Inflammation of hair follicles starts as soon as hair damage takes place. Although there is no age predilection for development of follicultis, children and folliculitis go hand in hand. For obvious reason of:
1) Underdeveloped immune system: this weak link makes a child more prone to suffer from diseases including folliculitis.
2) Bad hygiene: This is in part because of carelessness of parents for not keeping good child hygiene. Not changing soiled cloths promptly, results in itchy skin and hair damage. Not taking regular showers after school or sports activity creates favorable ground for follicultis in children, using common swimming pool or hot spa with group or community exposes a child to follicultis due less common bacteria.
3) Tightly packing an infant while traveling or making the child wear cloth of polyester material. This may cause sweating and friction on skin and which leads to follicultis in children.
4) Diabetes: Type 1 diabetes in a child or adolescent makes a child more susceptible to get skin condition from mild follicultis to boils on different areas. The immune system is compromised. Children with HIV/AIDS have very low immunity and get infected readily by fungi and yeast.
Follicultis in children has the same initiation as it occurs in all other age group. Hair damage for any of reason mentioned, and exposure of follicles to micro-organism present on skin of child as normal flora. The most common locations for follicultis in children, are scalp, buttocks, arms and legs and face. Commonly as it happens children recover from folliculitis if early and proper care is taken. The lesion is typical with small red pimple on locations where hair follicles are present. Effected child has mild to moderate itch, with tender pimple and a white head due to pus inside. The surrounding skin also is tender.
It usually resolves without aggressive treatment while keeping good hygiene of child . But delay may result in its progression to:
A) Development into a boil: in which the small red pimple becomes larger as pus collection continues.
B) Developement into furunculous: Which is a condition when boils spread in chain pattern by forming tunnel under superficial layer. This gives appearance of bunch of boils!
C) Development into cellulitis: More deeper involvement present as wide spread cellulitis. When this happens, the child may show signs of fever, chills and fatigue.
Management of children with follicultis: The following are some common and regular practices parents have to adopt when it comes to treating follicultis in children at early stage:-
a) Regular bath with anti-septic soap and drying immediately, usually makes follicultis heal and disappear.
b) Hot and moist compresses to effected area, will sooth itching. Use of calamine lotion is also very effective cooling agent in controlling itching and limiting folliculitis to small area.
c) Use of over the counter steroids of mild strength to relieve itching and inflammation. Application of hot and moist swabs also help give comfort from itching and clean the effected skin from dead tissues.
In case the above measure do not control pediatrician will advise for culture of effected lesion, be it a boil, small abscess or skin scrapings. This will help in finding specific organism causing follicultis in your child.
Most common bacteria which is involved is staphylococcus aureus. Measure usually advised are ;
1) anti-bacterial lotion hexachlophene wash.
2) anti-biotic local cream/lotion containing either clindamycin or erythromycin, twice daily application.
3) oral anti-biotic tablets or syrup formulation. Cephalexin or erythromycin may be given for 7-10 days. In resistant cases combination anti-biotics such as trimathoprim- sulfamethoxazole ,or amoxicillin and clindamycing are advised.
4) If fungal infection is the cause of child with follicultis , pediatrician may advise ketoconazole cream, or meconazole cream/ointment may be used twice daily for 14 days.
The best part of children with folliculitis is keeping a standard hygiene, early detection and home based or over the counter treatment to prevent aggravating folliculitis in children.