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    How to manage follicular disorders

    Follicular disorders can affect patients of all ages and skin types. Read more about how to diagnose and manage disorders of the follicle.

    follicular disorders
    Author
    HealthCert Education
    3 minute read

    Understanding and managing follicular disorders is essential for primary care doctors looking to expand their portfolios and increase patient satisfaction. Follicular disorders can affect patients of all ages and skin types, making them a common concern in general dermatology.

    For further information on this topic, you may be interested to learn more about the HealthCert Professional Diploma program in General Dermatology.

    The following guidelines provide a foundation for diagnosing and managing these conditions effectively.

    Understanding follicular disorders

    Follicular disorders involve the hair follicles, the tiny structures in the skin responsible for hair growth. These disorders can manifest in various ways, causing discomfort and cosmetic concerns for patients. Some of the most common follicular disorders include:

    • Acne vulgaris is a widespread skin condition that affects hair follicles and oil glands. Understanding the different types of acne lesions (comedones, papules, pustules, nodules, and cysts) is crucial for proper management.
    • Folliculitis is an inflammation of the hair follicles that can result from bacterial, fungal, or viral infections. Differentiating between superficial and deep folliculitis is essential for effective treatment.
    • Hirsutism involves excessive hair growth in women in areas where men typically grow hair. It may indicate an underlying hormonal imbalance.
    • Alopecia areata is an autoimmune disorder that causes hair loss in round, smooth patches. It can be emotionally distressing for patients.
    • Follicular cysts, including epidermoid and pilar cysts, are benign growths that form within the hair follicles. They may need removal if they become bothersome or infected.

    Diagnosis and evaluation of follicular disorders

    Accurate diagnosis is the first step in managing follicular disorders effectively. Here's how to approach the diagnostic process in a primary care setting:
    1. Start by taking a detailed medical history, including any family history of skin conditions, medications, and previous treatments. Pay attention to the patient's concerns and symptoms.
    2. Perform a thorough skin examination, noting the location, size, and appearance of lesions or abnormalities. Don't forget to examine the scalp, as many follicular disorders can manifest there.
    3. In some cases, a skin biopsy may be necessary to confirm the diagnosis. This involves taking a small sample of skin tissue for examination under a microscope.
    4. Depending on the suspected condition, you may need to order additional diagnostic tests, such as blood tests to assess hormonal levels or cultures to identify the causative organism in folliculitis.

    Treatment and management of follicular disorders

    Once you've made a diagnosis, you can outline a treatment plan tailored to the patient's specific condition:

    Lifestyle modifications

    For conditions like acne, educating patients about proper skincare, diet, and hygiene can be incredibly beneficial.

    Topical medications

    Topical creams, gels, or ointments containing antibiotics, retinoids, or anti-fungal agents may be prescribed, depending on the condition.

    Oral medications

    In some cases, oral antibiotics, hormonal therapy, or immunosuppressants may be necessary to manage follicular disorders effectively.

    Procedures

    Minor surgical procedures like cyst removal or corticosteroid injections for alopecia areata may be required.

    Patient education

    Offer guidance on long-term management, potential side effects of medications, and the importance of follow-up visits.

    Understanding common skin conditions like follicular disorders enhances your diagnostic abilities, enables you to address the diverse needs of your patients, and helps you create personalised treatment plans.

    – Dr Rosmy De Barros

    For further information on this topic, you may be interested to learn more about the HealthCert Professional Diploma program in General Dermatology.

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    Read another article like this one: How to treat common cutaneous fungal infections

    References:

    1. Sutaria AH, Masood S, Saleh HM, et al. Acne Vulgaris. [Updated 2023 Aug 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459173/
    2. Winters RD, Mitchell M. Folliculitis. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547754/
    3. Sachdeva S. Hirsutism: evaluation and treatment. Indian J Dermatol. 2010;55(1):3-7. Doi: 10.4103/0019-5154.60342. PMID: 20418968; PMCID: PMC2856356.
    1. Darwin E, Hirt PA, Fertig R, Doliner B, Delcanto G, Jimenez JJ. Alopecia Areata: Review of Epidemiology, Clinical Features, Pathogenesis, and New Treatment Options. Int J Trichology. 2018 Mar-Apr;10(2):51-60. doi: 10.4103/ijt.ijt_99_17. PMID: 29769777; PMCID: PMC5939003.
    2. Al Aboud DM, Yarrarapu SNS, Patel BC. Pilar Cyst. [Updated 2023 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534209/ 
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