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Folliculitis and Skin Abscesses

by A. Damian Dhar, MD, JD

Folliculitis and skin abscesses are pus-filled pockets in the skin resulting from bacterial infection. They may be superficial or deep, affecting just hair follicles or deeper structures within the skin.

Folliculitis is a type of skin abscess that involves the hair follicle. Abscesses may appear both on the skin surface and within the deeper structures of the skin without always involving a hair follicle. Most abscesses are caused by Staphylococcus aureus bacteria (see Staphylococcus aureus Infections) and appear to be pus-filled pockets on the skin surface. Recently, a strain of Staphylococcus that is resistant to previously effective antibiotics has become a more common cause. This strain is called methicillin-resistant Staphylococcus aureus (MRSA). Sometimes the bacteria enter the skin through a hair follicle, small scrape, or puncture, although often there is no obvious point of entry. People who live in crowded conditions, have poor hygiene or chronic skin diseases, or whose nasal passages contain Staphylococcus are more likely to have episodes of folliculitis or skin abscesses. A weakened immune system, obesity, old age, and possibly diabetes are also common risk factors. Some people may have recurring episodes of infection for unknown reasons.

Doctors may try to eliminate Staphylococcus from people prone to recurring infections by instructing them to wash their entire body with antibacterial soap, apply antibiotic ointment inside the nose, and take antibiotics by mouth.

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