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Developed pimple like bumps in groin and labia. Having itching. Medication of bacterial vaginosis. Prescribed anti fungal cream. Guide?

DOCTOR OF THE MONTH - Dec 2013
Dec 2013
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Dermatologist
Practicing since : 2002
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My symptoms occured in few step
1)In the month of May I developed a few pimple like painless bumps in my groin and labia and the whole pubic area was itching both from inside and outside.I did shave that area 2 weeks back.I was given medication for bacterial vaginosis. But that didnt clear the bumps.Then the Nurse also gave me an antifungal cream which cleared up the pimples in 3-4 days

2)I started applying caladryl(anti itch) in those areas and the next month (June) I developed a a big lesion on the lower lip of labia majora (right).The lesion was not inside but outside of the labia so my nurse didnt know if it was Bartholin's cyst.She thought it looked like a bigg blocked fair follicle.I took antibiotics and in 7-8 days it shrunk leaving a air filled red colored skin there.I was given to apply Hydrocortisone and Domeboboro solution in the parts that were itching.

3) 5 days after using Hydrocortisone I noticed some pimples whith small white heads just like they appear in the face.This was again before my monthly cycle . After a few days these pimples became bigger from inside the skin .Also the lesion that I had the month back filled up with pus again.This time they all drained and blood came out. When I went to my gynea ,she told me its a case of HS and that I have to be on antibiotics all the time. I was given 3 weeks of antibiotics.She also mentioned that in some cases it can be so bad that the skin needs to be taken out.These lesions went away in another 7-10 days.
4)I freaked out and went to the dermatologist but by that time everything had subsided.When he took a look he said that it was not HS but might have been furunculosis as HS always leaves a scar and in my case there was hyperpigmentation (blackening of the skin in the labia). He asked me to come if it recurrs. Now I am again nearing my monthly cycle and still as confused as ever.As of now I dont have any bumps there.Please do help!!!
Posted Wed, 21 Aug 2013 in Skin Hair and Nails
 
 
Answered by Dr. Sanjay Kumar Kanodia 1 hour later
Hello Madam,

Welcome and thanks for posting your query to XXXXXXX

I have gone through the whole series of problems as mentioned by you. I can understand the concern as well as dilemma of dubious nature of multiple diagnosis made.

Now as I read your problems thoroughly for multiple times and discussed with my panel of dermatologists we made a single pin pointed possibility of "Recurrent folliculitis" in yourself.

Medically you should understand that the skin at genital area is quite hairy, that too with coarse hair. These hair are quite prone for bacterial infection due to the fact that this is always closed so more of sweating and improper hygiene. Therefore by bacterial contamination as well friction results in the inflammation of the hair roots.

Now this infection and inflammation manifest differently at different places as well as during different phase of evolution. Therefore if not meticulously and closely seen there can be multiples of diagnosis. The same is evident in your case from bacterial vaginosis to Bartholin's cyst and to HS and lastly reaching close to the precise diagnosis of furunculosis.

So you must have understood by now that his problem is simple folliculitis or furunculoisis which can be present especially close to menses because of bit variation in hygiene as well use of pads. If you got the above things properly then half of your stress must have been relieved. So kindly relax and read below to relieve the other half.

For the betterment kindly follow the below:

- Do not scratch or even try to touch the area unnecessarily. This is the most important part in your treatment. Due to touching or scratching or pinching the area, there can be more spread of infection to the surrounding area and so further aggravation of the problem.

- You can do cold water orbit warm water compresses to reduce any discomfort and for soothing. Do not try to do hot water compress as can lead to more pain.

- stay away from hot and humid climate.

- Do not wear any synthetic undergarments coming in contact with the affected area. SO wear cotton undergarments to be changed two times in a day.

- Apply any antibacterial cream such as fucidin or mupirocin or gentamicin 2 times a day in a very thin layer so that it should not be visible to naked eye.

- You can take oral painkillers such as paracetamol round the clock to reduce the intensity of the pain.

