Although genital folliculitis may be unpleasant and a little painful, it’s easily treatable and preventable at home. Without prompt attention, however, an infected follicle can develop into a genital abscess, which will need medical attention.
What causes genital folliculitis?
Folliculitis, even in the genital region, is generally self-limited and not contagious. However, due to the proximity of hair follicles to one another in the vaginal region, the infection can spread from one to the next, eventually looking like a patch of acne.
The infection can be caused by bacteria, usually by Staphylococcus aureus (staph), by viruses or fungi.
The initially infected follicle may occur as a result of an ingrown hair, caused by a follicle block (or blockage) by sweat and dead skin cells. Genital folliculitis is more common in areas of the body where hair is rough and often shaved, including the vaginal region. There, the hair is coarser, the skin is more sensitive, and the risk of bacterial infection from razors or other hair removal products is higher.
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The skin around the vagina and inner thighs is thinner and more sensitive than the skin of other parts of the body. Tight clothing and elastic underwear bands can cause excess friction; that, coupled with sweat from vigorous exercise or even just continuous walking, creates an environment that is ideal for folliculitis to occur.
The tight clothing sloughs off dead skin cells, and the sweat and oils in that area become trapped in the hair follicles. Skin is especially susceptible after shaving.
Dirty hot tubs and spas may also cause folliculitis, as bacteria thrive in the hot water. Make sure to clean in between the legs and around the vagina thoroughly after sex and after using a hot tub to reduce your chances of infected hair follicles. Some women may also experience higher occurrences of vulvar folliculitis during their period, due to the shifts in hormone levels.
Main types of vulvar folliculitis
Redness, chafed skin, and itchiness is casually referred to as “razor burn,” occurring within 36 hours of shaving. The sensitive skin of the inner thighs and vaginal region is especially susceptible to irritation, both from tight clothing against the skin and from a partner who has recently shaved. Reduce the irritation with petroleum jelly, and make sure to keep the area clean.
Ingrown hairs are another source of genital folliculitis. New hairs that grow back after removal may become trapped beneath the top layer of skin and curl backwards. As the hair grows, the layers of the skin become irritated and can become infected. Remove ingrown hairs with sterilized tweezers or seek a professional dermatologist or aesthetician certified in genital hair removal.
Genital folliculitis symptoms
Vaginal folliculitis presents like a pimple on the inner thighs, labia, and pubic mound area of a woman’s body. Identify the difference by the position of the hair in the pustule — if the hair is in the middle, it’s genital folliculitis or an infected hair follicle. If it’s a pimple or a patch of pimples, then it’s vaginal acne. If you aren't sure, visit your ob-gyn or dermatologist for a diagnosis.
Folliculitis, unlike genital acne, is typically painless, although boils and carbuncles may be red or sore. There are also such symptoms associated with folliculitis as itching, crusty sores, and low fever. Folliculitis looks like a mosquito bite or raised bump. Vaginal folliculitis caused by ingrown hairs may look like a small splinter under the skin or a raised bump with a dark spot or line (this is the trapped hair).
Side effects of vaginal folliculitis
If left untreated, folliculitis can grow into boils or carbuncles. These are larger infections under the skin, full of pus, that can turn into abscesses. The risk of infection is higher the larger the boil is, and treatment should occur in a sterile medical setting. While these may heal on their own, people with a compromised immune system may end up with a severe infection.
Permanent hair loss is a rare side effect. It occurs when the infection penetrates deep enough into the skin and damage the hair follicle, preventing regrowth.
Genital folliculitis treatment
Treatment for folliculitis in the vaginal region should be handled carefully to prevent transferring the infection and scarring. Mild cases involving just a few infected hair follicles may be treated with warm compresses to loosen the infection and allow the skin to heal or with antibiotic creams recommended by your physician.
You may choose to remove the hair from the follicle if the folliculitis is caused by ingrown hair. Make sure to use sharp tweezers that have been cleaned, preferably with isopropyl alcohol — never use your fingers, as dirt under the nail can worsen the infection.
If the folliculitis has grown into a boil or carbuncle (a group of boils), then a medical professional should drain it.
Preventing Genital Folliculitis
Preventing infected hair follicles in the pubic region includes practicing proper hygiene, including regular washing with gentle soap and hot water. Do not share towels, and change your shower washcloth often to prevent bacteria buildup.
It’s especially important to practice good vaginal hygiene during your period. Not only do hormonal shifts cause the skin to be more sensitive, but there’s also a higher population of bacteria that can infect hair follicles and chafed skin.
Use an exfoliant recommended by your dermatologist — do not use facial products on the vagina unless prescribed. If you choose to shave, use a sharp, clean razor and change it frequently, or switch to an electric razor. You may also wish to consider alternative hair removal methods, such as waxing, depilatories, or laser hair removal.
These procedures remove the entire hair from the root. When the hairs grow back, they’re typically finer, with a smooth tip instead of the blunt, rough tip that shaved hairs have, reducing instances of ingrown hairs.
Genital folliculitis is generally mild and easily preventable with proper hygiene and care. However, it's important to note that certain STIs can look very similar to a folliculitis bump or vaginal acne. If you're sexually active, consider seeking medical attention to check up for a more serious condition.