Skin Health Skin Health Basics

Fighting Facial Infections: Folliculitis, Cellulitis and Impetigo

Although you might not like to think about it, millions of microorganisms, including bacteria, are living on the surface of your skin. Most of the time they are harmless, but, if you get a cut or even an insect bite everyday bacteria may take the opportunity to slip under the skin and cause an infection.

Streptococcus and Staphylococcus are two types of bacteria that may sound familiar. They are responsible for a wide range of infections seen throughout the body including strep throat and toxic shock syndrome. But when focusing on the skin, the most common infections caused by these bacteria are folliculitis, cellulitis and impetigo.

What is folliculitis?
Folliculitis is an infection of the hair follicle caused by Staphylococcus bacteria. It causes inflammation when the bacteria leaves the surface of the skin and enters the hair follicle where it begins to reproduce.

Men and women who shave are most at risk for folliculitis. Most often, it appears as pus bumps on the legs and bikini areas of women and the beard area of men. But folliculitis is more common among women when the weather gets warm and they start shaving more often.

How can folliculitis be prevented?
It’s helpful if people can stop shaving. If people do choose to shave, shaving in a downward fashion, as opposed to against the hair growth, can help. Shaving with a sharp razor so you only need one pass reduces risk. Sometimes using shaving creams that contain benzoyl peroxide or antibacterial agents can also help.

How is folliculitis treated?
Folliculitis is treated with topical and/or oral antibiotics, for example, dicloxacillin, erythromycin, cephalexin, for one to two weeks. Over-the-counter antibiotics such as Neosporin can have a mild antibacterial effect.

What is cellulitis?
Cellulitis is a bacterial infection of the skin that is much less common than folliculitis. It's usually caused by either Streptococcus or Staphylococcus. Usually, there's some kind of injury or opening of the skin that that allows the bacteria to slip beneath the surface. Sometimes even a significant scratch can cause an infection.

What are the symptoms?
The skin becomes hot, tender and swollen, and the surface may resemble the skin of an orange peel. With a severe infection, you can sometimes see a red streak across the affected area. Patients sometimes develop a fever or nausea. Symptoms usually develop within 24 hours after the skin has been injured and infected.

There can be serious consequences if cellulitis spreads to the face or hands. For example, in the hands, swelling can compress nerves and tendons, so you wouldn't be able to use your fingers. On the face, cellulitis can be catastrophic if it involves the eye and may cause the eyeball to swell or result in visual disturbances.

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