- A course of good oral antibiotic under medical advice can be taken for 3-5 days.

- Keep proper hygiene by trimming the hair with a trimmer (not shaving or hair removal creams as these itself irritates the hair and skin).

So just relax for the simple situation and by doing above measures you would be totally alright.

I hope these information's will help you. If you have further queries I will be happy to help.

"Wish you good health"

Regards,
Dr Sanjay Kumar Kanodia
MD (Dermatology and Sexually Transmitted Diseases)
Above answer was peer-reviewed by
 
Follow-up: Developed pimple like bumps in groin and labia. Having itching. Medication of bacterial vaginosis. Prescribed anti fungal cream. Guide? 15 minutes later
Thank you doc!! I was just wondering about the cyst/lesion that I had in my lower labia majora...which shrunk after I took antibiotics and again resurfaced when the other bumps came along? I didnt understand why that happened?Is it common to happen in the same place and same way again??That looked more like a longer lesion spreading on the lower lip of labia majora filled with fluid and was little more painful than the other bumps.I have already taken more than 1 month of antibiotics.
 
 
Answered by Dr. Sanjay Kumar Kanodia 37 minutes later
Hello young lady,

Thanks a lot for your prompt reply.

Now you got it properly that the lesion at inner labia was actually a folliculitis lesion turning into a cyst. Even a single hair root can become more infected so that due to pus collection it forms a cystic structure. It is common to find pus collection in these area because of soft and lose skin. So also is true that multiple of the hair roots get inflamed together to form pus filled cystic structure. As probably the pus was reduced by self regression as well by the course of antibiotics, the things became totally alright.

It is quite common to find this kind of problem at the same place because each artist is present for the show including your hair, hygiene issues and skin bacterias too as the main actor!!!

These bacteria are always present on our skin. But due to friction or trivial touching there can be entrance of the bacteria in the skin. Once these enter these proliferate to cause inflammation of the hair roots. The infection then spreads to side by roots and so results in red swollen area with moderate to severe pain, even sometimes of throbbing nature too.

As you have already taken a course of antibiotics for a month so there is no need to take care of any antibiotics further. You just take care of healthy hygiene issue and will be totally alright.

So kindly do not worry for this simple problem of yours. You are totally alright now as well as by doing simple methods will be staying healthy in future too!!

I hope these information's will help you. If you have further queries I will be happy to help.

"Wish you good health"

Regards,
Dr Sanjay Kumar Kanodia
MD (Dermatology and Sexually Transmitted Diseases)
Above answer was peer-reviewed by
 
Follow-up: Developed pimple like bumps in groin and labia. Having itching. Medication of bacterial vaginosis. Prescribed anti fungal cream. Guide? 33 hours later
Thank you very much doc!! Just to put my mind at peace I still need to ask you some more things....my gynae told me looking at me that it is Hidradenitis Supprativa and that it may reoccur...she also said in her report that there have been scarring ....when I went to the dermatologist although everything had subsided by then ,he said that there was no scarring and so not HS. I read on the internet that Stage 1 HS has no scarring..internet has all horrible stories saying doctors thought it was folliculities ...when I saw the images of HS one of the lesion looked like the one I had before. Why are these two docs saying different things?The doctors here dont say much and are very inaccessible.I have few black spots on my inner thighs.I am scared still!!!
 
 
Answered by Dr. Sanjay Kumar Kanodia 56 minutes later
My Dear young lady,

Welcome to the forum again.

I can very well understand your concern for any of the rarest of rare possibility. Now again to reassure you that according to the description given it not at all appears to be Hidradenitis Supprativa. It is a big term and in my clinical setup and experience I always go for biopsy(if needed on the basis of clinical picture) before I diagnose the case as Hidradenitis Supprativa.
HS is a rare disease and it has very different of the manifestations than what you have mentioned in your query. So it is totally injustice to diagnose HS. Therefore Iwould go with the dermatologist's opinion in this instance.

