Taming the Rash: A Dermatological Case Report on Effective Treatments for Refractory Folliculitis

Bacterial folliculitis, commonly associated with Staphylococcus aureus, often stems from trauma to hair follicles, such as during waxing, and can be exacerbated by improper aftercare that triggers inflammation and skin damage. This report describes a 23-year-old man with widespread folliculitis, mainly concentrated in the lower back, with involvement of the arms and entire back, post-waxing, aggravated by alcohol and soap use. He initially experienced high fever, trouble sleeping, discomfort when lying down, and strong itching, with the fever subsiding after a couple of days. He self-medicated with ibuprofen and diphenhydramine for five days without relief, followed by ineffective prescribed treatments with mupirocin and hydrocortisone. Adding oral azithromycin and Tend Skin® solution (isopropyl alcohol, water, propylene glycol, acetylsalicylic acid, cyclomethicone, glycerin, polysorbate 80) brought significant symptom relief, reduced pustule size, and less exudate within days. This case highlights the efficacy of combined systemic and topical therapies for refractory folliculitis and underscores the importance of proper post-waxing care to curb inflammation and skin damage.