What causes purple spots and strange skin on my mons pubis?

Hello,

Welcome to icliniq.com.

I am really sorry for what you are going through, and I can completely understand you. Thank you so much for sharing the detailed history along with the attached pictures (attachment removed to protect the patient’s identity) for better clarity. From the photo and the history you provided, you have two conditions.

First, the strange skin texture over the mons pubis is stretch marks, medically called striae distensae. These look like multiple pale or slightly depressed linear streaks running across the skin. They occur when the skin stretches due to weight gain, hormonal factors, or rapid body changes. Given your weight and the location, this explanation fits very well, and it is a benign condition. Stretch marks can make the skin feel wrinkled or ridged, which is likely the texture you are noticing.

Second, the purplish bumps that sometimes burst and leave stains of blood or pus are inflamed hair follicles, known as folliculitis or occasionally small boils. Shaving in the pubic area can irritate hair follicles, allowing bacteria to enter and cause these pustules. These lesions may swell, form pus, and then rupture, which explains the staining you notice in your underwear.

Another condition that can sometimes affect this area, especially in people with recurrent painful nodules in body folds, is hidradenitis suppurativa. However, in your case, the lesions appear relatively small and limited, and you did not mention severe pain, deep lumps, or draining tunnels, so simple folliculitis from shaving and friction is more likely.

I will guide you through some practical steps to reduce these lesions:

• Avoid shaving the area for a few weeks to allow the follicles to recover.

• If hair removal is needed, consider trimming instead of shaving or changing the direction of hair shaving.

• Also, try to gently buff the area with a pumice stone or gentle exfoliator beforehand to unlock or unclog the hair follicles, hence it will prevent recurrent folliculitis.

• Use a gentle antibacterial wash, such as Benzoyl peroxide or Chlorhexidine, a few times per week.

• Wear loose cotton underwear and avoid tight clothing that causes friction.

• Keep the area dry and clean after sweating.

• If a bump becomes painful, warm compresses can help it drain naturally. Instead of paper rosin, apply Fusidic acid cream on the affected area for three to five days for complete recovery.

• If it does not settle even after these steps, I would highly recommend that you go for laser hair removal on the area, as the laser will destroy the hair follicles and you will get rid of this situation.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.

Hello,

Welcome back to icliniq.com.

I understand your concern.

Thank you for the follow-up and for mentioning that you have polycystic ovarian syndrome (PCOS). That information is helpful. The marks visible in your photo are most consistent with striae distensae (stretch marks). These occur when the skin stretches and the collagen fibers underneath partially tear.

If you lose weight and reach a healthy weight for your height, the skin in the mons pubis area will usually improve in appearance, but stretch marks typically do not disappear completely. What usually happens is:

• They become lighter in color (whitish or skin colored).

• They become flatter and less noticeable.

• The surrounding skin texture often looks smoother.

So while the skin may not return to exactly how it looked before, many people notice a significant cosmetic improvement after weight loss and time.

You can also go for some dermatological treatments to further improve their appearance, like microneedling or fractional laser treatments. However, these are optional and usually done for cosmetic reasons.

In most cases, yes. As weight decreases, the fat pad over the mons pubis often reduces, the skin folds lessen, and the overall appearance becomes smoother. Stretch marks may remain, but usually look much less prominent.

Yes, it is very normal for the vulva, mons pubis, groin folds, and inner thighs to be darker than the rest of the body. This occurs because:

• These areas naturally contain more pigment cells.

• Friction from skin folds or clothing can increase pigmentation.

• Hormonal influences play a role.

People with polycystic ovary syndrome (PCOS) also develop darker or thicker skin in body folds due to insulin resistance, a condition called acanthosis nigricans. This often appears as dark, slightly velvety skin in areas like the groin, neck, or underarms.

Some helpful steps to improve the genital skin include:

• Gradual weight reduction, which improves hormonal balance and skin friction.

• Wearing loose, breathable underwear.

• Avoid frequent shaving or irritation of the area.

• Keeping the area dry to reduce follicle inflammation.

• Managing PCOS and insulin resistance.

Additionally, after the weight reduction, you can use glycolic acid 10 percent cream on alternate nights in the affected area for pigmentation improvement under the cover of a moisturiser to avoid dryness. Do this only when you lose the weight, because until the friction is present, even the use of glycolic acid will not be that much useful.

If darkening is due to friction or hormones, it will definitely improve slowly with weight loss and hormonal control.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.