Mild and moderate cases of folliculitis usually clear quickly with treatment and leave no scars. However, more severe cases of folliculitis may lead to complications, such as cellulitis an infection of the deeper skin tissue , scarring, or permanent hair loss. Make an appointment to be evaluated by a dermatologist or by another physician if the above self-care measures do not resolve the condition within 2—3 days, if symptoms recur frequently, or if the infection spreads.
Be sure to tell your doctor about any recent exposure to hot tubs, spas, or swimming pools, as a less common form of folliculitis may be caused by contamination from these water sources. If you are currently being treated for a skin infection that has not improved after 2—3 days of antibiotics, return to your doctor. Community-associated methicillin-resistant Staphylococcus aureus CA-MRSA is a strain of "staph" bacteria resistant to antibiotics in the penicillin family, which have been the cornerstone of antibiotic therapy for staph and skin infections for decades.
CA-MRSA previously infected only small segments of the population, such as health care workers and persons using injection drugs. While CA-MRSA bacteria are resistant to penicillin and penicillin-related antibiotics, most staph infections with CA-MRSA can be easily treated by health care practitioners using local skin care and commonly available non-penicillin-family antibiotics.
Staph infections typically start as small red bumps or pus-filled bumps, which can rapidly turn into deep, painful sores. If you see a red bump or pus-filled bump on the skin that is worsening or showing any signs of infection ie, the area becomes increasingly painful, red, or swollen , see your doctor right away. The bullous form of impetigo presents as a large thin-walled bulla 2 to 5 cm containing serous yellow fluid.
It often ruptures leaving a complete or partially denuded area with a ring or arc of remaining bulla Figure 5. More than one area may be involved and a mix of bullous and nonbullous findings can exist.
Nonbullous impetigo was previously thought to be a group A streptococcal process and bullous impetigo was primarily thought to be caused by S. Studies 16 , 17 now indicate that both forms of impetigo are primarily caused by S. If the infection is a toxin-producing, phage group II, type 71 Staphylococcus the same toxin seen in Staphylococcus scalded skin syndrome, a medical emergency where large sheets of the upper epidermis slough off , large bullae will form as the toxin produces intradermal cleavage.
A study 19 published in concluded that topical mupirocin Bactroban ointment is as effective as oral erythromycin in treating impetigo. However, because the lesions of bullous impetigo can be large and both forms of impetigo can have satellite lesions, an oral antibiotic with activity against S. Because of developing resistance, erythromycin is no longer the drug of choice. Food and Drug Administration for treating skin and soft tissue infections.
As with other diseases involving Streptococci, there is a small chance of developing glomerulonephritis, especially in children aged two to six years. Presenting signs and symptoms of glomerulonephritis include edema and hypertension; about one third of patients have smoky or tea-colored urine.
Streptococcal glomerulonephritis usually resolves spontaneously although acute symptoms and problems may occur. Impetigo can be spread by direct person-to-person contact, so appropriate hygiene is warranted. Nasal carriage of S. Hair follicles can become inflamed by physical injury, chemical irritation, or infection that leads to folliculitis Table 1.
Classification is by the depth of involvement of the hair follicle. The most common form is superficial folliculitis that manifests as a tender or painless pustule that heals without scarring.
Multiple or single lesions can appear on any skin bearing hair including the head, neck, trunk, buttocks, and extremities. Associated systemic symptoms or fever rarely exist. These lesions typically resolve spontaneously. Topical therapy with erythromycin, clindamycin, mupirocin, or benzoyl peroxide can be administered to accelerate the healing process. Staphylococci will occasionally invade the deeper portion of the follicle, causing swelling and erythema with or without a pustule at the skin surface.
These lesions are painful and may scar. This inflammation of the entire follicle or the deeper portion of the hair follicle isthmus and below is called deep folliculitis. Oral antibiotics are usually used in the treatment and include first-generation cephalosporins, penicillinase-resistant penicillins, macrolides, and fluoroquinolones.
Gram-negative folliculitis usually involves the face and affects patients with a history of long-term antibiotic therapy for acne. Pathogens include Klebsiella, Enterobacter, and Proteus species.
It can be treated as severe acne with isotretinoin Accutane , but use of isotretinoin is associated with major side effects, including birth defects. Multiple pustular or papular perifollicular lesions appear on the trunk and sometimes extremities within six to 72 hours after exposure Figure 6 , and mild fever and malaise may occur. Lesions in the immunocompetent patient typically resolve spontaneously within a period of seven to 10 days.
