I’M SUFFERING FROM SEVERE PIMPLES

QI’m a 17-year-old girl who has pimples on my extreme lower back. I’ve tried several medicines but in vain. This has left me severely depressed.

AThe sudden eruption of “pimples” exclusively involving the area you mention most likely indicates an infection, most commonly bacterial primarily targeting the hair follicles, a condition known as eruptive folliculitis. Hair follicle infection can be caused either through direct contamination of the skin after coming in contact with another infected source, or it could be initiated by follicular injury of any nature, for example, shaving, lasering or waxing the body hair, or by vigorous scrubbing of the skin (as seen in Moroccan or Turkish baths). These traumatised follicles initially developed an inflammatory reaction which later become an attractive site for bacteria to invade. Hot oil deep body massages can also cause such eruptions.

The closest differential diagnosis will be acne eruptions, but this is unlikely.

A much rarer differential diagnosis can be dermatitis herpetiformis – a condition producing similar skin lesions which are more vesicular in outlook and are very itchy. This is usually associated with gluten sensitivity and celiac disease of the gut. I would recommend that you see an experienced dermatologist, who could first established a conclusive diagnosis which will also require taking a skin surface swab from the affected areas, to detect the involved bacteria and the most optimally effective antibiotic to treat it by performing a culture/sensitivity test.

The diagnosis of acne is mostly made through clinical examination, but to rule out the diagnosis of DH, a gluten sensitivity test together with celiac disease screening would definitely be required.

The above mentioned skin conditions/ailments are treatable. All it needs is patience and immediate treatment.