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Last Updated on November 3, 2023


Eczema is a term that encompasses a range of skin conditions characterized by inflammation, itching, and discomfort. However, among the various forms of eczema, follicular eczema stands out as a distinctive and often perplexing condition. Nonetheless, this comprehensive guide will unravel the complexities of this type of eczema, exploring its causes, symptoms, and available treatment options. Whether dealing with this condition or seeking to understand it better, you’ll find valuable insights within these pages.

What is Eczema

However, before diving into the specifics of Eczema of follicles, let’s understand eczema as a broader category. Eczema, often referred to as dermatitis, is a common skin condition characterized by inflammation, redness, itching, and the formation of itchy, scaly, or crusty patches on the skin. Eczema is not a condition but a term that includes various forms, each with unique characteristics and triggers.

What is Follicular Eczema?

This eczema, also known as follicular dermatitis, is a less common form of eczema that primarily affects the hair follicles. However, in this condition, the hair follicles become inflamed and often present as tiny, itchy papules or pustules. Unlike other types of eczema, FE tends to have a propensity for specific body areas, such as the back and chest.

What Causes Follicular Eczema?

The precise cause of FE has yet to be fully understood, a common characteristic of many skin conditions. However, several factors are believed to contribute to the development of this condition.

  • Inflammation: Inflammation within the hair follicles is a crucial feature of Eczema of follicles. Various factors, including immune system dysfunction, may trigger this inflammation.
  • Immune System Aberrations: Moreover, some researchers believe that abnormalities in the immune system may lead to an overreaction to ordinarily harmless substances, resulting in inflammation.
  • Genetic Predisposition: There is evidence to suggest that genetics may play a role in the development of FE, as it tends to run in families.

What Are The Symptoms of Follicular Eczema?

However, eczema of follicles is characterized by a distinct set of symptoms, including

  • Small Bumps or Papules: These may appear as tiny red or skin-colored bumps around hair follicles.
  • Itching: Moreover, intense itching is a hallmark of Eczema of follicles. The itching can be exceptionally bothersome and may interfere with daily activities
  • Pustules: In some cases, bumps (pimple-like lesions filled with pus) may develop.

Diagnosing follicular eczema typically involves a thorough examination by a dermatologist. The appearance of the skin, along with a review of the patient’s medical history, plays a significant role in diagnosis.

Common Triggers and Risk Factors

Understanding the common triggers and risk factors associated with Eczema of follicles is essential for prevention and management. Some factors include

Family History.

Moreover, you may be at a higher risk if you have a history of eczema or related skin conditions.


Exposure to irritants like harsh soaps, detergents, or environmental factors can trigger or exacerbate follicular eczema.


Furthermore, emotional stress can lead to worsening of symptoms. Stress management techniques are essential.

Dietary Factors

While not a direct cause, certain foods may trigger or worsen symptoms in some individuals.

  • Allergies: Allergies to substances such as pollen, dust mites, or animal dander may exacerbate Eczema of follicles.

Treatment and Management Options

Managing follicular eczema typically involves a combination of strategies to reduce symptoms and improve the quality of life. Treatment options may include

a. Topical Treatments


Moisturizers and emollients can help keep the skin hydrated, reducing dryness and itching.

Topical Steroids:

These anti-inflammatory creams or ointments are often prescribed to reduce redness and inflammation.

Topical Calcineurin Inhibitors:

These medications can help control inflammation and itching.


In cases where abscesses are present, antibiotics may be prescribed to treat underlying infections.

b. Lifestyle Modifications

Avoiding Irritants:

Identify and eliminate environmental triggers, such as harsh soaps or detergents.

Gentle Skincare:

Use mild, fragrance-free skincare products that won’t exacerbate symptoms.

Stress Management:

Employ stress-reduction techniques like meditation or yoga.

Dietary Changes:

Experiment with nutritional changes to identify and avoid potential triggers.

c. Medications

Oral Medications:

Medications like antihistamines or systemic steroids may be prescribed in severe cases.


Light therapy, or phototherapy, can be an effective treatment option for some individuals.

d. Alternative Therapies

Wet Dressings:

Applying wet dressings to the affected areas can relieve itching.


Some individuals find acupuncture to be beneficial in managing eczema symptoms.

Herbal Remedies:

Certain herbal preparations may help reduce inflammation and itching. Consult a healthcare provider before trying any herbal remedies.

Coping Strategies and Tips

Additionally, living with follicular eczema can be challenging. However, some strategies can help individuals cope.

Mindful Skincare:

Pay attention to your products and their impact on your skin. Opt for gentle, fragrance-free options.

