Check-up folliculitis

I have developed a rash on my face and neck, with tiny white pimples at the base of the hairs. What could this be?

It sounds like a skin condition known as folliculitis which is caused by inflammation of one or more hair follicles. It typically occurs in areas of irritation.

In most cases, the inflamed follicles are infected with bacteria, usually Staphylococcus organisms that normally live harmlessly on the skin.

Common causes of damage to hair follicles and subsequent infection include irritation from shaving, friction from tight clothing or a pre-existing skin condition, such as eczema, acne or dermatitis.

Abrasions of the skin or prolonged contact with plastic bandages or adhesive tape may also precipitate the problem. Sometimes, hairs in the beard area curl and become inward growing after shaving, causing irritation without substantial infection. This type of folliculitis is called pseudofolliculitis barbae.

I had an outbreak of something similar before, but I got it all over my body after using a jacuzzi.

You can develop folliculitis after exposure to a poorly chlorinated jacuzzi or hot tub. This condition is more commonly caused by the bacterium Pseudomonas aeruginosa. It begins anytime from six hours to five days after the exposure. Areas of skin covered by a bathing suit, such as the torso and buttocks, are the most common sites.

While this rash resolved without treatment after a few days, this new outbreak on my face is not clearing up. Can I get treatment for it?

Folliculitis is treated with antibacterial cleansers or topical antibiotics. Large areas of folliculitis may require antibiotics taken by mouth.

If the problem is severe or recurs, your doctor may take a bacterial culture (a sample of pus is sent to a lab for examination). The results of the culture will then be used to prescribe an effective antibiotic.

You may be advised to temporarily stop shaving until the problem is resolved.

Hot-tub folliculitis goes away in a week without any treatment. However, adequate chlorination of the hot tub is necessary to prevent recurrences and to protect others from infection.

Thank you to all the readers who took the time to contact this column to share their experiences of trigeminal neuralgia – the topic of a recent Check-Up. While some reported satisfactory pain relief using standard pain medications, others recounted resolution of this painful condition following treatment with antidepressant and anti-epilepsy drugs as well as acupuncture.