Complications
Severe (or deep) cases of folliculitis can evolve into abscesses, which are treated with antibiotics and incision and drainage. The antibiotic of choice for uncomplicated skin abscesses is trimethoprim/sulfamethoxazole. Clindamycin is an alternative option.[38]
The likelihood of severe folliculitis evolving into an abscess depends on the patient population. The likelihood is higher in patients who are immunocompromised; patients with diabetes mellitus or hidradenitis suppurativa; and those with antibiotic-resistant folliculitis.
Systemic infection resulting from localised folliculitis is rare among healthy individuals but can occur in immunocompromised patients. Systemic infection usually stems from progression of deep, untreated, bacterial folliculitis. When systemic infection is recognised, every measure must be taken to identify the infectious agent and initiate appropriate antibiotic therapy. In many cases, prompt, empiric antibiotic therapy is necessary before information regarding the aetiological agent becomes available. Blood cultures should be drawn before administering empirical antibiotics if possible.
Scarring can occur following deep and extensive inflammation around hair follicles. Timely treatment of deep, infectious folliculitis may reduce the risk of scarring.
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