Folliculitis: Recurring Issues in the Intimate Area

Folliculitis in the genital area?

Hello, doctor.
Since October of last year, I have noticed that near my Bartholin's gland, there are bumps resembling pimples.
Initially, they were small, and I thought they were just regular pimples, so I didn't seek medical attention.
However, after about two days, they became swollen to the point where I couldn't walk or sit down.
I then visited a general gynecologist, who diagnosed it as folliculitis and performed an incision to drain the pus.
Afterward, I took oral antibiotics and recovered in a few days.
However, even after recovery, I could still feel a lump under the skin.
To my surprise, it recurs every month, always swelling to the point where I can't walk or sit.
I have consulted many gynecologists, and they all said it was folliculitis.
Since the first episode, I have been wearing loose clothing and have changed my intimate apparel, as well as significantly altering my diet.
During the past year, there were three months without a recurrence, but during that time, I could still feel a lump under the skin.
Recently, it has recurred again, swelling to the point where I cannot sit or stand.
I would like to ask the doctor if this is folliculitis, a sebaceous cyst, or another condition? If it is still folliculitis, is there a way to completely cure it?

Miss Pan, 20~29 year old female. Ask Date: 2021/10/16

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, it is recommended to visit the obstetrics and gynecology department for a thorough examination.
Wishing you good health.

Reply Date: 2021/10/16

More Info

Folliculitis, particularly in the intimate area, can be a frustrating and recurrent issue. Based on your description, it sounds like you have been experiencing painful bumps near the Bartholin glands, which could indeed be folliculitis or possibly another condition such as a sebaceous cyst (often referred to as a pilar cyst or epidermoid cyst).
Folliculitis is an inflammation of the hair follicles, often caused by bacterial infections, particularly Staphylococcus aureus. It can present as small red bumps or white-headed pimples around hair follicles, and in more severe cases, it can lead to painful abscesses that require drainage, as you have experienced. The fact that you have had recurring episodes, despite changes in clothing and hygiene, suggests that there may be underlying factors contributing to this condition.

On the other hand, if you are feeling a firm lump beneath the skin that does not seem to resolve, it could be a sebaceous cyst. These cysts are typically benign and can occur when a hair follicle or skin pore becomes blocked. They can sometimes become inflamed or infected, leading to symptoms similar to those of folliculitis.

To differentiate between these conditions, a thorough examination by a healthcare provider is essential. They may perform a physical examination and, if necessary, imaging studies or a biopsy to determine the exact nature of the lump.
As for treatment, if it is indeed folliculitis, the management typically involves:
1. Antibiotics: Since you have already been prescribed antibiotics, it is important to complete the course as directed. If you experience recurrent infections, your doctor may consider a longer course or a different antibiotic.

2. Hygiene: Maintaining good hygiene in the affected area is crucial. This includes regular washing with mild soap and water, and avoiding tight clothing that can irritate the skin.

3. Warm Compresses: Applying warm compresses to the area can help reduce inflammation and promote drainage if there is an abscess.

4. Topical Treatments: Your doctor may recommend topical antibiotics or antiseptics to help prevent further infections.

5. Lifestyle Modifications: As you mentioned, dietary changes and wearing loose-fitting clothing can help reduce friction and irritation in the area.

If the condition persists or worsens, further evaluation may be necessary. In some cases, recurrent folliculitis may require referral to a dermatologist for specialized care. They may consider treatments such as laser hair removal, which can reduce the incidence of folliculitis by minimizing hair growth in the affected area.

In summary, while your symptoms are consistent with folliculitis, the presence of a persistent lump raises the possibility of other conditions such as a sebaceous cyst. A definitive diagnosis can only be made through a clinical evaluation. If you continue to experience significant discomfort or if the lesions do not improve with standard treatment, it is advisable to seek further medical attention. Your healthcare provider can help determine the best course of action for your specific situation.

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