Gram-negative folliculitis is an infection caused by gram-negative bacteria. The infection may occur as a complication in patients with acne vulgaris and rosacea and usually develops in patients who have received systemic antibiotics for prolonged periods. Gram negative folliculitis should be considered in patients with acne who have a flare-up of pustular or cystic lesions and in patients whose acne is resistant to treatment.
is caused by an infection of hair follicles, usually from the bacteria. The
condition is classified as either superficial or deep, based on how much of the
hair follicle it involves. Deep folliculitis is usually more severe. Systemic
antibiotics, such as tetracyclines, can alter the nasal flora. The resultant
overgrowth of gram-negative bacteria can lead to folliculitis.
Gram negative folliculitis is
an advanced form of inflammatory acne. When inflammatory acne persists beyond
treatment and even worsens, gram negative folliculitis sets in. After continued
resistance to antibacterial treatment, the body gradually develops immunity to
the antibiotic, eventually producing acne that is worse than ever before. Four
percent of people who have inflammatory acne will go on to develop
gram negative folliculitis.
There are two clinical variants
of gram negative folliculitis:
Since it results from
antibiotic-resistant bacteria, treating gram negative folliculitis used to be
very difficult. Sufferers can be prescribed systemic, bacteriostatic
antibiotics such as ampicillin, although there is conflicting evidence about
the effectiveness of antibiotics on gram negative folliculitis.
Because of the risk of
serious side effects, especially in women of childbearing age, a medical
observation and evaluation is mandatory before treatment.
Gram negative folliculitis
usually clears promptly with: