I guess this question is geared more toward Sam since he has been diagnosed with folliculitis decalvans, but feedback from any other informed individuals would be most appreciated.
I suffer from MPB, but as of about 8 months ago I've also been suffering from chronic folliculitis of the scalp. I can't pinpoint it for sure, but it seems to have started while I was on Accutane. My derm gave me topical clindamycin, which didn't work, and eventually gave me a six day course of Zithromax which pretty much knocked it out.
One month after the course of oral antibiotics the folliculitis returned. I can't use minoxidil any more due to irritation. The folliculitis is pretty much all over my entire head and seems to increase my MPB sheds by a whole lot.
Has anyone had luck with any products besides Inflamil. Also, what is the difference between chronic scalp folliculitis and folliculitis decalvans? I couldn't find too much info on folliculilitis decalvans online, but the photos I did see of it generally showed very large crusted infections (mine is just a general redness/itchiness with some small pustules.
I am concerned about the discomfort of course but more so about the potential for permanent hairloss due to scarring alopecia. Do these hairs normally grow back unless they are severely infected?
Scalp Folliculitis
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HairLossFight.com
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Hello JMS and thanks for your questions.
I have been thinking about getting a second opinion on my own folliculitis diagnosis. It seems to me to have gone down considerably since I stopped all topicals. Sadly I have lost a lot of hair in the crown due to the MPB.
Now from what the doctor told me, folliculitis decalvans is a broad diagnosis that is synonymous with scarring alopecia, and there are supposedly many kinds. In my own case there is no VISIBLE scarring or any crusted infections or anything like that. The scarring is at the follicle level, so it's microscopic and underneath the epidermis (from my understanding anyway).
It sounds to me from your description that your situation is very similar to mine. I haven't had any infections of the scalp in a long time, and I think that again, not using topicals has helped. I think when you have a very sensitive scalp, or scalp that has inflammation, you're more susceptible to infections and the like (just my own thoughts, not based on anything in particular but my own perception of my own situation). Sadly, in a situation like that, the topicals tend to have to go (unless of course you're prescribed something topical for the folliculitis itself).
Unfortunately, even if you don't have the visible scarring, if you suffer from scarring folliculitis then those hair will most likely die and be lost permanently. If you're like me, and the hair loss from the folliculitis is following the same pattern as the hair loss from regular MPB, then we're luckier than people that have the scarring alopecias that hit their normally safe regions (the donor areas on the sides and back of the scalp) so in the future it may be possible that you can get a hair transplant once your folliculitis comes to a halt, but we have to be VERY careful in such a consideration and that means getting multiple opinions from qualified dermatologists (preferably ones that specialize in hair and hair-related conditions).
In my own case, it would appear that I no longer have any infection, but their is a slight soreness still to the areas of my scalp where I am losing hair, and sadly I think that's from the folliculitis. I fear losing these will result in permanent loss that no hair loss treatments can regrow.
That's why in our case it is imperative to get inflammation under control to the best of our abilities. JMS, if you figure out something that I haven't yet learnt in your continued research please share it here. I will do the same.
Regards,
Sam
I have been thinking about getting a second opinion on my own folliculitis diagnosis. It seems to me to have gone down considerably since I stopped all topicals. Sadly I have lost a lot of hair in the crown due to the MPB.
Now from what the doctor told me, folliculitis decalvans is a broad diagnosis that is synonymous with scarring alopecia, and there are supposedly many kinds. In my own case there is no VISIBLE scarring or any crusted infections or anything like that. The scarring is at the follicle level, so it's microscopic and underneath the epidermis (from my understanding anyway).
It sounds to me from your description that your situation is very similar to mine. I haven't had any infections of the scalp in a long time, and I think that again, not using topicals has helped. I think when you have a very sensitive scalp, or scalp that has inflammation, you're more susceptible to infections and the like (just my own thoughts, not based on anything in particular but my own perception of my own situation). Sadly, in a situation like that, the topicals tend to have to go (unless of course you're prescribed something topical for the folliculitis itself).
Unfortunately, even if you don't have the visible scarring, if you suffer from scarring folliculitis then those hair will most likely die and be lost permanently. If you're like me, and the hair loss from the folliculitis is following the same pattern as the hair loss from regular MPB, then we're luckier than people that have the scarring alopecias that hit their normally safe regions (the donor areas on the sides and back of the scalp) so in the future it may be possible that you can get a hair transplant once your folliculitis comes to a halt, but we have to be VERY careful in such a consideration and that means getting multiple opinions from qualified dermatologists (preferably ones that specialize in hair and hair-related conditions).
In my own case, it would appear that I no longer have any infection, but their is a slight soreness still to the areas of my scalp where I am losing hair, and sadly I think that's from the folliculitis. I fear losing these will result in permanent loss that no hair loss treatments can regrow.
That's why in our case it is imperative to get inflammation under control to the best of our abilities. JMS, if you figure out something that I haven't yet learnt in your continued research please share it here. I will do the same.
Regards,
Sam
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James
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JMS
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Thanks for the replies guys. My derm had told me to use nizoral shampoo for the folliculitis and all it did was make it worse.
As a side note, I used to suffer from chronic folliculitis on my neck in the bearded area. Nothing got rid of it, including topical antibiotics. A derm I was seeing suggested using benzoyl peroxide on it. I've been using 2.5% benzoyl peroxide on my neck every morning for the last couple of years, and it continues to keep my neck 95% clear of folliculitis. I'm sure it would work for the scalp, but unfortunately it dyes your hair. Well, at least it's of some comfort that if we go to the shaved/bald head look we can use benzoyl peroxide and won't have to worry about walking around with folliculitis all over our scalp.
Sam, you said you are no longer using any topicals, does that include inflamil? I thought you liked that product. What do you guys think about using hair gel?
As a side note, I used to suffer from chronic folliculitis on my neck in the bearded area. Nothing got rid of it, including topical antibiotics. A derm I was seeing suggested using benzoyl peroxide on it. I've been using 2.5% benzoyl peroxide on my neck every morning for the last couple of years, and it continues to keep my neck 95% clear of folliculitis. I'm sure it would work for the scalp, but unfortunately it dyes your hair. Well, at least it's of some comfort that if we go to the shaved/bald head look we can use benzoyl peroxide and won't have to worry about walking around with folliculitis all over our scalp.
Sam, you said you are no longer using any topicals, does that include inflamil? I thought you liked that product. What do you guys think about using hair gel?
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HairLossFight.com
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I am going to buy some more Inflamil soon. Just haven't gotten around to it. Yeah, I do like it and it was one of the only topicals that helped my scalp inflammation settle down.
I don't use hair gel at all because (a) makes my scalp really visible because of the thinning hair and (b) causes a lot of itchiness for me...
I don't use hair gel at all because (a) makes my scalp really visible because of the thinning hair and (b) causes a lot of itchiness for me...