I do not like shaving because every time I do, I get sores. So I hardly ever wear vests and when I do, that’s when I shave. But the sores come from nowhere and they are actually quite painful. And it’s a general problem with my private areas. Why is this so? Sometimes I press them and something that looks like water comes out. I find it very disgusting to not shave but these sores and tiny swellings are giving me no choice. I’d like to say that it only started recently but it has been a problem for a very long time. Please help me. Is there medication I can take or a cream of some sort?

Agatha

Dear Agatha

Sores after shaving   invariably occur due to bacterial infection, mostly by Staphylococci. Staphylococci are microbes which normally stay in the nose and skin of healthy individuals can cause boils or sores when opportunity presents itself. Poor hygiene can contribute to it.

The problem does not occur with the act of shaving.   A shared and or contaminated razor is the most likely cause. Hidradenitis is a condition where the hair follicles get blocked and can become infected, inflamed, for example, swollen and red. This always occurs in folds of the body like the arm pits, buttocks and groin e.t.c. 

Stress and smoking are said to aggravate this condition. A small genetic predisposition is also said to exist.

Poor hygiene and dampness, among other things, can cause fungal infections in the underarms and private parts. These parts become itchy and scratching them can cause sores due to secondary bacterial infection. At times one may have herpes infection which if not cleared can cause recurrent eruptions, which become painful and swollen due to secondary bacterial infection. 

Conditions like diabetes, renal failure and HIV, which reduce immunity, predispose an individual to recurrent or persistent sores. Long term use of corticoids (many beauty enhancing products do contain corticoids) can also reduce immunity and predispose one to recurrent sores.

Allergy to some substances used can lead to itching and eruptions in underarms and or private parts and also sores. These will be recurrent due to repeated exposure to allergy causing substances.  

Use of soaps with harsh chemicals or strong perfumes may also contribute in a small way to occurrence or persistence of these sores. Wearing very tight clothes or nylon clothes can also cause sores.

The best option for now is to avoid shaving till the condition is cured. Waxing is a better option. Maintain good hygiene; wash soft moist areas of the body with a soft soap. Avoid perfumes and deodorants which can possibly cause allergy. This can be tested by preparing a list of substances you have been using regularly. 

Try to avoid one substance daily for 3-4 days everyday and then reusing it. If sores improve after removal of a substance and recur after reusing it, that is the most likely allergy causing substance.

Avoid stress and smoking. Avoid wearing very tight clothes. Preferably use light cotton clothes which are more suitable for a tropical climate like in Rwanda. Also avoid very strong perfumes.

It would also be good to get tested for diabetes, because diabetes, if present, its management would cure the condition. This is done by doing a simple blood test before eating. A complete course of suitable antibiotic and anti-inflammatory medicine will cure the condition and use of preventive measures will avert its recurrence.

Dr. Rachna is a specialist in internal medicine at Ruhengeri Hospital.