Sterile Folliculitis

For the past six or seven years, I’ve been getting folliculitis on the back of my scalp only during the winter. My new dermatologist claims that I have ‘sterile folliculitis.” Apparently, when I get haircuts, the hairs regrow skew and my immune system attacks them as if they were foreign. I have two questions 1) why does this only happen in the winter and 2) why is there a time lag between the emergence of the hair from my skin and the onset of inflammation (my hair is already 1-2 inches long when pus starts to form around the follicle…I would expect the pus to form just as it was emerging, not a couple of inches later). Thanks for your help.

P.S. I’m a medical student and would love technical details about the inflammatory response against my hair because I find the whole thing sort of mystifying, assuming the diagnosis is correct.

A good friend of mine has the same problem that you mentioned whenever he gets a haircut, and I have a similar problem around the winter months (when I am in colder weather).

As a medical student you should know that this is the “practice” of medicine… and not the “science” of medicine. There is no solid scientific explanation, but doctors are keen to ‘describe’ what they see and give it fancy names (sterile folliculitis sounds good, and I am supposed to be an expert in the field).

My personal theory is that in the winter months, your skin is more dry; dry skin promotes irritation to the skin. I suspect your neck/back of scalp is more sensitive to dry skin.

With respect to haircuts and folliculitis, I suspect that the short haircuts irritate your skin (the same way dry air/weather does).

You must remember it is not all about the diagnosis, but what you do with it and how you treat it. We can all try to be intellectual and talk about the immune system and the mediators such as IL2, IL4, TGF, B cells, T cells, etc, etc (immunology), but in the end it seems cold weather and short haircuts just don’t agree with you. Avoid short haircuts and try moisturizing cream.