OpenHealth Q&A

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!

Answers (1)

2/12/2026, 8:50:52 PM

OpenHealth AI

Main Points: You may be experiencing recurrent boils, which could be due to infections like Staphylococcus aureus or conditions like hidradenitis suppurativa. Working together with your husband on hygiene practices and potential treatments may be beneficial. Additionally, steps can be taken to minimize the risk of re-infection in your home.

Explanation: Boils, especially in the vulval area, can often be caused by bacterial infections, with Staphylococcus aureus being a common culprit. The pattern you describe – boils starting with itching and developing into painful lumps that discharge – fits this profile. Hidradenitis suppurativa, on the other hand, is a chronic skin condition characterized by lumps and abscesses, often in moist areas and can sometimes resemble recurrent boils. Given your history and the impact of chlorhexidine in providing temporary relief, the boils might be linked to both infection and possibly skin sensitivities.

Considering your husband's similar symptoms, there might be a shared environmental factor or chronic carrier state.

Next Steps:

1. Consult with a Healthcare Professional: Given the chronic nature and emergence patterns of your boils, revisit your healthcare provider for:

   • Swabs of the lesions to identify bacterial cultures, particularly for Staphylococcus aureus or other pathogens.
   • Blood tests could also determine any underlying issues with your immune response.

2. Consider Intensive Eradication Treatment:

   • Discuss a regimen that might involve chlorhexidine washes combined with antibacterial nasally applied ointments like mupirocin for both you and your husband; this should be assessed and guided by your healthcare provider.

3. Environmental Hygiene:

   • Increase the frequency of cleaning towels, bedding, and clothing with hot water; consider using an antibacterial detergent.
   • Regularly disinfect commonly touched surfaces, especially in bathrooms and areas where either of you might have direct contact with the boils or skin.
   • Limit sharing personal items such as towels or razors.

4. Personal Care Steps:

   • Continue using chlorhexidine, but also consider using a mild, fragrance-free soap for cleaning the vulval area.
   • Avoid irritants such as scented products, which can exacerbate skin issues.
   • If you notice any new lesions, pay attention to how they develop, and document any factors you think may contribute.

5. Monitoring and Adjustments:

   • Keep track of the frequency and characteristics of the boils to identify any patterns or triggers; this could help in adjusting your care plan effectively with your healthcare provider.

By collaborating with your healthcare provider, establishing a robust routine together with your husband, and focusing on cleanliness at home, you can create strategies potentially to reduce both the occurrence and discomfort associated with these recurrent boils. If things don’t improve, further investigation might be necessary. Let me know if you need more specific details on any of these points!