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A follicle refers to a crust or cavity from which the hair emerges on the surface of the skin. The term folliculitis is used to describe the inflamed condition of the hair. Depending upon the causal organism, folliculitis causes can be characterized as follows:

• Bacterial Folliculitis
• Fungal Folliculitis
• Viral Folliculitis
• Parasitic Folliculitis

Bacterial folliculitis
Bacterial folliculitis develops when bacteria enters the body through a cut, scrape, surgical incision, or multiplies in the skin near a hair follicle. The bacteria can get trapped and the infection may spread from the hair follicles to the other parts of the body.

Bacterial folliculitis may be superficial or deep. Superficial folliculitis, also called impetigo, consists of pustules which are small-circumscribed elevations of the skin containing pus. The pustules are often surrounded by a ring of redness. Deep folliculitis results when the infection goes deeper and involves more follicles to produce furuncles and carbuncles. These are more serious than folliculitis and can cause permanent damage and scarring to the skin.
Bacterial folliculitis usually occurs in children and adults. Staphylococcus aureus is the most common of bacterial folliculitis causes. It also causes sycosis, a deep chronic infection that involves the entire hair follicle.

Besides the species of streptococcus, pseudomonas, proteus and coliform bacteria have also been indicated as of bacterial folliculitis causes. “Hot Tub” Folliculitis is a condition caused by the pathogen pseudomonas aeruginosa. This disease is often caused due to unsanitary conditions at a spa. The pathogens identified in Gram-negative folliculitis include Klebsiella, Enterobacter, and Proteus species. This type of folliculitis sometimes develops in people receiving long-term antibiotic treatment for acne.

Some superficial follicle infections spontaneously resolve themselves. However, bacterial infections like impetigo, furuncles, carbuncles and “hot tub” folliculitis may not resolve spontaneously and generally require prescription therapy. All these infections are typically diagnosed by clinical presentation, after which predisposing factors are identified and eliminated.

Fungal folliculitis
As the name suggests fungal folliculitis is caused due to fungal infections. Superficial fungal infections are found in the top layers of the skin; deep fungal infections invade deeper layers of the skin. The infection from hair follicles can also spread to blood or internal organs.

The dermatophytic fungus, pityrosporum fungus and the yeast candida folliculitis are the prominent among the fungal folliculitis causes.

Dermatophytic folliculitis is caused most often by a zoophilic species, i.e. fungal species that show attraction to or affinity for animals. The condition presents as follicular pustules around a hardened erythematous (reddened) plaque. A deep fungal penetration causes a high degree of inflammation and determines the extent of hair shaft loss that occurs due to the infection.

Tinea capitis or ringworm of the head is the most important form of pediatric dermatophytic folliculitis. The clinical features of tinea capitis vary considerably depending on the species responsible for the infection. Typically, there is partial alopecia with a varying amount of inflammation.
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The term “trichotillomania” comes from the Greek words “thrix,” meaning “hair” and “tillein” meaning “to pull” and “mania,” the Greek word for “madness” or “frenzy”. As the name suggests trichotillomania is a psychiatric condition in which an individual has an uncontrollable urge to pull out his or her own body hair. For people suffering from trichotillomania, hair pulling is more than a habit. It is rather a compulsive behavior, which the person finds very hard to stop. The cause of tricholomania is supposed to be the imbalance of chemicals in the human brain.

People with trichotillomania pull their hair out of the root from places like the scalp, eyebrows, eyelashes, or even the pubic area. Some people even pull handfuls of hair, which can leave bald patches on the scalp or eyebrows. Other people pull out their hair one strand at a time. Some inspect the strands after pulling them out or play with the hair after it’s been pulled. About half of people with this condition also have the habit of putting the plucked hair in mouth.

Trichotillomania has been mentioned as a disorder in very early historical records. But clinically the condition trichotillomania was first described in 1889 by the French physician Francois Hallopeau. The condition is rare – statistics show it affects only 1% to 3% of the population, although new research suggests that the rate of hair pulling may be around 10% or higher.

Trichotillomania affects about twice as many girls as boys. Most people who have trichotillomania develop the condition during adolescence. However, it can start when a person is as young as 1 year old.
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