Consistent Treatment:

Adhering to your treatment plan and maintaining regular follow-ups with your healthcare provider is vital.

Stress Management:

Incorporate stress-reduction techniques into your daily routine to minimize symptom exacerbation.


Prioritize self-care and maintain a healthy lifestyle to support your well-being.

When to Seek Medical Help

While many cases of Eczema of follicles can be managed effectively with topical treatments and lifestyle modifications, it’s important to recognize when medical intervention is necessary. Most importantly, seek medical help under the following circumstances:

Symptoms worsen or spread rapidly:

You develop signs of infection, such as increased redness, pain, or discharge from pustules.

Furthermore, your skin becomes excessively dry, cracked, or prone to bleeding.

Seeing a doctor for Eczema of follicles is essential, especially if you experience symptoms or situations that indicate a need for medical evaluation and treatment. Here are some specific scenarios when you should consider scheduling an appointment with a healthcare provider:

Worsening Symptoms:

However, seeking medical attention is essential if your follicular eczema symptoms become more severe or persistent. Furthermore, includes increased itching, redness, inflammation, or the appearance of new or spreading skin lesions.

Infection Signs:

If you notice signs of infection in the affected areas, such as increased pain, heat, redness, swelling, or pus-filled bumps, consult a healthcare provider. Nonetheless, these conditions can complicate eczema and require treatment with antibiotics.

Bleeding or Excessive Dryness:

If your skin becomes excessively dry, cracked, or prone to bleeding, it’s a sign that your condition is not well-controlled, and you should seek medical guidance.

Difficulty Sleeping or Daily Functioning:

Moreover, if itching and discomfort from Eczema of follicles are interfering with your ability to sleep, work, or engage in daily activities, it’s time to consult a healthcare professional.

Failure of Over-the-counter Treatments:

If over-the-counter treatments and home remedies do not provide relief or show limited improvement. However, seeing a doctor who can prescribe stronger medications or therapies is a good idea.

Persistent Rash:

However, medical evaluation is necessary if your follicular eczema rash persists for an extended period without improvement.

Children and Infants:

If a child or infant is affected by Eczema of follicles, it’s essential to consult a pediatrician or dermatologist. They can provide specialized care and guidance tailored to the child’s age.

Stress and Emotional Impact:

If the emotional toll of dealing with Eczema of follicles is significant or worsens your symptoms, a healthcare provider can offer support and recommend stress management techniques.

Personalized Treatment:

Eczema of follicles varies from person to person. Seeking medical help is essential to develop a customized treatment plan that addresses your specific needs and triggers.

Difference Between Follicular Eczema and Atopic Dermatitis

Aspect Follicular Eczema Atopic Dermatitis (Eczema)
Affected AreasPrimarily affects hair follicles, often found on the back, chest, and occasionally on the arms or legs.It can occur anywhere on the body, commonly affecting the face, neck, elbows, wrists, and knees, and may also appear on the hands and feet.
PresentationCharacterized by small papules or pustules around hair follicles, intense itching, and occasional pimple-like lesions filled with pus.Appears as red, dry, itchy, and inflamed patches of skin. Itching can be severe, leading to skin thickening and discoloration.
Common TriggersGenetics, immune system dysfunction, environmental irritants, stress, dietary factors, and allergies.Strong genetic component, family history of eczema, asthma, or allergies, environmental factors, irritants, allergens, and stress.
PrevalenceLess common and primarily affects hair follicles.One of the most common types of eczema affects a broader range of body areas.
Treatment OptionsTopical treatments, such as emollients, topical steroids, calcineurin inhibitors, and sometimes antibiotics if pustules are present. Lifestyle modifications, stress management, and, in some cases, oral medications or alternative therapies.Similar to Eczema of follicles, but with a focus on managing general eczema symptoms. This includes emollients, topical steroids, calcineurin inhibitors, antihistamines, lifestyle modifications, stress management, and identifying triggers.


Although less common than other forms of eczema, Follicular eczema presents unique challenges. However, with the right approach, you can manage symptoms effectively and improve your quality of life. Moreover, understanding the causes, symptoms, and available treatment options is the first step in this journey. Nevertheless, individuals with Eczema of follicles can lead fulfilling and comfortable lives by working closely with a healthcare provider, adopting a personalized treatment plan, and making lifestyle adjustments. Eczema need not define your existence; it’s a condition you can manage, allowing you to embrace life’s beauty and vitality fully.


MetroBoston Clinical Partners is a well established and experienced research center in the greater Boston area. Under the leadership of qualified physicians and medical professionals, we coordinate a range of clinical research trials in Dermatology and Internal Medicine.

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