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What is the Difference Between Bacterial and Fungal Folliculitis

December 29, 2021 Posted by Dr.Samanthi

The key difference between bacterial and fungal folliculitis is that bacterial folliculitis is an infection of one or more hair follicles caused by bacteria such as Staphylococcus aureus and Pseudomonas aeruginosa while fungal folliculitis is an infection of one or more hair follicles caused by fungi such as Trichophytom rubrum and Malassezia.

Bacterial and fungal folliculitis are two types of folliculitis caused due to bacterial and fungal infections, respectively. Folliculitis is an infection of one or more hair follicles in the skin. The rash may appear like pimples. These rashes can be observed on the face, chest, back, arms, legs, buttocks, or head. Folliculitis can be caused by different pathogens such as bacteria, fungi, viruses, and mites.

CONTENTS

1. Overview and Key Difference
2. What is Bacterial Folliculitis
3. What is Fungal Folliculitis
4. Similarities – Bacterial and Fungal Folliculitis
5. Bacterial vs Fungal Folliculitis in Tabular Form
6. Summary – Bacterial vs Fungal Folliculitis

What is Bacterial Folliculitis?

Bacterial folliculitis is an infection of one or more hair follicles caused by bacteria such as Staphylococcus aureus and Pseudomonas aeruginosa. This common type of folliculitis is marked by itchy, white, pus-filled bumps. This condition usually occurs when hair follicles become infected with skin bacteria such Staphylococcus aureus and Pseudomonas aeruginosa. Staphylococcus bacteria normally live on the skin all the time. However, they cause problems only when they enter the human body through a cut or another wound.

Bacterial and Fungal Folliculitis - Side by Side Comparison

Figure 01: Bacterial Folliculitis

Hot tub folliculitis is another bacterial folliculitis that is caused by Pseudomonas aeruginosa. With this type, the patient may develop a red rash and itchy bumps after exposure to bacteria. The Pseudomonas aeruginosa bacteria generally can be found in many places, including hot tubs and heated pools, where chlorine and pH levels are not well regulated. Young adult males are often affected by bacterial folliculitis. Moreover, bacterial folliculitis can lead to medical conditions such as cellulitis and lymphangitis. The subsequent bacteremia results in osteomyelitis, septic arthritis, and pneumonia. This condition can be diagnosed through bacterial swabs sent for microscopy and culture, skin biopsy, blood test, and histology. The treatments usually include antibiotics such as erythromycin, clindamycin, mupirocin, and fusidic acid, photodynamic therapy, laser removal of hair, analgesics, and anti-inflammatory medicines (codeine, fentanyl, methadone, naloxone, oxycodone), warm compressors to relieve itchiness, antiseptics (hydrogen peroxide, chlorhexidine, triclosan), incision and drainage.

What is Fungal Folliculitis?

Fungal folliculitis is an infection of one or more hair follicles by fungi such as Trichophytom rubrum and Malassezia. Majocchi’s granuloma is a type of fungal folliculitis caused by Trichophytom rubrum. The symptoms include lesions with a pink, scaly central component with pustules or folliculocentric papules at the periphery. The diagnosis can be made through physical examination, skin biopsy, and fungal culture. Treatment options include antifungal medications such as griseofulvin, ketoconazole and itraconazole, oral potassium iodide, filtered local X-radiation, and application of tropical asterol.

Bacterial vs Fungal Folliculitis in Tabular Form

Figure 02: Fungal Folliculitis

Furthermore, Pityrosporum folliculitis is a well-known fungal folliculitis condition. It is also known as Malassezia folliculitis. This type produces chronic red, itchy pustules on the back, chest, neck, shoulders, upper arms, and face. The diagnosis of this condition is made through physical examination. The treatment is through oral and topical antibiotics and antifungal medications, and NSAIDs or antihistamines to relieve the itching.

What are the Similarities Between Bacterial and Fungal Folliculitis?

  • Bacterial and fungal folliculitis are two types of folliculitis caused by bacterial and fungal infections.
  • Both medical conditions are skin infections.
  • In both medical conditions, red skin rashes are a common symptom.
  • They are both caused by pathogenic invasion by normal skin microbes.
  • They are treatable conditions through oral and topical medicines.

What is the Difference Between Bacterial and Fungal Folliculitis?

Bacterial folliculitis is an infection of one or more hair follicles by bacteria such as Staphylococcus aureus and Pseudomonas aeruginosa while fungal folliculitis is an infection of one or more hair follicles by fungi such as Trichophytom rubrum and Malassezia. Thus, this is the key difference between bacterial and fungal folliculitis. Furthermore, bacterial folliculitis is normally treated with antibiotics, while fungal folliculitis is normally treated with antifungal medications.

The below infographic presents the differences between bacterial and fungal folliculitis in tabular form for side by side comparison.

Summary – Bacterial vs Fungal Folliculitis

Bacterial and fungal folliculitis are two types of folliculitis. They are common skin infections. Bacterial folliculitis is caused by bacteria such as Staphylococcus aureus and Pseudomonas aeruginosa, while fungal folliculitis is caused by fungi such as Trichophytom rubrum and Malassezia. So, this summarizes the difference between bacterial and fungal folliculitis.

Reference:

1. “Bacterial Folliculitis.” Bacterial Folliculitis | DermNet NZ.
2. Watson, Kathryn. “Pityrosporum Folliculitis.” Healthline, Healthline Media, 12 Sept. 2019.

Image Courtesy:

1. “Folliculitis” By James Heilman, MD – Own work (CC BY-SA 3.0) via Commons Wikimedia
2. “Pityrosporum folliculitis 2” By Ran Yuping et al. – [1] (CC BY-SA 3.0) via Commons Wikimedia

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Filed Under: Dermatology

About the Author: Dr.Samanthi

Dr.Samanthi Udayangani holds a B.Sc. Degree in Plant Science, M.Sc. in Molecular and Applied Microbiology, and PhD in Applied Microbiology. Her research interests include Bio-fertilizers, Plant-Microbe Interactions, Molecular Microbiology, Soil Fungi, and Fungal Ecology.

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