What are the Implications of Blocked Hair Follicles?

Hair follicles are small structures located within the skin. All the hair on your body, head, and face grows from these hair follicles. If you develop a blocked hair follicle, you will observe pimple-like bumps that develop under the skin which may be red in color and often painful. When the hair follicles get blocked in parts of the body that contains sweat and oil glands, they can evolve into hidradenitis suppurativa, which is a chronic skin condition. This skin condition can affect those areas of the body that sweat or have skin folds. Read on to find why hair follicles get blocked and what are the implications of blocked hair follicles.

Unlike what many believe, blocked hair follicles are not caused due to poor hygiene. Neither are they contagious. The exact trigger that leads to blocked hair follicles is not entirely understood. However, it is believed that hair follicles get blocked through this process:^(1, 2)

• The hair follicles get clogged with keratin, which is a naturally occurring protein that is found in the skin, hair, and nails.
• The clogged hair follicle starts trapping sweat inside.
• The clogged hair follicle starts to fill with bacteria, which then start multiplying and growing.
• The clogged hair follicle that is now filled with bacteria, starts to expand and eventually ruptures.
• This causes a swollen lump or painful pimple filled with pus to develop under the skin.
• Bacteria from the burst follicle now spread, causing more follicles to become blocked. This causes more pimples to form.

There are several risk factors that make you more prone to getting blocked hair follicles. These include:

Having a family history of hidradenitis suppurativa. If one of your parents suffered from blocked hair follicles, there is a high possibility that you might inherit the genes that cause the condition. However, not everyone who develops this condition tends to have a direct relative with blocked hair follicles.^(3, 4, 5)

• Having psoriasis
• If you are a female
• Having certain health conditions that cause insulin resistance or a hormonal imbalance such as polycystic ovarian syndrome (PCOS)
• Being overweight or obese
• Being Hispanic, Black, or biracial
• Smoking cigarettes

Blocked hair follicles tend to develop in parts of the body that contain sweat glands and include skin folds, including:

• Under the breasts
• Armpits
• Inner thighs and groin
• Buttocks

Blocked hair follicles can range in severity from being mild to severe. They typically begin like small or irritated red pimples, and over some time they start to look like pus-filled boils or cysts. They may even abscess and start draining pus and blood. Before seeing the bump of the pimple, you will start to feel a sensation in the skin of that area where the bump is about to appear. Some people also experience skin burns, excessive sweating, or itching.

If left untreated for a long time, the symptoms of blocked hair follicles can worsen and end up developing into other conditions, such as:

• Growing lumps: The symptoms of blocked hair follicles commonly start with the development of a lump that gradually starts becoming painful. These lumps can either develop in just one spot or in multiple parts of the body. These lumps can then continue to persist for several weeks or months even.
• Blackheads: These are pairs of small black bumps that resemble blackheads. These start developing in the advanced stages of blocked hair follicles.
• Abscesses: As the lumps start to grow and begin to fuse, they start to fill up with fluid that turns into painful abscesses.⁽⁶⁾
• Foul Odor: An abscess can eventually break open, secreting pus and blood. These fluids can quickly collect in the clothes and cause a foul odor.
• Scars: Abscesses do not heal quickly, and even if they heal, the process is slow and they tend to return. The recurrence of abscesses causes tunnels to form underneath the skin, which causes permanent scars.

Blocked hair follicles are painful, especially if the boils develop deep underneath the skin. They may also be itchy. Your skin is likely to feel irritated and sore, especially if the cysts and pimples occur in parts of the body that rub together and cause friction.

If left untreated, the condition starts to progress and you may start to see the block dots that appear like blackheads, usually in pairs.

Hidradenitis suppurativa is a type of chronic condition that comes and goes over a period of time. The lumps that develop because of the blocked hair follicles can get connected by tunnels underneath the skin. These tunnels may eventually start leaking blood or pus.

Scar tissue can also form during the healing process, and eventually, this scar tissue can thicken and start to appear red. Over time, parts of the skin such as in the underarms or groin may begin to be filled with a huge amount of thickened scar tissue or widespread lumps. The thickened scar tissue and tunnels can lead to chronic pain and also inhibit the movement of your legs or arms if they develop on these parts.

If you have mild hidradenitis suppurativa, it may appear like folliculitis, which is a common skin condition.^(7, 8, 9) A dermatologist will help determine the exact condition you have. It is important to not leave blocked hair follicles untreated and seek medical care if you develop pimples, rash or boils that don’t seem to resolve over a period of time or they reoccur. Early or ongoing treatment can help prevent any complications from blocked hair follicles.

Once you start to notice the signs and symptoms of blocked hair follicles, it is important to visit a doctor to find out your treatment options so that your condition does not worsen. Treatment recommendations for blocked hair follicles involve making lifestyle changes to medication or even surgery, depending on the severity of your case.

Here are some lifestyle modifications you should make to prevent the condition from spreading to other parts of the body.

