Brief Answer:
Recurrent folliculitis:Maintain good scalp hygiene

Detailed Answer:
Hello,

Welcome and thanks for posting your query to the forum.

I can understand your concern for the problem of frequent instances of painful boils on scalp.

Before I guide you regarding your condition let me guide you for some important points regarding your condition.

To tell you simply - This is a condition of inflammation and infection of the hair root and oil gland attached to it which is medically known as folliculitis.

To explain it medically, we have hair all over our body which have opening of the oil glands attached to it. By many a factors these hair root and oil gland can become inflamed and infected leading to folliculitis.

The reason for the inflammation and infection of the area is due to the fact that our body harbor multiple types of bacteria on the skin which are known as “Normal flora” of the skin.

Most specifically the bacteria “Staphylococcus aureus” is also a part of that flora, but as soon as there is some break in the skin or trivially also due to bit ups and downs in immunity, the bacteria gets access into the skin and causes the aforesaid process of inflammation and infection.

Scalp area has high oil secretion therefore is more prone for such kind of infections. It is quite common in diabetics too to get more infection of the oil glands and hair rots to get more infection.

When it is superficial it heals without any problem, but when it is deep it causes lot of pain and swelling around the area. In general these persist for few weeks and heal without any problem. After a period of time our immunity prevents the further formation and inflammation. The main concern is when it is occurring frequently and regularly.

As I can get from your query that you are diabetic so this can be the main cause of recurrent boils. Though your sugar is under control but even a mild fluctuation can cause more propensities for infection.

There are certain important tips regarding your problem:

1. Do not pinch, pop or even try to touch any of the area.

2. Kindly avoid scratching any area of normal skin also, as it leads to minor entry points for the entry of bacteria.

3. Maintain proper hygiene and take two times daily bath.

4. Avoid any kind of stress, even for this condition also as stress is one of the very important factor playing role in our immunity (making it low) so prone for infections. Yoga, meditations and simple walk do help a lot in improving immunity.

For the remedy part follow the things below:

1.Wash your scalp daily. You will say you are already doing it. But my way of application is- it is to be done twice in a single bath. It means when you are washing your scalp apply first time shampoo for washing the hair part only, then rinse it off immediately with water. Reapply the shampoo again immediately, leave it for around 5 minutes, do a good gentle massage by your fingers for around 2 minutes and then wash it off. By doing so for around 7 days you will get good benefit.

2.The other way if you can not do two time wash is apply your shampoo ( diluted with water) for around half an hour before bath like an hair oil. And then rest of the second application and bath as told above. You can reduce the frequency of twice application after 2 weeks and then can optimize it according to your own need.

3.Stick to one good mild shampoo which is suiting your hair, don’t change the shampoos frequently. If you are using any conditioner also then to be used over the strands of hair only and not over the scalp skin. Do not use antibacterial shampoos frequently as can cause lot of dryness of scalp.

4.Do not use any kind of hair oil or any oily or creamy stuff any time on your scalp. People do have a myth that applying hair oil makes hair good- but we dermatologists totally disagree with that. On one side there is no direct or indirect benefit of hair oil, on the other side it actually attract more of dirt and grease over the scalp leading to more proliferation of germs.

5.Comb your hair at least 3-4 times a day and most importantly at night time so that the dust particle and other of dead skin is taken off.

6.Eat a lot of good healthy diet, do mild exercises, reduce your work stress as all these have bit impact on skin so also on scalp skin.

For the folliculitis of existing origin If I were your treating dermatologist then would have suggested you to apply plain antibacterial cream such as fusidic acid or mupirocin (latest is retapamulin) and to take pain killer tablet such as Ibuprofen or paracetamol by mouth for reducing the intensity of pain and redness.

If these are enlarging and painful, then along with above mentioned measures you would require a course of oral antibiotics (best after culture and sensitivity of pus) under medical advice. If at all you take oral antibiotic, then do take proper dose and full course of antibiotics (as improper dosing and schedule leads to antibiotic resistance and then recurrent nature of the situation).

Let me know if you have gone for the HbA1C test or better known as glycated Hb.

Eat healthy and nutritious food to improve your immunity at its best because is the most important factor in reducing and eliminating any infection from the body.

Hope I have answered your query. If you have any further questions, I will be happy to help.
Wish you good health.

Regards,

Dr Sanjay Kumar Kanodia
MD- Dermatology & Sexually transmitted diseases

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