Hydradenitis of the scalp( abscessed perifolliculitis): symptoms, treatment

August 12, 2017 15:30 | Hydradenite

Abscessed and undermining perifolliculitis( not to be confused with inguinal and axillary hydenaditis) is a purulent disease that has foci of inflammation in hair follicles and capsules of the sebaceous glands.It is also called the hydradenitis of the scalp, about treatment at home, symptoms and reviews, we'll burn today.

Features of the ailment

Abscessed perifolliculitis, called perifolliculitis Hoffman, is infrequent.The main contingent of cases are residents of the Caribbean. The disease is more common in men than in women( 5 times more often). Representatives of the Negroid race are more often treated with complaints to the scalp.The age contingent of cases varies from 18 to 40 years.The problem of perifolliculitis of all varieties and forms is solved by a dermatologist.

The scalp is exposed to rashes, the formation of abscesses on both the skin surface and in its deep layer - the dermis.Sometimes perifolliculitis affects areas of hair bulbs in the axillary and inguinal areas.The disease is know

n from ancient times, but is described in detail by Dr. Goffman.

Classification and stages

Perifolliculitis usually affects isolated areas of the head covered with hair in the area of ​​the crown, forehead or temporal areas.

  • In the first stage of hydradenitis, the rash becomes larger( from small to lenticular seeds).A hyperemic zone appears on the circumference of the fluid element.
  • As the disease progresses, the hair in the lesions( papules and pustules) falls out or breaks.Characteristic is the formation of pustules as a result of the fusion of the affected areas.In the second layer of the skin, the dermis, abscessing nodes are found, often accompanied by the formation of fistula holes with prominent pus and blood.
  • The pathological process ends with the formation of scar tissue and focal alopecia.

Nodal formations that distinguish Hoffmann's perifolliculitis reach up to one and a half centimeters in diameter.Fusing nodes begin to abscess and perforate the surface of the skin with numerous fistulas that have a branched subcutaneous fistula.

Causes of hair loss in the scalp

All the possible causes of abscessed perifolliculitis have not been identified yet, but examination of the majority of patients shows the presence of a gram-positive bacterium - staphylococcus. There is a relationship between the disease and the closure of the sebaceous glands of the skin.The disease is usually accompanied by hydradenitis and acne with deep pustules.


Nodal formations characteristic of the initial stage of the disease are found deep in the subcutaneous layer.The resulting nodes first do not exceed half a centimeter in diameter, as they develop, the dimensions reach 1.5 cm or more.

Skin first without changing the color, gradually appears hyperemia.To the touch, the nodal formations in the initial stages are dense, in the course of development the density decreases, which can be detected by palpation.The skin is affected, the passages between the fistulas increase.About occurring processes are judged by pressing on the cutaneous surface of the affected area, since pus with blood is secreted.

Fistulous formations become fistulas, ulcers and other cutaneous pathological formations.Chronic disease in acute moments is manifested by stretched skin at the site of injury, after healing of the holes on the surface, dense skin rolls, representing scar tissue, are noticeable.Absence in many places of the dermis is felt by the thinness of the skin.

Undercutting perifolliculitis shows similarities with vulgar acne.Common symptoms for both diseases are:

  • proliferation of the stratum corneum in the follicular estuary;
  • congestion of comedones in pustules;
  • a deepening of the follicle from the epidermis into the dermis layer, which increases the risk of inflammation;
  • invasion of infection and the initiation of an infectious secondary process;
  • formation of numerous subcutaneous courses with foci of abscess;
  • formation of pustules and epithelial replacement with a cicatrical connective tissue.


Head hydraenitis 1 In summary, for a number of reasons, the disease is diagnosed based on the following indicators of the examined procedures:

  • hyperplasia of the cervical lymph nodes;
  • subfebrile temperature( about 37 degrees);
  • increase in ESR;
  • decrease in albumin concentration in the blood;
  • Immunodeficiency of cells;
  • leukocytosis;
  • bacteriological shift in the specific content of prokaryotes to the pathogenic side;
  • inflammation of surrounding tissues around the follicular nodes;
  • availability of comedones.

Diagnostic methods are laboratory analysis of blood, palpation, visual examination, anamnesis, bacteriological and histological analyzes.



Patients with undermining perifolliculitis are shown therapy for the correction of immunity combined with antibiotics.Immunoglobulins, Bacteriophan, Staphylococcal Anatoxin, etc., proved to be more effective. The general strengthening of the body is achieved by the intake of vitamins, the qualitative composition of which is determined by the attending physician, biologically active substances, iron-containing drugs.

A good effect is achieved when using applications applied to the affected areas.The composition of applications includes antibiotics( for example, penicillin series) and dimexide.Application with this composition is recommended to be applied every 5-6 hours.

Ichthyol cakes are used only for foci that do not have an autopsy.When the follicles open, they are washed with antiseptic solutions: iodoform, manganese, hydrogen peroxide, etc.

Ultraviolet irradiation, laser irradiation using carbon dioxide, ultrasound treatment are effective from physiotherapeutic procedures.


When the doctor prescribes antibacterial agents for hydrodenite, two basic properties of the drugs are taken into account:

  1. Versatility of action( antibiotics with a wide spectrum of action).
  2. Bacteriological analysis of exudate with the subsequent selection of an antibiotic to the detected species of the bacterium.

Among universal antibiotics, semisynthetic drugs are given priority: Amoxiclav, Klavutin, etc. Cephalosporin drugs are not inferior to them: cefazol, Cefuroxime.Quite often, fluoroquinolone agents such as Ciprofoxacin or Tarivid are used.The antibiotic treatment regimen consists of 2-3 courses with interruptions.The time interval for the duration of the courses and breaks is the same: 10 days.

It is desirable to supplement the medicinal antibacterial treatment with the prescription of sulfonamides of the combined type: Biseptol or Bactrim.The duration of treatment depends on the number of prescribed courses of antibacterial agents.


Peripheriliculitis of Hoffmann with prolonged chronic course and scale of flowing abscesses needs radical treatment.The consequences of operations are treated as well as all purulent wounds.

About the treatment of hydradenitis folk remedies at home below.

Traditional medicine

Hydradenitis of the head In the treatment of abscessed perifolliculitis, folk medicine can be used as an additional therapeutic method.When choosing the directions of herbal medicine, two properties of medicinal plants are used:

  1. Anti-inflammatory.For this purpose, recipes are used using nutmeg, parsley, ginger, aloe, turmeric, garlic.
  2. Immunomodulating.Only germination of seeds of cereal crops, tincture of green walnut fruit, vitamin ashberry tea, primrose leaves as the ingredients of spring salads, eleutherococcus extract, oat broth with honey and other recipes of fortifying folk medicine will only give a positive effect.

Prevention of the disease

In case of unclear reasons for the disease, preventive measures should be of a fortifying nature:

  • adherence to the rules of healthy lifestyle,
  • systematic vitaminization of food and support of immunity,
  • timely treatment of bacterial diseases.

Complications of abscessed perifolliculitis

With the neglect of the disease and the lack of treatment, squamous cell carcinoma can not be ruled out.


The majority of clinical signs are eliminated, although the treatment is of a long duration. Relapses of the disease are not excluded, but it is possible to completely eliminate the disease. The only irreversible consequence after abscessed undermining perifolliculitis is alopecia in affected areas.

This video shows how an abscess is opened with a hidrodenite: