I am an otherwise healthy, young male of color that is prone to recurrent folliculitis located along the lateral border of my perineum. It reoccurs almost yearly, for a 3 year period now, and results in an abscess in the same area and pattern. As opposed to most cases I've reviewed, I do not shave the area. I would like to avoid another incsion and drainage, as well as the discomfort associated with the abscess, am considering LHR. Do I sound like a possible candidate, given my 'different' circumstance?
Answer
Your condition may get very painful, bothersome and socially embarassing. It might be a true chronic recurrent bacterial infection of the hair follicles (folliculitis) or possibly an inflammatory reaction to ingrown hairs (especially if you had shaved this area at one time) and this is called a pseudofolliculitis. Recurrent cysts may occur without a folliculitis and some rupture underneath the skin and cause tunnels that come out the surface or develop another cyst that erupts and these sinus tracts, are difficult to cure without surgical removal. Hidradenitis Suppurativa is thought to be a chronic condition of the apocrine sweat glands. It is possible that your doctors may not be able to give you a definitive diagnosis. If standard therapy does not provide improvement, then you might consider laser hair removal. This has been very successful for those individuals who suffer with pseudofolliculitis barbae (of the beard).
Dr. Ron Shelton, MD
Board Certified Plastic Surgeon
Answer
Sounds like you may have hidradenitis suppurativa or severe folliculitis. Our office specializes in laser, medical, and surgical options for hidradenitis and folliculitis. Melapads work well to lessen the problem. Best, Dr. KaramanoukianRealself100 Surgeon
Dr. Raffy Karamanoukian, MD, FACS
Board Certified Plastic Surgeon
Answer
I'm not sure why you're getting abscesses or folliculitis in your perineal area, unless you're shaving the area. I've had wonderful results and resolution of razor bumps of the neck using IPL permanent hair removal. You could have IPL treatments to your perineum. You said you were of color. If your skin is brown, you're less likely to have a great result, and more likely to experience a complication like a burn.
Dr. Eric M. Joseph, MD
Board Certified Plastic Surgeon
Answer
You may be suffering from hidradinitis suppurativa. Hidradinitis is an acne-related condition that occurs in the underarms, groin and perineum. Laser hair removal is an effective additional treatment, along with traditional acne regimens and intralesional steroid injections. For darker skin, the long-pulsed Nd:YAG laser (Lyra-i) is the only safe hair removal laser.
Answer
I agree with Dr. Aldea that you need to be checked for cysts, hidradenitis and even for inflammatory bowel disease related fistulas. If all check out negative and the source of the abscesses are ingrown hairs than you are an excellent candidate for laser hair removal. For darker skinned individuals we use a 1064nm laser (Nd:YAG) preferentially to avoid burns.
