Dear doctor;

I shaved my beards recently and applied aftershave on my face. Unfortunately, instead of getting the desired effect, I developed pimples which continue to make me very uncomfortable. What could be the problem?

Ndizeye

Pimples are oil glands (sebaceous glands), which get blocked due to excess sebum, then become infected by bacteria, swell up and fill with pus. Sebum is a waxy substance produced by sebaceous glands present all over body except palms and soles. It helps to lubricate the skin and hair. Pimples occur due to overactive sebaceous glands. Common sites for pimples are face, chest, shoulders and back.

Pimples most commonly occur during puberty because due to hormonal changes, sebaceous glands become more active, producing more sebum. The skin pores get blocked and infection occurs with Propniumbacerium acne (a slow growing microbe normally present in skin).This causes inflammation of surrounding skin which manifests as itchy and or painful red eruptions. Superadded infection in them can cause small painful boils.

At times bacterial infection due to use of an unsterilised razor can cause small painful boils which may look like pimples. A small cut can also become infected. Pseudofolliculitis Barbae is a condition commonly found in black population. Because of the tight curls in beards, hair often grows back into the skin, causing an inflammatory response, which manifests as reddish painful spots or eruptions. Some drugs like corticoids, androgens and oral contraceptives among others can cause similar eruptions due to allergy.

Diagnosis of the causative condition can be made by microscopic examination of scraping or discharge from pimples. Treatment consists of antibiotics, ointments containing retinoids and anti allergy drugs. Anti inflammatory drugs can be added if there is inflammation.If good hygiene is maintained, risk of injury and infections will be minimised when shaving.

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