Folliculitis caused by contamination of undertreated water in a hot tub or whirlpool. Furuncles and carbuncles occur as a follicular infection progresses deeper and extends out from the follicle Table 1.
Commonly known as an abscess or boil, a furuncle is a tender, erythematous, firm or fluctuant mass of walled-off purulent material, arising from the hair follicle. These lesions may occur anywhere on the body, but have a predilection for areas exposed to friction. Furuncles rarely appear before puberty.
The pathogen is usually S. Typically, the furuncle will develop into a fluctuant mass and eventually open to the skin surface, allowing the purulent contents to drain, either spontaneously or following incision of the furuncle.
Carbuncles are an aggregate of infected hair follicles that form broad, swollen, erythematous, deep, and painful masses that usually open and drain through multiple tracts. Constitutional symptoms, including fever and malaise, are commonly associated with these lesions but are rarely found with furuncles.
Loculations should be broken with a hemostat. The wound may be packed usually with iodoform gauze to encourage further drainage. In severe cases, parenteral antibiotics such as cloxacillin Tegopen , or a first-generation cephalosporin such as cefazolin Ancef , are required. The majority of bacterial skin infections are caused by the gram-positive bacteria Staphylococcus and Streptococcus species.
Antibiotics are used empirically with consideration for resistance patterns. Current antibiotic recommendations include penicillinase-resistant penicillins, first-generation cephalosporins, azithromycin, clarithromycin, amoxicillin-clavulanic acid, or a second-generation fluoroquinolone in the skeletally mature patient.
Gram-negative coverage with a second-, third-, or fourth-generation cephalosporin is usually indicated in children under three years and in patients with diabetes or who are immunocompromised.
Already a member or subscriber? Common skin infections include cellulitis, erysipelas, impetigo, folliculitis, and furuncles and carbuncles. Cellulitis is an infection of the dermis and subcutaneous tissue that has poorly demarcated borders and is usually caused by Streptococcus or Staphylococcus species.
Erysipelas is a superficial form of cellulitis with sharply demarcated borders and is caused almost exclusively by Streptococcus. Create a personalised content profile. Measure ad performance. Select basic ads. Create a personalised ads profile. Select personalised ads.
Apply market research to generate audience insights. Measure content performance. Develop and improve products. List of Partners vendors. Bacterial skin infections are fairly common. They can be mildly annoying to life-threatening. Most bacterial infections are caused by Staphylococcus aureus staph or Streptococcus pyogenes the same bacteria responsible for strep throat. Bacterial infections can look different ways depending on where they are located, the type of bacteria, and a person's age.
Most can be treated by your doctor. However, you may need to see a dermatologist or rheumatologist for more complicated infections. In the most serious cases, a bacterial infection can spread to the bloodstream. This is known as septicemia , and it can be life-threatening. Here is a rundown of the nine most common bacterial infections and how to identify them.
This photo contains content that some people may find graphic or disturbing. Cellulitis affects the two deepest layers of the skin—the dermis and the subcutaneous tissue. It often appears as a swollen, red area on the skin and feels tender and hot when touched.
Cellulitis usually occurs when the skin is broken, such as near ulcers, bruises, burns, or recent surgical wounds. While many types of bacteria can cause cellulitis, Staphylococcus and Streptococcus are the most common culprits. If the cellulitis spreads to your lymph nodes and bloodstream, it can be deadly. Seek medical help immediately if you suspect you have this infection.
Erysipelas infects the top two layers of the skin. It is commonly known as "St. Anthony's Fire" because of the intense, burning sensation that occurs with it. Symptoms include extreme redness, swelling, and a sharply defined border between the normal and infected skin. It is similar in appearance to cellulitis. However, cellulitis occurs in the lower layers of the skin. Streptococcus bacteria cause erysipelas. Minor things like athlete's foot or eczema can lead to erysipelas by causing a break in the skin.
It can also occur when bacteria spread to the nasal passages following a nose or throat infection. Bacterial folliculitis is a relatively common infection of the hair follicles.
It is usually caused by a fungus , ingrown hair , or blockages from moisturizers or other products applied to the skin. Shaving or plucking hairs can also increase risk. Symptoms of bacterial folliculitis include tiny, red bumps or white-headed pimples filled with pus. This infection tends to occur more often in people with acne than those who have clearer skin. While bacterial folliculitis usually heals on its own, more severe cases may require antibiotics. Left untreated, folliculitis can cause permanent hair loss.
Hot tub folliculitis causes pus-filled bumps and an itchy red rash. These symptoms come on a few hours to several days after exposure to the bacteria that cause it.
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