PSEUDOFOLLICULITIS OF THE BIKINI LINE and LEGS OF A WOMAN
By Gary M. White, MD
It is not uncommon for a woman to get a folliculitis or a pseudofolliculitis in the pubic area (or legs) after shaving. There can be a true folliculitis, e.g. staphylococcus, or ingrown hairs, or irritation or a combination.
Red follicular papules and at times pustules are seen. Sometimes larger "cystic" lesions may occur and last for weeks. Careful inspection may show ingrown hairs.
- Shave in the shower pretreating the area with warm water. Some recommend a minimum of 10 minutes to hydrate the skin.
- You may try exfoliating before with e.g. a pumis stone to release ingrown hairs.
- Then apply a lotion or baby oil.
- With regard to razor, one patient did well with the Schick Quattro For Women Trimstyle Razor & Bikini Trimmer
- Shave with the direction of hair growth and don't stretch the skin.
- Shave each area only once. Use short strokes.
- After shaving, apply a soothing cream/lotion (e.g. with aloe vera) or hydrocortisone 1% cream/lotion.
- Don't wax, pluck or pull hairs. This only leads to ingrown hairs.
- Replace the razor heads every few weeks.
- If a breakout is particularly bad, try to let the hair grow out for up to a week.
- Don't scratch.
The presence of any pustules might prompt a bacterial culture. Topical benzoyl peroxide e.g. 5% several times a week may be helpful, preferably one that you put on and leave on (not a wash). The patient must be careful not to get it on clothes as it will bleach them. One approach is to apply before bedtime every other night and wear white underwear. Alternatively, clindamycin solution/gel/lotion may be prescribed. Also, washing daily in the shower with Hibiclens OTC may reduce the bacterial count.
Ultimately laser hair removal may be the best solution for woman with a chronic problem.
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