Herpes and Folliculitis: Their Co-existence

The inflammation of hair follicles termed follicultis can effect an individual of any age, region or sex. It also can be initiated by one or more micro-organisms at a given instance. It is the damaged hair follicle, which is a pre-requisite to initiate folliculitis. It can then be invaded by staphylococcus aureus, the commonest infecting agent, fungus such candida, pityrosporum or malassezia , demodex mite, or virus of herpez class.

Herpes virus itself causes skin eruption. Its two different entities are seen in young children and adult age groups. Varicella (chickenpox) is one type which appears as systemic illness with typical skin eruption on face, trunk and other body parts. The rash  is quite distinct from typical folliculitis. It is vesiculo-papulo-pustular and a black scabbing at the end of this eruptive illness. All  forms of rash can be seen at one time on different parts of body. Face and trunk are mostly crowded with typical chickenpox rash as its commonly known name. This variety of herpes vericella skin eruption is most commonly confined to kids and young adults. The rash and the accompanying systemic illness is highly contagious in herpes vericella infection, either as droplets infection through coughing, sneezing or even the vesicular lesion can spread the illness.

The red pimple of folliculitis is papulo-pustular in appearance and it is seen in hairy parts of body, where injury to follicles gives way to invasion by micro-organism residing on skin as normal flora. Folliculitis can spread from one individual to another due to unhygienic lifestyle. Sharing the same toiletries, swimming pools, hot bath tubs are the common mode of its spread.

As for management is concerned, vericella (chicken pox) is self limiting, and rash resolve in about week to ten days time. Only supportive treatment is enough. Itching is controlled by some soothing agent, such as calamine lotion. A local anti-viral cream (zovirex) is also used when extensive facial eruption occur.

Treatment protocol for simple folliculitis stresses more on adopting better hygiene in daily life. Anti-septic soap baths and concurrent use of some solution of anti-infective property must be used along with warm damp washout of effected skin will help in faster healing. Itching is controlled with anti-allergic formulations.

Folliculitis and herpes varicella share common symptoms of severe itching and therefore spread from one part to another part of body. Same virus reactivates many years of being dormant after primary infection but it is localized to nerves and the rash is also distributed in same pattern of nerves. This is commonly called herpes zoster or shingles. Severe pain is predominant in shingles.

In some instances, herpes simplex virus itself causes inflammation of follicles commonly at bearded area. This  can become stubborn in responding to conventional methods of treatment unless a definitive diagnosis is made by isolating virus by doing smear of skin lesion and positive culture for infecting virus. Anti-viral drugs can effectively treat folliculitis of HSV, given for 5-10 days. Isolation of infected individual until active phase is over can save many  from getting troublesome skin condition