Scalp folliculitis: causes and symptoms

A hair follicle, also known as a pilosebaceous follicle, is a cavity in the skin where hair grows. It is a specific skin structure that produces hair from keratinised cells. Found throughout the skin, with the exception of certain areas such as the palms of the hands, the soles of the feet, and others, these follicles are associated with sebaceous glands that lubricate the hair with sebum. However, inflammation can occur in the hair follicle, leading to folliculitis, characterised by papulo-pustular lesions. This inflammation can have various causes, whether bacterial, fungal, viral, or non-infectious.

What is alopecia-inducing folliculitis of the scalp?

Folliculitis decalvans is a form of folliculitis that specifically affects the scalp. Folliculitis decalvans, also known as Quinquaud’s folliculitis, is an inflammatory condition characterised by the presence of pustules and scabs on the scalp. It is a chronic condition that can lead to the destruction of hair follicles and permanent hair loss in the affected areas. Staphylococcus aureus is often isolated as the causative pathogen for this condition, and anti-staphylococcal antibiotics are effective in controlling pustular flare-ups and preventing relapses. Folliculitis decalvans belongs to a group of scalp conditions known as "scarring alopecias."

How long does scalp folliculitis last?

The duration of folliculitis can vary depending on several factors, including the underlying cause of the infection, the severity of symptoms, and the response to treatment. Generally, folliculitis can last from a few days to several weeks. Mild cases of folliculitis may clear up on their own without treatment, while more severe cases may require topical or oral medications to control the infection and reduce inflammation. It is important to consult a healthcare professional for an accurate diagnosis and an appropriate treatment plan if you have persistent or recurrent folliculitis.

In addition to folliculitis, the scalp can be affected by several other issues. Here is a list of some of them:

• Seborrheic dermatitis: characterised by dandruff, redness, and yellowish, greasy scales on the scalp.

• Scalp psoriasis: causing intense itching and sometimes skin lesions.

• Lichen planopilaris (LPP): characterised by hair loss and scarring on the scalp.

• Frontal fibrosing alopecia: affecting women after menopause, a form of lichen planopilaris.

• Discoid lupus erythematosus: causing the appearance of red, scaly patches on the scalp.

Folliculitis can be caused by bacteria, fungi, viruses, or non-infectious factors. Sometimes, excessive sweat and sebum production on the scalp can also lead to inflammation of the hair follicles, resulting in unsightly bald patches. Here are some of the main causes of scalp folliculitis:

• An infection of the hair follicles by a bacterium such as Staphylococcus aureus

• Fungi, viruses, or physical trauma to the follicles can also cause folliculitis

• Risk factors: Acne or atopic dermatitis, long-term use of certain medications such as cortisone creams, regularly wearing clothing that traps heat and sweat, a weakened immune system due to illness, being overweight, using bathtubs or swimming pools with insufficient chlorine, stress

Superficial folliculitis (ostio-folliculitis)

• Appearance of a red, painful papule around the hair follicle

• Progression to the formation of a pustule centered on a hair

• No general symptoms or fever

Deep folliculitis (boil, staphylococcal carbuncle, etc.)

• Formation of a red, painful inflammatory nodule around the hair follicle

• Presence of a pustule at the top of the nodule centered on a hair

In all forms of scalp folliculitis, the following symptoms are observed:

• Irritated skin

• Itching

• The presence of pustules (whiteheads) or inflammatory nodules centred around a hair

• Scab formation

• A flaky appearance of the skin

• Skin sensitivity and pain.

Expert Tip

If you notice any of these symptoms, we recommend that you make an appointment with a doctor as soon as possible.

Scalp folliculitis can be contagious in some cases, particularly when the infection is caused by bacteria or fungi. People who come into direct contact with infected lesions—such as by sharing combs, hairbrushes, or towels—may potentially contract the infection. It is therefore recommended to avoid direct contact with the affected areas and to maintain good personal hygiene to prevent the spread of the infection. If you suspect scalp folliculitis, we advise you to consult a healthcare professional for an accurate diagnosis and appropriate treatment.

It is important to note that treatment for scalp folliculitis is not a cosmetic matter but rather a therapeutic one and should be supervised by a qualified physician.

We recommend pampering your scalp daily to prevent inflammation in this highly sensitive area, which deserves our full attention. Here are some good habits to adopt daily for a healthy scalp:

Which shampoo should you use to care for your scalp?

We recommend using natural shampoos for a soothed and healthy scalp. Here is our natural shampoo recipe specially designed for sensitive and irritated scalps

To treat scalp folliculitis, it’s important to maintain good hair hygiene and follow the recommendations of a healthcare professional. Choose mild, non-irritating shampoos formulated specifically for scalp issues to gently cleanse and reduce inflammation. Avoid touching or scratching the affected areas to prevent further infection. If the folliculitis persists or worsens, consult a dermatologist who can prescribe appropriate treatment, such as topical medications or antibiotics, to help control the infection and promote healing.

Gipsy graduated from ESJ Paris and spent 10 years working in general and women’s magazines before specialising in health and wellbeing. Now a certified Yin Yoga teacher, she combines her passion for writing with her love of yoga. Through her articles, she aims to share simple, practical habits that support wellbeing and encourage a more mindful approach to everyday life.