Brief Answer:
"Folliculitis"; apply mupirocin cream
Detailed Answer:
Hi,
Thanks for your follow up and sending important details with the picture. After analyzing the information and the picture with diligence it seems that you are suffering from the problem of "Folliculitis" or simply known as boils.
To tell you simply - This is a condition of inflammation and infection of the hair root and oil gland attached to it. To explain it medically, we have hair all over our body which have opening of the oil glands attached to it. By many a factors these hair root and oil gland can become inflamed and infected leading to folliculitis.
The reason for the inflammation and infection of the area is due to the fact that our body harbor multiple types of bacteria on the skin which are known as “Normal flora” of the skin. A bacteria “
Staphylococcus aureus” is also a part of that flora, but as soon as there is some break in the skin or trivially also due to bit ups and downs in immunity, the bacteria gets access into the skin and causes the aforesaid process of inflammation and infection. When it is superficial it heals without any problem, but when it is deep it causes lot of pain and swelling around the area.
In you I can correlate the course of steroid taken for the weight gain and simultaneous shaving of the area before the appearance of the lesions. Steroids have a tendency to reduce immunity as well as in turn cause formation of hormones which induces more folliculitis. That is why you developed aggravation of acne on back and due to shaving there was minor trauma to the skin inducing folliculitis.
In general the folliculitis persist for 1-2 weeks and heals without any problem. After a period of time our immunity prevents the further formation and inflammation. The main concern is when it is occurring frequently and regularly.
There was one more possibility of herpes by the type of description you have given. But I rule out the same on the basis of the picture which shows scattered appearance of the lesions with deep redness and pus over some of the areas, going more in favor of folliculitis. This is confirmed by single relationship in last 3 years.
There are certain important tips regarding your problem:
1. Do not pinch, pop or even try to touch any of the area of boils.
2. Kindly avoid scratching any area of normal skin also, as it leads to minor entry points for the entry of bacteria.
3. Wear cotton clothes and cotton undergarments to be changed two times a day.
4. Maintain proper hygiene and take two times daily bath.
5. Avoid any kind of stress, even for this condition also as stress is one of the very important factor playing role in our immunity (making it low) so prone for infections.
6. For the boils present now, you can do warm saline compresses (1 glass of water and pinch of salt in it) for 2-3 times a day.
If I were your treating
dermatologist then would have suggested you to apply plain antibacterial cream such as
fusidic acid or mupirocin (latest is
retapamulin) and to take pain killer tablet by mouth for reducing the intensity of pain and redness.
If these are enlarging and painful, then along with above mentioned measures you would require a course of
oral antibiotics (best after culture and sensitivity of pus) under
medical advice. If at all you take oral antibiotic, then do take proper dose and full course of antibiotics (as improper dosing and schedule leads to
antibiotic resistance and then recurrent nature of the situation).
Eat healthy and nutritious food to improve your immunity at its best because is the most important factor in reducing and eliminating any infection from the body.
Do not take steroids for gaining weight as I have personally seen so many of the side effects in most of the patients.
Hope I have answered your query. If you have any further questions, I will be happy to help or if you do not have any clarifications, you can close the discussion and rate the answer.
Wish you good health.
Regards,
Dr Sanjay Kumar Kanodia
(MD- Dermatology & STD)