Folliculitis, Barber’s itch

Diagnosis 

If the first treatments don’t work in treating the infection, the patient’s healthcare provider may take the following steps: 

• Medical history and physical examination: The provider will ask questions about your medical history and habits, such as whether you sweat excessively or engage in activities that cause increased sweating. They’ll also inquire about exposure to hot tubs or saunas, shaving practices, and any medications you’re currently using, including acne treatments. This information helps them confirm the diagnosis of folliculitis and determine its specific type. 
• Scraping of the skin sample: The provider will gently scrape the affected skin’s surface to collect a sample. They will then examine this material under a microscope to check for the presence of yeast or other microorganisms. 
• Biopsy (rare cases): In some instances, a skin biopsy may be necessary to rule out other potential conditions. This involves taking a small sample of the affected skin for further examination, helping to confirm the diagnosis and exclude other possible causes. 

Treatment  

The treatment approach for folliculitis depends on factors such as the type and severity of the condition, previous self–care attempts, and the individual’s preferences. If over–the–counter products have been ineffective after a few weeks, it is advisable to consult a healthcare provider who may prescribe stronger medications. Dermatologists can assist in managing folliculitis, identifying potential drug–induced symptoms, and minimizing skin damage or scarring. They may also offer solutions to reduce the visibility of scars. It’s essential to be aware that even with successful treatment, there is a possibility of the infection recurring. Therefore, discussing the risks associated with various treatment options with your healthcare provider is crucial. 

Medications 

• Bacterial Infection Control: Mild bacterial infections can be treated with antibiotic lotions or gels, while more severe or recurrent infections may require oral antibiotics. 
• Fungal Infection Management: Antifungal creams, shampoos, or oral medications are effective against yeast–caused infections, not bacterial folliculitis. 
• Inflammation Relief: To alleviate itching in mild eosinophilic folliculitis, steroid creams may be recommended. For individuals with HIV/AIDS, antiretroviral therapy may help improve eosinophilic folliculitis symptoms. 

Other interventions 

• Minor Surgery: If you have a large boil or carbuncle, your healthcare provider may perform a small incision to drain the pus. This can provide relief from pain, accelerate healing, and reduce the risk of scarring. The area may be covered with sterile gauze to absorb any residual pus.
• Laser Hair Removal: For pseudofolliculitis barbae, especially when other treatments have not been effective, laser hair removal may be suggested. Multiple visits to the healthcare provider’s office are often required for this treatment. Talk with your health care provider about possible side effects of laser treatment. They include scarring and skin that lightens (hypopigmentation) or darkens (hyperpigmentation).