Please don't try to search internet for this kind of possibility because it can give you unnecessary tensions and you would start building vague ideas.

Yes for the scarring part also every of the folliculitic lesion can form the scar. If the inflammation had been deeper then there is always a possibility of mild to moderate scarring in any case. This particular injury we call as dermal injury. So dermal injury always leads to scarring depending upon the level in the dermis.

Now for the few black spots on inner thighs- these are again a part of simple pigmentation basically common in people of Asiatic origin or in other races too. This is due to friction of thigh with opposing surface. You need not to do anything for the same. Just reduce weight to see the improvement.

So relax and reassure yourself for this simple problem!!

I hope these information's will help you. If you have further queries I will be happy to help.

"Wish you good health"

Regards,
Dr Sanjay Kumar Kanodia
MD (Dermatology and Sexually Transmitted Diseases)
Above answer was peer-reviewed by
 
Follow-up: Developed pimple like bumps in groin and labia. Having itching. Medication of bacterial vaginosis. Prescribed anti fungal cream. Guide? 23 hours later
Thank you again doc! I also experience a pricking sensation in the hair follicles, sometimes a little burning sensation /sensitivity and also sometime a little pain just like the pain we experience when we have pimples.When i take a mirror and look I cant see any pimples or bumps though....I always feel that they are forming and there will be an outburst.why is that happening? I also read on internet that lot of times the docs think its folliculities but turns out to be HS!!!
 
 
Answered by Dr. Sanjay Kumar Kanodia 10 hours later
Hi Mam,

Welcome again to the forum.

Now pricking as well as burning or pain sensation or any type of sensitivity is one of the very usual symptoms in normal circumstances to everybody at this area. Along with this there is proven fact that whenever we have any apprehension to any problem then even a slightest thing is perceived on the higher side. I have many time clinically seen persons with lacerated wound without a single wink and persons with a single boil wincing in pain just because of apprehension.

So kindly relax and go through the facts provided by me. So also there are two dermatologists favoring the fact of nothing serious in your case- the one who has seen you in person and myself who has gone through the whole series of description.
So whom would you like to believe - your dermatologists or internet!!
Kindly relax and calm down see the part of glass half filled and not the emptier side of it.
Even though I have not seen you personally but even then based on all the informations provided by you I am so confident that your problem is not at all HS.

Kindly try to ignore the situation and do not put your attention again and again on it. Stop searching internet for HS and search for some good moral boosting stories or something creative.

Even if you feel any problem I am always with you to solve any of your health queries but for the best of this time please forget about HS.

I hope these information's will help you. If you have further queries I will be happy to help.

"Wish you good health"

Regards,
Dr Sanjay Kumar Kanodia
MD (Dermatology and Sexually Transmitted Diseases)
Above answer was peer-reviewed by
 
Follow-up: Developed pimple like bumps in groin and labia. Having itching. Medication of bacterial vaginosis. Prescribed anti fungal cream. Guide? 14 hours later
Thaaank you again doc!!!

You really made me feel at ease....thank u for your patience and explaining things so clearly!I will try and be more positive and not think about it very much.If the next time I have to take your opinion then how do I contact you?I think if I just post it here then it can go to any doc!!!Please do letme know...thank you once again!!!
 
 
Answered by Dr. Sanjay Kumar Kanodia 14 minutes later
Hello Mam,

A bunch of thanks for your appreciation.
Your appreciation is the source of inspiration to work best and provide the best.
You are most welcome for any of dermatological query in future also. You can ask a direct question with reference to my name or can visit my page and ask a direct query form that page. But I pray let you not have any health problem and always remain healthy !!!
Its really nice to have user like you on internet!!!
Thanks a lot again.
"Wish you good glowing skin and healthy life ahead"
Regards,
Dr Sanjay Kumar Kanodia
MD (Dermatology and Sexually Transmitted Diseases)
Above answer was peer-reviewed by
 
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