Acne... Down There...

January 03, 2021

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Getting breakouts in the groin can be exceedingly uncomfortable.  There are a number of triggers for this.

The most common cause for breakouts in the groin is actually a bacterial folliculitis. Staphylococcus aureus is a bacteria that is commonly found in the environment. It can take up residence on the skin- inside the nose, under the arms or in the fold between hip and groin. When it lives in the fold between hip and groin you may not always see signs of it. However, after shaving or sweating or periods of stress there will be ‘breakouts’ that develop in the hair follicles. Most people think they just get ‘ingrown hairs’. Although this can occur, it often develops in pus bumps, boils and cysts that can be recurrent, persistent and scarring for years. 
Other causes include hormonal changes, allergic reactions, hidradenitis (consisted autoimmune), etc. 
Often those who find that they sweat more, have hormonal fluctuations, people that play contact sports, those that share razors, wear tight clothing, etc are more likely to deal with this issue.
How can you tell this apart from an STI?

Herpes is exquisitely tender or painful and classically appears as vesicles or blisters grouped together in a patch or plaque. They are not necessarily based around a hair follicle the way folliculitis is. The other key point: herpes will resolve without treatment within a couple of weeks. Folliculitis will persist and recur and need to be treated.
The other sexually transmitted infections such as syphilis (classically painless), chancroid, gonorrhea and chlamydia often have an enlarged lymph node in the area. Always check for ‘lumps’ that can be painful along the fold between the hip fold. I strongly recommend a dermatologist evaluation as sometimes the clearest diagnosis is made by biopsy or culture of the lesions. 

Do's and don'ts when you do get breakouts:

  • Wash with an antibacterial soap like dial or lever 2000
  • Use disposable razors or frequently change the blade to avoid reinfecting or spreading
  • See your doctor to confirm diagnosis and treatment
  • Wipe down gym equipment and use hand sanitizers 
  • If you feel as though you suffer from excess sweating then consider using a stick  antiperspirant in the fold between hip and groin to decrease sweating 

  • Don’t wear tight constrictive clothing
  • Don’t share razors 
  • See your doctor! You will likely benefit from a slightly longer course of antibiotics along with an antibiotic cream called mupirocin to the fold between hip and groin one week per month for 3 months to treat staph carrier state. 


Can we explain further what “draining tracts” are with reference to hidradenitis suppuritiva?


Draining tracts are actual channels that develop under the skin. They generally start with a nodule or inflamed focus under the skin that seeks an “exit” out of the skin to release pressure that is building up in the skin.  This results in the inflammatory fluid developing a tunnel under the skin that start at the nodule and travel to the surface of the skin to drain.  Once these channels or tracts develop, they can persist and continue to drain fluid to the skin.  They can also serve as a conduit for bacteria to travel backwards from the outside of the skin to under the skin to continue a vicious cycle of persistent drainage.




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