Chronic Vulval Boils: A Struggle with Discomfort
**About Me:**
- **Age:** 28
- **Gender:** Female
- **Health Background:** I have a history of persistent migraines, recurring urinary tract infections (UTIs), hypermobility spectrum disorder, eczema, piriformis syndrome, and pelvic floor dysfunction.
- **Current Medications:** I take Galcenzumab (Emgality), Candesartan, Pizotifen, Methenamine Hippurate, and Desogestrel.
- **Supplements:** My regimen includes D-Mannose, magnesium glycinate, coenzyme Q10, riboflavin, cod liver oil, a multivitamin containing iron, vitamin D, and folic acid.
- **Weight:** 78 kg
- **Height:** 164 cm
- **BMI:** 29
- **Issue Duration:** Over 2 years
For a couple of years, I've been experiencing painful boils on my vulval area. These painful bumps arise on the labia majora (the hairy part) and the labia minora or the creases in between (the hairless area). Typically, I’ll develop 1 or 2 at once, beginning as an itchy patch that transforms into a tender red lump over 2 to 3 days. They persist for another few days, eventually bursting and discharging pus, and typically take about 2 to 5 days to heal after that, resulting in a total duration of nearly two weeks from the initial itch to complete recovery.
Earlier, I would only encounter one boil every 3 to 4 months. However, lately, these have been occurring frequently back-to-back without much reprieve, leading to significant discomfort. This has notably impacted my intimate life due to their contagious nature.
Occasionally, I also have boils appearing in my hairline at the nape of my neck, although these occurrences are less frequent and far less painful.
Two years ago, a visit to my general practitioner led to a prescription of lymecycline for three months, which successfully cleared the infections during that period, but they returned shortly afterward. About a year ago, I attempted a decolonization protocol using a chlorhexidine wash, which provided relief for approximately 3 to 4 months, but now the frequency of the boils has escalated, with shorter intervals between outbreaks.
I regularly cleanse the vulval area with chlorhexidine every other day to stave off new infections, but so far, this approach hasn't yielded effective results. I avoid shaving, opting instead to trim the hair in that region.
I share my home with my husband and two cats. Interestingly, my husband also experiences similar boils around his hips and buttocks from time to time. We noted an improvement when using the chlorhexidine wash, although he currently has a few spots again. As for my professional life, I work in healthcare and occasionally care for my mother, who is a known carrier of resistant strains of carbapenem and methicillin bacteria. It’s likely that I acquired this issue through exposure at work or close contact with her.
Despite my efforts to lose weight and maintain good hygiene, I’m still grappling with this problem.
**My Questions:**
- Based on my experiences, could this condition be recurrent Staphylococcus aureus infections, or is it more likely something like hidradenitis?
- Are there specific tests, such as blood work or swabs, that would be beneficial in diagnosing my issue?
- What management strategies would you recommend? Should my husband and I consider a more intensive eradication treatment (such as chlorhexidine combined with nasally applied cream), or is there an alternative solution?
- How can I effectively eliminate Staphylococcus from my living environment? I have concerns that my home may be contaminated, increasing the risk of re-infection.
Thank you for your assistance!
ArthritisInternal MedicineRheumatology