Resolution of folliculitis decalvans with medical honey

Dermatol Online J. 2019 Aug 15;25(8):13030/qt07n6v0hs.


Folliculitis decalvans is a rare scarring alopecia that presents with indurated, tender pustules and papules on the vertex and occipital scalp. Although systemic antibiotics with activity against Staphylococcus species provide some symptomatic improvement, folliculitis decalvans remains a significant management challenge and often exhibits a relapsing-and-remitting course. In this report, we posit the potential utility of medical grade honey as a safe and cost-effective adjuvant therapy in the treatment of folliculitis decalvans. We describe a patient with painful, boggy scalp pustules who achieved clearance of his scalp lesions with the addition of Manuka honey. To our knowledge, this report is the first to demonstrate the clinical use of honey in the management of folliculitis decalvans and may lend support to the role of Staphylococcus in the pathogenesis of this disease.

Publication types

  • Case Reports

MeSH terms

  • Alopecia / etiology
  • Alopecia / pathology
  • Alopecia / therapy*
  • Anti-Bacterial Agents / therapeutic use
  • Cephalexin / therapeutic use
  • Folliculitis / complications
  • Folliculitis / pathology
  • Folliculitis / therapy*
  • Glucocorticoids / therapeutic use
  • Honey*
  • Humans
  • Injections, Intralesional
  • Male
  • Scalp Dermatoses / complications
  • Scalp Dermatoses / pathology
  • Scalp Dermatoses / therapy*
  • Staphylococcal Skin Infections / complications
  • Staphylococcal Skin Infections / pathology
  • Staphylococcal Skin Infections / therapy*
  • Treatment Failure
  • Young Adult


  • Anti-Bacterial Agents
  • Glucocorticoids
  • Cephalexin