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Having a red area with a white head on waist, itching and swollen. Pimples in between my thighs. Advise?

Dec 2013
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Answered by

Practicing since : 2002
Answered : 4168 Questions
Hello Doc,

I hope you remember me.I can send you the list of problems I have had incase you dont have it with you anymore.

I noticed 2 days back while showering what looked like a red area with a white head (like a pus head)in my first there was nothing but something was itching there and i scratched it and then it developed is at the side of my waist where the leg meets the stomach(between the thigh and the stomach).I dont know if I am explaining correctly. Today it has become more swollen and red and the white area in the middle has also become bigger.It appears more spread and although the swelling as of now is not much the area looks red.I dont have a lot of pain right now.Also I developed white head like pimples in between my thighs but today they are gone.How ever they leave behind dark spots. My questions are

1)Does this look like what my gynae diagnosed as HS being correct??As the boilscysts are recurring almost every month?

2)I have not had any skin problems before and now for the past 3-4 months once a month I am getting something or the other.Is there something very wrong with me?I have taken more than a month of antibiotics.

3)Can this be due to some food sensitivity?Should I try some elimination diet?

Please do advice as am really in a dilemma and dont know what to do.

Posted Mon, 2 Sep 2013 in Skin Hair and Nails
Answered by Dr. Sanjay Kumar Kanodia 2 hours later

Welcome to the forum again. I very well remember the sweet and gentle young lady.
So, still you have some of the problems related to skin. Now taking all the problems one by one:

After reading your first query I can make out that you are still not able to come out from the XXXXXXX of HS. I know that from last 3-4 months you are getting the problem of boils and cysts. This is quite a common phenomenon to get boils and cysts at any part of life. This is due to a common reason of inflammation and infection of the hair root and oil glands which I had explained you previously.

You should also know about skin flora- there are the group of bacterias which are normally present on the skin. Whenever these gets access into the skin then it can cause the folliculitis or boils. So it is a very common process to form boils especially the areas which are more sweaty and are most often closed, such as in your case at the inguinal folds (folds between thigh and abdomen). This is also supported by the fact that there is a continuous friction at this area due to closely opposing skin of abdomen and thigh. So both these factors can cause development of simple boils.

I just traced your IP address which is coming from the Dracut, Massachusetts, United States. Oh, you must be wondering why I am interested in above- it is because of simple reason that I wanted to know the weather condition at your local area. It is coming as bit cloudy and slightly warm side. So If I am correct about the weather condition then you must know that weather is also one of the important factor in contribution to boils and folliculitic lesions. The cloudy and warm weather is always favorable for the growth and proliferation of the bacterias.

Along with this there are body factors responsible for the things. Most importantly hygiene, immune status and blood sugar level. If there is any ongoing stress is present then it weakens the immunity and can also lead to folliculitis. I have many time seen in my clinical practice that despite giving antibiotics patient do not respond well. When I try and explore the reason then surprisingly stress appears to be very important factor. Stress itself can weaken the immunity drastically which fights from these bacterias. So all of the above factors are responsible for the development of simple problem from which your are suffering.

There is nothing wrong in yourself. Kindly don't take tensions. At the maximum if you are so much worried then just go for your complete blood count and blood sugar status. In my view these would be normal but will give you a point of satisfaction regarding everything is normal in the body.

Regarding food elimination - there is nothing to be avoided in the diet. There is no direct evidence that folliculitis can be due to particular food item. Even then you can reduce spicy things in your diet which causes more of sweating. Rest you can eat everything.

Lastly, let you should know that HS once happen heals in multiples of months of time. It means a single lesion of HS is so painful and hardy that it do not heal with itself and we have to do multiples of the measures to treat it. Even the initial stages of HS is so bad that are really difficult to manage and once heals leaves bad scarring. In your query I can make out that the lesions develop and then heals swiftly without any scaring. This is the main point of differentiation of HS from the simple folliculitis. So kindly do not worry about your problem of simple folliculitis.

