It comes on, generally in the 30s and 40s, a good dozen years or so after the person thought he or she were past the acne years. And where it happens, mostly in the scalp, might be disconcerting, but initially it is easy to assume “It’s hidden by my hair.”

“It” is folliculitis. Sometimes referred to by the full name “folliculitis decalvans,” it’s a skin condition, a term for inflammation of hair follicles. In the initial stages the hair does not seem to be affected – and for the most part it isn’t. But over time, if allowed to persist and become severe, the inflammation can destroy the hair follicles permanently. The result is patchy bald spots.

The cause might be overuse of oils and greases that clog the follicles. However, the cause is most often from a variety of things that break the skin and enable bacteria to invade the hair follicles. Exposure to bacteria from clothing (hats) and impure water (hot tubs are often problematic if not well maintained) might be to blame. Other means by which the bacteria can enter the skin and hair follicles include: shaving, plucking, or waxing; topical application of medication such as coal tar to the skin; and in the case of folliculitis on parts of the body other than the scalp, obesity, tight clothing, or equipment required for sports or an occupation that touches the skin.

Getting a professional diagnosis is an important step in addressing the problem of folliculitis. This isn’t typically a condition that can be addressed by hair loss solutions offered by a hair loss treatment clinic. A dermatologist can usually identify it from an in-office observation.

The cure might simply include eliminating the causes. For example, if the skin eruptions are where the individual shaves, the dermatologist can recommend different ways to shave. Where clothing or hot tubs are to blame, shifting away to other clothes and cleaner (or none) hot tubs can make the difference. A dermatologist might also suggest applying a warm compress several times a day, for 15 to 20 minutes each time, to help clear the skin more quickly. In more severe cases, an antibiotic prescribed by a dermatologist might be the smarter route to go.

As for hair loss, the longer the problem is allowed to persist the greater the chance the hair loss will be permanent. It’s truly a case where an early intervention is the best cure.

So, if you want to keep your hair but are experiencing the pimple-like symptoms of folliculitis, see a dermatologist. He or she will be able to identify a smart treatment and, with luck, a way to keep your hair.