Tufted hair folliculitis is a type of alopecia which involves scarring of the skin and primarily affects the scalp. This condition is rare but is a progressive disorder. The most characteristic feature of this condition is the presence of 10 to 15 hair emerging from one follicular opening. Tufting of hair and scarring of the skin results in inability of new hair to grow from the same follicles.
The pathophysiology of the condition is characterized by convergence of the follicular infundibula (or stem) with several hairs emerging from the same opening, while the lower portion (root) of the hair remain separate and are usually not affected by the scarring. Reports have suggested staphylococcal infections, but their role in the development of tufted hair remains vastly unclear.
The key feature of this condition is presence of tuft of hair that emerges from one orifice. The surrounding areas are scarred with complete loss of follicles. Occasionally the surrounding area may be associated with edema, redness and tenderness (indicating inflammation). In relatively rare cases, pustules may also been seen around the hair follicles.
What Causes Tufted Hair Folliculitis?
Hair folliculitis indicates advanced stage of damage to the hair follicle. Experts believe that tufts are formed due to inflammation of the upper and middle part of the dermis, which spreads on to the inter-follicular dermal tissue and results in the convergence of the follicles.
Some experts believe that inflammation results in retention of telogen hair, which in turn gives it the typical tufting appearance. While others believe that tufting is associated with malformation of the hair.
Biopsy studies have often shown the presence of staphylococcus aureus on the scalp; however most experts believe that it is more of an opportunistic infection, then the primary cause which lead to the tufting of hair.
Tufted hairs are found to be associated with the use of certain medications including cyclosporine. In addition there are reports of tufted hair being associated with conditions like lichen planus, pemphigus vulgaris, acne keloidalis, dissecting cellulitis and folliculitis decalvans.
Natural Remedies For Hair Folliculitis
Contemporary medicine suggests the use of antimicrobial agents to avoid infection and scaring of the scalp, however there are certain home remedies that can be tried.
- Local application of almond oil or walnut oil can help in reducing scarring. These oils contain vitamin E which plays a vital role in the formation of collagen tissue. In addition, local application of vitamin A oil is also very useful as it helps in reducing scarring and hastens the healing of the skin. It is recommended to gently massage the scalp with these oils. Wash the scalp with lukewarm water about an hour later.
- Local application of turmeric paste around the tufted hair can help avoid infection. Turmeric has strong anti-microbial and anti-inflammatory properties which can be useful in avoiding inflammation and scarring. Further, turmeric is considered potent in fighting bacterial infections, which is considered to be the primary cause for this disorder.
- While the role of diet is very limited in this condition, it is recommended to have a diet rich in proteins and vitamins.
- Maintaining scalp hygiene is also considered to be beneficial. Wash your hair regularly with lukewarm water. Add a few drops of tea tree essential oil in a bucket of water before taking a head bath. Tea tree oil helps control the spread of bacterial infection in the scalp.