Our Delhi clinic recently had a visitor in the form of Akash, who wanted to learn and understand more about a condition known as folliculitis decalvans.

Here are excerpts from that conversation:

Akash: Doctor, I would like to know more about the condition called folliculitis decalvans. I believe it is a type of alopecia only?

Doctor: You are absolutely right Akash. Folliculitis decalvans is a type of alopecia, which has some amount of scarring involved. We doctors are able to identify it, by observing the red spots, swelling as well as the pustules that tend to form around the hair follicle. The condition leads to the complete obliteration of the follicles, which is why the hair loss caused by this condition, is permanent. This is actually one of the reasons for cicatricial alopecia or baldness which is accompanied with scarring.

Akash: Is it a condition that affects only men?

Doctor: Folliculitis decalvans can affect men as well as women, and the symptoms first start appearing during adolescence. In females, however, it tend to occur at a later age.

Akash: What causes this condition?

Doctor: Well, the exact cause is not yet known, there are those who feel that the condition is caused by deeper infection of the hair follicle by Staphylococcus aureus, a bacteria.

Akash: What are the signs, with which we can identify folliculitis decalvans?

Doctor: Most often, the condition affects the scalp hair. Rarely, the condition can affect hair present on other areas like the lower legs, underarms, thighs, beard and even the pubic region. We are able to detect the condition by observing patches that are roundish in shape and have pustules and crusting  around the follicles which is why there is a tuft like area on the affected region. Since the follicle is destroyed, there is a scar that is left behind and hence the name. For most people, there is severe itching, which leads to the redness and swelling.

We do a scalp biopsy to confirm the diagnosis and start with appropriate treatment.