. A low-fat diet is advised, avoiding spicy foods, and consuming more green vegetables and coarse fibers to regulate lipid metabolism, in addition to anti-inflammatory and other symptomatic treatments. Oral medications such as ebastine tablets, compound glycyrrhizin tablets, and vitamin B6 tablets can be used in combination with systemic antibiotics like clarithromycin extended-release tablets and doxycycline hydrochloride capsules. Traditional Chinese medicines like tanshinone can also be utilized, along with topical applications such as clindamycin phosphate gel and fusidic acid cream. (Please follow medical advice when using medications.)

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How should folliculitis be treated?

Folliculitis is caused by a bacterial infection of the hair follicles. If the folliculitis is severe and there is obvious surrounding swelling, it is known as a furuncle or boil. When multiple furuncles involve several hair follicles, it forms a carbuncle. Thus, the infection severity differs between folliculitis, furuncles, and carbuncles. How is folliculitis treated? First, it is important to maintain clean and hygienic skin and to enhance the body's immune system. Treatment primarily involves topical medications. In the early stages before abscess formation, mupirocin ointment can be used. If there is significant surrounding swelling, ichthammol ointment or topical iodine complex can be used. For more severe cases of folliculitis, oral antibiotics may be selected based on the condition, including penicillins such as cephalosporins, or erythromycin and other macrolide antibiotics, but it is important to ensure there is no allergy to these antibiotics before use.