Skincare Case 104

The patient is a 40-year-old male with Fitzpatrick skin type 3 and combination skin. His main concern is pustule-like lesions on his back following his first-ever back waxing session with soft wax about four days ago. The procedure was reported as significantly painful and uncomfortable. He has tried to follow all after-waxing recommendations to his recollection. The waxing site remains sensitive to touch. His homecare routine includes washing his back once daily with a body wash. The findings include raised pustules all over his back, mainly in the middle part and on the sides, with redness extending to the surrounding normal skin.

Causes

The pustule-like lesions on the patient’s back are likely related to the recent waxing procedure. This condition, also known as folliculitis, is an inflammation of the hair follicles often caused by bacterial infection (often Staphylococcus aureus). Contributing factors may include:

1. Waxing technique: Improper waxing technique can lead to skin irritation and damage, creating an environment conducive to bacterial growth.
2. Aftercare: If aftercare instructions were not followed correctly, this could have contributed to the development of folliculitis.
3. Personal hygiene: Insufficient cleaning of the waxed area could also lead to bacterial growth.

What was Done Wrong

1. Waxing technique: If the waxing was not performed correctly, this could have contributed to skin irritation and subsequent folliculitis.
2. Aftercare: Although the patient tried to follow after-waxing recommendations, he may have missed or misunderstood some critical steps.
3. Hygiene: Washing the area only once daily might not have been sufficient to keep the area clean, especially after a procedure like waxing.

Office and Home Treatment Options

Office treatment options may include:

1. Medical evaluation: The patient should consult a healthcare provider or dermatologist to confirm the diagnosis and obtain appropriate treatment, possibly including topical or oral antibiotics.

Home care options may include:

1. Hygiene: The patient should clean the area gently but thoroughly at least twice daily with a mild antibacterial soap.
2. Topical treatments: Over-the-counter topical creams containing benzoyl peroxide may help reduce inflammation and combat bacteria.
3. Warm compress: Applying a warm, moist washcloth to the area several times a day can help soothe the skin and encourage drainage of the pustules.

Prevention

1. Proper waxing technique: Ensuring the waxing procedure is done correctly can prevent skin damage and subsequent complications.
2. Aftercare: Following aftercare instructions carefully can help prevent folliculitis. This often includes avoiding tight clothing, excessive sweating, and skincare products that can irritate the skin for a couple of days post-wax.
3. Hygiene: Regularly cleaning the waxed area can help prevent bacterial growth.

Home Care Daily Routine

While the skin is healing, the daily routine for the patient could look like this:

Morning and Evening:

1. Cleanse the back gently but thoroughly using a mild antibacterial soap.
2. Apply an over-the-counter topical cream containing benzoyl peroxide to the affected area.
3. Wear loose, breathable clothing to prevent irritation.

Throughout the Day:

1. Apply a warm compress to the affected area several times a day to soothe the skin and encourage drainage.

Once the skin has healed, the patient can gradually return to his normal routine, being mindful to maintain proper hygiene in the waxed area. If he chooses to continue with waxing in the future, he should ensure the procedure is done correctly and follow all aftercare instructions to prevent recurrence.