You will be quite alright by simple hygiene measures and reliving your stress as well as diverting your attention form HS.
Hope I have answered your query. If you have any further questions, I will be happy to help.

"Wish you good health"


Dr Sanjay Kumar Kanodia
(MD- Dermatology & STD)
Above answer was peer-reviewed by
Follow-up: Having a red area with a white head on waist, itching and swollen. Pimples in between my thighs. Advise? 13 hours later
Hello Doctor!

Thank you again!So what do you think I might have developed now?It looks like a white pus head with surrounding redness in the area that has not yet gone down.The pus head was there from the very begining and now it has only become bigger.It is not very painful though but the surrounding area has become very red.

I know I shouldnt be so freaked out but when I had gone to a gynae she really freaked me out.....she told me i will keep getting them over and that is why i am being extra cautious.Not that it is helping as am still getting these boils and cysts. Please do letme know.
Answered by Dr. Sanjay Kumar Kanodia 11 hours later
Hello Mam,

Thanks for your reply.

I can very well make out the degree of stress regarding the one name of "Hidradenitis". It has been so much troublesome to you that the things are revolving every now and then in your mind. I am really empathetic to your situation and can feel the pressure in your mind.

So your gynae told you about your skin problem will continue on and on. Alright let me ask you a simple question if you have any problem related to eye then would like to visit a dentist for same. Even if suppose you visited and dentist told you something about eye problem would you be blindly follow the same!!!

I think probably you got the logic of asking my question. With due respect to your gynae, how can a gynae comment on skin problem that too directly to HS. It is one of the rarest possibility and is one of the diagnosis by exclusion of other of the possibilities. We always make the common diagnosis first and then we go for the rare possibilities. HS is not so commonly encountered entity that in a single hit even we dermatologist do not make this diagnosis until and unless it is proved by biopsy and strict clinical picture. The skin problems vary so much in its appearance that even we dermatologist lastly go for biopsy for the confirmation.

In your case seeing the kind of stress you have taken I first and foremost request you to visit the same dermatologist who had seen you before. Explain him about the complete series of problem and the stress regarding your condition. Ask him if biopsy is needed to rule out the possibility of HS. Ask for other of the measures to take care of the problem. A culture and sensitivity of the pus and or skin can be taken to see the most effective mediations suitable to you.

I again request you to kindly not to worry a simple dermatological advice in practical is suffice to sole your problem.
I hope you will not take stress regarding the skin condition and will take proper advice and guidance from the dermatologist.

With best wishes of early recovery of the problem"

Dr Sanjay Kumar Kanodia
(MD- Dermatology & STD)
Above answer was peer-reviewed by
Follow-up: Having a red area with a white head on waist, itching and swollen. Pimples in between my thighs. Advise? 20 hours later
Thank you again doc!!

It is a little difficult here to get appointment ...usually takes 2-3 months to get an appointment from a dermatologist...I have already taken one ...though i find it a lot easier to ask you questions.

I get a lot of pimple like erruptions in the inner thighs on almost everyday basis.Is there any ointmnet or lotion that I can apply there??

About this boil that I am having currently...although the white head had opened it still is inflammed and painful (not very much).Not a lot of pus came out but everytime I warm compress,the white head again opens and very small amount of white pus comes out.Is there anything else that I should do about it?The surrounding area still looks very red and inflammed.
Answered by Dr. Sanjay Kumar Kanodia 5 hours later
Hi young lady,

Welcome to the forum again.

I can understand the part of difficulty in getting appointment of dermatologist in US. Anyway I am there with you to take care of the things till you XXXXXXX the dermatologist.

I have already told you to take care of the things in our previous discussion. I am again enumerating the things:

- Apply any antibacterial cream containing "fucidin" or "mupirocin" two times a day in a very thin layer so that it should not be visible to naked eye.

