| Condition | Distinguishing Features | |-----------|--------------------------| | Bacterial folliculitis | Purulent, often staphylococcal; responds to antibiotics | | Lymphadenopathy | Deep, non-mobile; no surface changes initially | | Contact dermatitis | Sharp margins, history of deodorant use; spares deep folds | | Epidermoid cyst | Central punctum; cheesy content; not strictly follicular | | Metastatic carcinoma (rare) | Firm, fixed, progressive growth; older patient | | Tuberculosis of axilla | Rare, cold abscess, systemic symptoms |
| Strategy | Mechanism | |----------|-----------| | Regular gentle exfoliation | Removes surface keratin (e.g., salicylic acid wash) | | Topical niacinamide | Reduces keratinocyte turnover and inflammation | | Low-glycemic diet | Reduces insulin/IGF-1 signaling which promotes follicular hyperkeratinization | | Laser hair removal | Destroys follicle and apocrine gland (best for HS/Fox-Fordyce) | | Avoid antiperspirants with aluminum salts | Aluminum chloride irritates and physically blocks ducts | clogged sweat glands armpit
Predisposing factors include:
Apocrine glands drain into hair follicles, making them prone to obstruction by keratin plugs, sebum, and debris. Eccrine ducts are superficial and can be blocked by hyperkeratosis or external agents. This also increases blood flow to the area,
Applying a warm, damp washcloth to the armpit for 10 to 15 minutes can help open the pores and encourage the trapped material to drain naturally. This also increases blood flow to the area, promoting healing. history of deodorant use