Folliculitis

Alibert, 1825

Chronic folliculitis of the beard, folliculitis barbae, sycosis simplex, sycosis non parasitaria, Alibert-Mentagra disease.

Chronic folliculitis of the beard.

Inflammation usually caused by Staphylococcus aureus, sometimes by gram-negative bacteria.

Red, succulent, follicularly centered papules, plaques and pustules, which may become confluent over large areas.

• Clinical examination

• Bacterial swab

• Mostly upper lip and cheeks

Sometimes heals with scarring and hair loss.

• Disinfect the razor. Wet shaving should be discontinued

Topical therapy

• Quaternary ammonium compounds

  • Apply 1–2 times daily (for short-term use only)

• Clindamycin emulsion twice daily

  • To prevent the development of resistance, always prescribe in combination with Triclosan skin wash lotion once daily.

  • Adverse effects (very common): Skin irritation (burning, itching, scaling, dry skin and redness)

  • Contraindications: Antibiotic-associated colitis. Breastfeeding

• Clindamycin solution twice daily.

  • To prevent the development of resistance, always prescribe in combination with Triclosan skin wash lotion once daily.

  • Adverse effects (very common): Skin irritation (burning, itching, scaling, dry skin and redness)

  • Contraindications: Antibiotic-associated colitis. Breastfeeding

• Triclosan skin wash lotion

  • Application: Use like liquid soap or shampoo; leave on for 1–2 minutes.

  • Contraindications: Hypersensitivity to ingredients

  • Systemic therapy according to the antibiogram

1. Lohrer R, Rubben A. [Folliculitis barbae in herpes simplex infection]. Hautarzt 2004;55:74-6.

2. Anliker MD, Itin P. [Herpetic folliculitis barbae. A rare cause of folliculitis]. Hautarzt 2003;54:265-7.

3. Meinhof W, Haneke E. [Morphological variants of folliculitis barbae candidomycetica]. Hautarzt 1978;29:74-6.

4. Diernaes JE, Bygum A. Successful treatment of recalcitrant folliculitis barbae and pseudofolliculitis barbae with photodynamic therapy. Photodiagnosis Photodyn Ther 2013;10:651-3.

5. Alexis A, Heath CR, Halder RM. Folliculitis keloidalis nuchae and pseudofolliculitis barbae: are prevention and effective treatment within reach? Dermatol Clin 2014;32:183-91.