- You can take oral painkillers round the clock to reduce the intensity of the pain. This will also reduce the redness over the affected area.

-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 or bit 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.

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

If it is possible for you to go for culture and sensitivity of the pus at any good laboratory then accordingly a good effective antibiotic can be taken.

Stress is very important part in reducing our immunity, which in turn cause proliferation of infection. So kindly relax and reduce your stress also!!

I hope you will take good care of yourself. Eat a lot of nutritious food in form of fruits, green vegetables and good protein intake will help you in good recovery of the situation.

Feel free to ask any further queries,
With best wishes of early recovery of the problem"


Dr Sanjay Kumar Kanodia
(MD- Dermatology & STD)
Above answer was peer-reviewed by
Follow-up: Having a red area with a white head on waist, itching and swollen. Pimples in between my thighs. Advise? 2 days later
Hello Doc,

So I did all the measures that you had asked me to take.That boil is healing and has gone down a lot in size.I have one more in the groin area....not very painful but definitely a little painful when i walk.I will attach a picture so that you can take a look.It looked like a red pimple in the begining and then today it looks white.I have had it for 4 days I think.What do you think this could be? I have attached the picture of the new erruption that i have got
Answered by Dr. Sanjay Kumar Kanodia 2 hours later
Brief Answer:
Picture shows simple boil only and not HS

Detailed Answer:

I am really happy to know that you are following the suggestions and the things are slowly working. I have seen the picture sent by you which typically shows a single boil which is typical of simple folliculitis or we say it pyoderma only. The typical yellowish bead is characteristic of above.

So young lady this is really nice and fine to think only in the line of simple things rather than making big diagnosis.

Do not worry about this simple skin problem, you will be totally alright in due course of time. Read all my instructions properly again and follow them properly.

I am always with you to take care of your skin realted health problems.

"With best wishes of early recovery of the problem"


Dr Sanjay Kumar Kanodia
(MD- Dermatology & STD)
Above answer was peer-reviewed by
Follow-up: Having a red area with a white head on waist, itching and swollen. Pimples in between my thighs. Advise? 9 hours later
Dear Doc,

Sorry to be asking you so many questions. Thank you for all your suggestions...I have now stopped thinking about HS and trying to eat healthy rather.The boil seems to have burst today on its own due to friction and looks like its drying.It has been 4 days sinceit popped up.

Today I noticed one more similar red bump near to the one I already had.It looks red and raised at the moment and no pain as of now.I think it will also become into a big boil or pimple just like the earlier one.Is this normal??Why am I getting them so frequently?I do remember getting some bumps earlier but dont rememebr getting them this frequently.Earlier I would never pay so much of attention!!

Please do let me know is it normal to get these kind of bumps during the summer and this frequently?
Answered by Dr. Sanjay Kumar Kanodia 6 hours later
Brief Answer:
you would be completely alright.

Detailed Answer:

This is so nice of you that now you have diverted your mind from HS and are thinking in right direction.

As I have already told sometimes during summer season we get more of eruptions than usual. I have seen some times my patients get continuous eruptions for 3 months to up to 6 months. The basic thing I go for is mainly blood sugar level. If this is normal then there is no need to go any further tests. Basically I avoid giving antibiotics but even then if the eruptions are really large enough then I go for culture and sensitivity of the pus so that the most sensitive and effective antibiotics can be given.

Right from the beginning as I told you that your condition is a simple part of usual boils which sometimes we get more than often. During summer time there is more of humidity and ill maintenance of hygiene as well as more bacterial proliferation, all these factors collectively causes more eruptions. In general our immunity prevents the further eruptions but sometimes it takes longer to combat the situation.
Do not worry about the things, I am totally confident that you would be completely alright.

Lastly you are most welcome to ask your queries and do not at all feel sorry for a single instance.

Get well soon.


Dr Sanjay Kumar Kanodia
(MD- Dermatology & STD)
Above answer was peer-reviewed by
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