• Maintain proper hygiene to prevent outbreaks in the first place.
• Have an everyday skincare routine in place. Use products like antibacterial soaps or antiseptic washes that will kill the bacteria that cause blocked hair follicles.
• Avoid using loofahs or washcloths to scrub the skin as it can cause further irritation to the affected part.
• After cleaning the area, apply an over-the-counter cream on the infected area or you can even sprinkle antifungal powder.
• To manage the main, use warm compresses or even tea bags for ten minutes on the affected part to reduce swelling.
• Avoid squeezing the breakouts as this may cause damage to the skin and also cause the infection to spread.
• Frequently change the dressing on the wound to avoid infections.
• Avoid wearing body-hugging, tight, clothes that cause irritation to the skin. Wear loose-fitting, cotton, or lightweight clothes that do not chafe or rub against the skin.
• Follow a healthy diet and practice some amount of physical activity every day to prevent being overweight and the development of blocked hair follicles.
• Avoid consuming foods with a high glycemic index as they can worsen the condition. This includes foods like red meat and dairy products.
• If you are a smoker, quit at the earliest. Consumption of tobacco products can aggravate the symptoms of blocked hair follicles.

If your doctor determines that you need medications to reduce the severity of your symptoms, you might be prescribed topical medications for the treatment of mild symptoms. These medications help lower inflammation caused by blocked hair follicles, stop any new breakouts, and also heal bacterial infections.^(10, 11)

If you have severe symptoms of blocked hair follicles, your doctor may prescribe systemic medications where the medication has to be administered to the entire body.

Your doctor may prescribe over-the-counter pain relievers to help alleviate the discomfort and pain caused by these skin breakouts.

Retinoids might be prescribed to treat the symptoms of blocked hair follicles. These drugs may take 6 to 12 months to clear up the symptoms, but they can cause side effects like dry skin. Retinoids are also not safe to be had for pregnant or breastfeeding women.^{(12, 13, 14)}

In some severe cases of blocked hair follicles, the doctor may prescribe steroid shots or pills to lessen the swelling and also prevent new breakouts. However, steroids have various side effects, including weight gain, mood swings and upset stomach.

In severe cases where the condition has penetrated underneath the skin and can no longer be treated with medications, a dermatologist may recommend that you undergo surgery. There can be several surgical routes to take for treating severe cases of blocked hair follicles:

• Surgical Drainage: This surgical procedure involves cutting out the lumps and draining them. This provides relief from the pain. However, this only provides temporary relief as these sores tend to reoccur.^(15, 16)
• Surgical Removal: Surgical removal involves surgically removing the lumps as well as the infected skin of that area. The operated area is then sealed with the help of skin grafts. After the surgery, the lumps do not reoccur in the same place, but these sores can still develop in other parts of the body.^{(17, 18, 19)}
• Laser Therapy: This is believed to be the most effective surgical treatment for getting rid of blocked hair follicles. In this form of treatment, beams of cold gases or light are used for destroying the infected hair follicles completely and removing the lumps.^{(20, 21, 22, 23)}
• Electrosurgery: This process involves combining skin-tissue-sparing removal of the damaged tissue with the use of electrosurgical peeling. This type of treatment is used to treat the severe complications that arise from blocked hair follicles.⁽²⁴⁾
• Deroofing: This form of treatment is used to remove the painful nodules by removing the upper layer of the tissues to directly explore the tunnels that form underneath the skin between the nodules.^(25, 26)

It is a challenging process to get rid of blocked hair follicles completely or prevent them from reoccurring. However, here are some tips to help prevent or slow down the occurrence of blocked hair follicles:

According to the American Academy of Dermatology, nearly 70 to 90 percent of people with hidradenitis suppurativa smoke cigarettes.⁽²⁷⁾ If you limit or stop smoking cigarettes altogether, you may experience reduced flare-ups or sometimes even help eliminate the condition entirely.⁽²⁸⁾

• Watch your weight and maintain a healthy weight.
• Reduce your sugar intake.
• Try to eliminate simple carbohydrates from your diet, including white bread, desserts, white potatoes, white pasta, etc.
• Try to opt for laser hair removal.
• Manage your stress levels as stress is known to aggravate the condition. Practice stress-relieving activities like yoga, meditation, and exercise regularly.
• While exercising, try to remain cool. If you find your clothing has become damp and sweaty, you should try to change into dry clothes at the earliest.

Blocked hair follicles can develop when the hair follicles or hair shafts present in the skin become clogged. Blocked hair follicles tend to develop in places where the skin rubs together or in the skin folds, such as the armpits or groin. If left untreated, blocked hair follicles can turn into a chronic skin condition known as hidradenitis suppurativa, which causes painful lumps, scarring, and tunnels to develop underneath the skin.

Early diagnosis of the condition and right treatment can help reduce the severity and reoccurrence of the condition. This can also prevent potential complications to develop from blocked hair follicles.

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