Recurring Folliculitis: Causes and Treatments for Women

Recurrent folliculitis

Hello Doctor: I often get pimples near my vulva.
Two weeks ago, I visited a gynecologist who diagnosed it as folliculitis.
One of the largest lesions had developed into a mild cellulitis.
I was prescribed antibiotics and an ointment, and the wound has healed, but there is some hyperpigmentation and a hard lump underneath.
Recently, in the last couple of days, I have developed four to five small blisters and pimples in other areas of my vulva.
One of them resembles the previous cellulitis lesion; it’s just a small hard area, but I can't find any redness.
I mostly wear skirts.
Why do I keep experiencing these recurrences, and are all of these issues related to folliculitis?

Xiao Yu, 30~39 year old female. Ask Date: 2021/07/11

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, it is still possible.
I recommend continuing treatment with an obstetrician-gynecologist.
Wishing you good health.

Reply Date: 2021/07/11

More Info

Recurring folliculitis, particularly in the genital area, can be a frustrating and uncomfortable condition for many women. Folliculitis is an inflammation of the hair follicles, often caused by bacterial infections, but it can also be triggered by other factors such as friction, moisture, and certain skin conditions. In your case, the presence of small bumps or "pimples" around the vulvar area, along with a previous diagnosis of folliculitis and a more severe case of cellulitis (a deeper skin infection), suggests that there may be underlying factors contributing to the recurrence of these lesions.

Causes of Recurring Folliculitis
1. Bacterial Infection: The most common cause of folliculitis is a bacterial infection, often due to Staphylococcus aureus. If the initial infection was not completely resolved, it could lead to recurrent outbreaks.

2. Friction and Irritation: Wearing tight clothing or materials that do not allow the skin to breathe can cause friction and irritation, leading to inflammation of the hair follicles. Even though you mentioned wearing skirts, other factors such as sitting for prolonged periods or wearing non-breathable fabrics can contribute to this issue.

3. Moisture: The genital area is naturally moist, and excessive sweating or moisture can create an environment conducive to bacterial growth. This is particularly true if hygiene practices are not optimal.

4. Skin Conditions: Conditions such as eczema or psoriasis can also predispose the skin to folliculitis. If you have a history of sensitive skin or other dermatological issues, this could be a contributing factor.

5. Hormonal Changes: Hormonal fluctuations, such as those occurring during menstruation or pregnancy, can affect the skin and may lead to increased oil production, which can clog hair follicles.

6. Immune System Factors: A compromised immune system can make it more difficult for your body to fight off infections, leading to recurrent issues.

Treatment Options
1. Antibiotics: Since you have already been prescribed antibiotics, it is crucial to complete the full course as directed. If the lesions do not improve, a follow-up with your healthcare provider may be necessary to consider a different antibiotic or a longer course.

2. Topical Treatments: Continue using the topical ointments prescribed by your doctor. These may include antibiotic creams or antiseptic solutions to help reduce inflammation and prevent further infection.

3. Hygiene Practices: Maintain good hygiene by washing the area gently with mild soap and water. Avoid using harsh soaps or scrubs that can irritate the skin. After bathing, ensure the area is thoroughly dried to reduce moisture.

4. Loose Clothing: Opt for loose-fitting clothing made from breathable fabrics like cotton. This can help reduce friction and moisture buildup.

5. Avoid Shaving or Waxing: If you are prone to folliculitis, consider avoiding hair removal methods that can irritate the skin. If you must shave, use a clean, sharp razor and shaving cream to minimize irritation.

6. Follow-Up Care: Since you have experienced recurrent issues, it is advisable to follow up with your healthcare provider. They may recommend further evaluation, such as a culture of the lesions to identify the specific bacteria involved, or referral to a dermatologist for specialized care.

7. Consider Underlying Conditions: If you have other symptoms or a history of skin conditions, discussing these with your healthcare provider can help identify any underlying issues that may be contributing to your recurrent folliculitis.

Conclusion
Recurring folliculitis can be a complex issue influenced by various factors, including hygiene, clothing choices, and underlying skin conditions. By following proper hygiene practices, wearing appropriate clothing, and adhering to your treatment plan, you can help manage and reduce the frequency of outbreaks. If symptoms persist or worsen, seeking further medical advice is essential to ensure effective treatment and address any underlying concerns.

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