Folliculitis after hair transplant

Sep 19, 2018 | By Dr. Sangay Bhutia (Hair Transplant Specialist in Delhi)

A common skin condition, Folliculitis is inflammation of skin caused by fungal or bacterial infection. It happens when hair follicles get blocked, are rubbed or catch an infection causing redness and bumps around them. It is characterised by small red bumps, or pimples with whiteheads around the hair follicles. It usually happens after a shave or a hot tub.

While shaving, for instance, the blade of the razor opens up the skin and irritates the follicle. It can also leave particles or bacteria under the skin. That’s when folliculitis occurs. And repeatedly shaving over the same area increases the susceptibility to an infection.

The common cause of folliculitis is staphylococcus aureus (staph) bacteria, but it can also be caused by an inflammation from ingrowth of hair, or a virus or fungi. It can occur anywhere on the body but usually happens on the scalp. In appearance, these are small red bumps, or pimples with whiteheads around the follicles. In severe cases, they can become crusty, pus-filled sores.

Folliculitis usually takes care of itself and can be treated with simple care and oral antibiotics. Doctors also recommend antibacterial skin washes. Folliculitis cause by yeast or fungi can be treated with antifungal shampoo or body wash such as ketoconazole or Nizoral.

But it is a problem if it reoccurs, and becomes severe and spreads.

Here are some of the types for folliculitis:
1. Pseudofolliculitis barbae or razor bumps are a common occurrence in the beard area, and it happens to a high percentage of men with curly hair. It occurs when there is ingrowth of hair, which causes inflammation.

2. Folliculitis Decalvans is kind of hair loss or alopecia. It appears in the form of redness and pustules around the follicles. It can destroy the hair follicle and cause permanent hair loss.

3. Eosinophilic folliculitis happens to people with weak immunity. It is characterised by recurring itchy rashes, and red bumps and pustules.

4. Keloidalis acne is a chronic inflammatory condition that occurs on the back of the neck and resembles keloid scars. It is caused by short haircuts, trauma, ingrown hair, and close-shaving.

5. Malassezia folliculitis or Pityrosporum folliculitis is a condition in which the hair follicles in sebaceous areas (upper trunk, shoulders, and occasionally head and neck) are infected by yeast, causing itchy, acne-like condition.

So what does Folliculitis have to do with a hair transplant?

It is a common occurrence after a hair transplant procedure appearing within the first few weeks of the surgery to about six months or so. While few small red bumps or redness in and around the transplanted area are normal, but if the whole area is filled with them, it is a cause of concern and the patient must report to their doctor immediately.

During a hair transplant procedure, surgeons makes tiny incisions in the back and sides of the scalp to extract follicles for transplanting, and place them onto the bald or thinning spots. The grafts may become ingrown hairs. But that is usually only for a short period and clears up itself.

But sometimes these ingrown hair become big bumps with pus, and become itchy, that’s when they need treatment before they hamper the growth of the new follicles, and ruin the transplant.

If that occurs, immediate treatment is needed, before the condition worsens. The important thing to know is that it can be treated. The patient should avoid scratching, picking or trying to remove any kind of crusting with their nails because that will only cause scarring and even dislodge the grafts.

The treatment for folliculitis after a hair transplant includes cleaning the infected area two to three times a day with an antibacterial soap or shampoo. And drying it with a clean towel, without rubbing too hard.

The patient can also use acne face wash containing salicylic acid or benzoyl peroxide. These will strip the grease out of the skin, clean the follicles, and kill bacteria. The patient should not apply any lotions or moisturising products to the skin, to avoid blocking the pores. They should also sleep on clean sheets and keep the affected area dry.

This routine followed for a few days should clear up the infection. But in some cases the infection may recur and the patient might be in pain with persistent itchiness.

These patients will need antibiotics, which can be prescribed by a dermatologist or by the surgeon who conducted the procedure. The severity of the condition can be diagnosed by doing a simple swab test.

Mild folliculitis after a hair transplant procedure is nothing to worry about, it can easily be taken care of with antibiotics. But the important thing is to choose the right surgeon to avoid any severe case of folliculitis. Often surgeons place the grafts too deep where they get buried and can cause an infection.

An experienced surgeon can ensure that proper care is taken during the surgery so that the chances of an infection are significantly reduced.