Folliculitis and Bacterial Infections: Symptoms and Treatment

Folliculitis and Bacterial Infection

Hello, Doctor.
Six days ago, I noticed a small red swelling on my right thigh, which has progressively enlarged.
By the third day, a white spot (likely pus) appeared in the center.
On the fourth day, not only did I feel discomfort while walking, but it also affected my sleep, and any accidental contact caused significant pain.
The swelling has exceeded the size of a 50 NT dollar coin.
Yesterday, I immediately consulted a doctor (currently I am abroad).
Upon examining the wound, the doctor promptly treated it by making a small incision to allow the pus to drain.
The doctor mentioned that there was a significant amount of pus, and after it drained to just blood, they applied iodine and covered it with what seems to be an absorbent bandage, along with several small gauze pieces secured with an elastic bandage.
The doctor did not explain why it became so severe or whether I should apply any medication or avoid water; they only prescribed 20 antibiotics for me to take.
I would like to ask the doctor: when I removed the bandage today to change it, I noticed the wound is somewhat deep, and there are some white areas inside (similar to pus).
I used a cotton swab to clean it off; is this appropriate? Given that the wound is a bit deep, should I avoid water for a few more days until it heals? Is it appropriate to apply iodine when changing the bandage?
In April of this year, I experienced a similar situation on my left thigh, where the redness and swelling were more extensive, but there was not as much pus as this time.
At that time, I was still in my home country, and the doctor helped drain the pus, applied iodine, and wrapped it in gauze, mentioning it was folliculitis and that I was close to developing cellulitis, possibly due to a slight decrease in my immune system.
I took antibiotics for nearly two weeks and fully recovered.
Aside from this more severe wound, I have developed small pimples (which are different from regular acne) on about ten other areas of my legs, with slight redness and peeling around them, and some have a small amount of pus.
I would like to know why these continue to appear.
Is it also related to my immune system? Currently, I have not been addressing these small pimples (some have faded to just redness over time).
Is this an appropriate way to manage them, or is there a better method? Thank you, Doctor.
I have been troubled by these symptoms for three weeks now...

nelly, 20~29 year old female. Ask Date: 2015/07/23

Dr. Wu Yuxin reply Dermatology

It seems that the handling methods are fine; however, there may need to be more effort put into cleanliness and wearing looser clothing.

Reply Date: 2015/07/23

More Info

Folliculitis is a common skin condition characterized by the inflammation of hair follicles, often caused by bacterial infections, particularly Staphylococcus aureus. Your symptoms, including the development of a painful, swollen area on your thigh with pus, suggest that you may be experiencing a more severe form of folliculitis, possibly progressing towards an abscess. The treatment approach you've described, including incision and drainage of the pus, is a standard procedure for managing such infections.

When it comes to the antibiotics prescribed by your doctor, they are essential in treating the underlying bacterial infection. It's crucial to complete the full course of antibiotics as directed, even if the symptoms start to improve. This helps ensure that the infection is fully eradicated and reduces the risk of developing antibiotic resistance.

Regarding your questions about wound care, here are some recommendations:
1. Wound Cleaning: It is generally advisable to keep the wound clean and dry. If you notice white discharge that resembles pus, it's essential to clean it gently with saline or mild soap and water. Using a cotton swab to remove excess discharge is acceptable, but avoid aggressive scrubbing, as this can irritate the wound further.

2. Avoiding Water: It is wise to avoid submerging the wound in water (like baths or swimming) until it has healed significantly. Showers are usually fine, but try to keep the area dry afterward.

3. Using Antiseptics: Applying iodine or other antiseptic solutions can be beneficial, but be cautious. Overuse of strong antiseptics can irritate the skin and delay healing. If your doctor recommended using iodine, it should be fine, but if you notice increased irritation, consider consulting your healthcare provider for alternatives.

4. Monitoring Symptoms: Keep an eye on the wound for any signs of worsening infection, such as increased redness, swelling, warmth, or fever. If these symptoms occur, seek medical attention promptly.

5. Dealing with Other Pimples: The small red bumps you mentioned on other areas of your legs could also be a manifestation of folliculitis or another skin condition. If they are not causing discomfort and are gradually fading, they may not require immediate intervention. However, if they persist or worsen, it would be wise to consult a dermatologist for further evaluation and treatment options.

6. Immune System Considerations: Recurring skin infections can sometimes indicate an underlying issue with your immune system. Factors such as stress, poor nutrition, or other health conditions can contribute to a weakened immune response. If you find that these infections are frequent, it may be beneficial to discuss this with your healthcare provider, who may recommend further testing or lifestyle modifications to support your immune health.

In summary, it sounds like you are on the right track with your treatment and care for the infected area. Continue to follow your doctor's advice, complete your antibiotics, and monitor your symptoms closely. If you have any concerns or if the situation does not improve, do not hesitate to seek further medical advice. Your health and recovery are paramount, and addressing these issues promptly can help prevent complications.

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