Dissecting cellulitis of the scalp

Dissecting cellulitis of the scalp (also called dissecting folliculitis of the scalp, perifolliculitis capitis abscedens et suffodiens, or Hoffmann disease) is a rare, long-lasting skin condition that affects the scalp. It causes painful, pus-filled lumps and tunnels under the skin that connect different areas of the scalp. Over time, these areas can scar and lead to permanent hair loss in the affected patches. The condition happens when hair follicles become blocked and then infected or inflamed deep under the skin. This creates swollen, soft bumps that may burst and drain fluid or pus. The tunnels that form under the skin (called sinus tracts) are a hallmark of this disease. It most often affects young adult men, particularly those with darker skin tones, and it can be both physically painful and emotionally distressing. Treatment aims to reduce inflammation, control infection, and slow scarring. Options include antibiotics, isotretinoin (a strong acne-like medication), steroid injections, and in some cases surgery or laser therapy. While there is no cure, early and consistent treatment can help manage symptoms and reduce permanent hair loss. This condition is part of a group called the 'follicular occlusion tetrad,' which includes similar scarring skin diseases.

Bring these to your next appointment

• Q1.What treatment do you recommend for my specific case, and how long will I need to take it?,Is isotretinoin a good option for me, and what are the risks and side effects I should know about?,Can any of the hair I have already lost grow back, or is it permanently gone?,Are there any newer treatments or clinical trials I should consider?,How often should I come in for follow-up appointments, and what signs should prompt me to call sooner?,Are there any lifestyle changes, hair care routines, or products I should avoid?,Should I see a mental health professional to help cope with the emotional impact of this condition?

Common questions about Dissecting cellulitis of the scalp