A sore or painful pubic mound can be caused by a variety of factors. The pubic mound is the rounded, fleshy area located over the pubic bone. It is covered with pubic hair after puberty. Tenderness or soreness in this area is common among women.
Causes of a Sore Pubic Mound
Some potential causes of pubic mound soreness include:
- Folliculitis – inflammation of the hair follicles in the pubic area, often due to infection, irritation from shaving, or ingrown hairs.
- Boils – red, swollen bumps that are tender and may drain pus. Caused by infected hair follicles.
- Cellulitis – a bacterial skin infection that causes swelling, redness, and pain.
- Abscess – a collection of pus under the skin, caused by a bacterial infection.
- Cysts – fluid-filled lumps that can develop under the skin and may get inflamed or infected.
- Pubic bone bruising – caused by trauma or injury to the pubic area.
- Hidradenitis suppurativa – chronic skin condition causing painful lumps and abscesses in areas with apocrine glands like the pubic mound.
- Bartholin gland cyst – cysts that can form in the Bartholin glands located near the vaginal opening, causing swelling and pain.
Common Causes
Some of the most common causes of a sore pubic mound include:
Folliculitis
Folliculitis is inflammation of the hair follicles in the pubic area. It is often caused by infection with bacteria like Staphylococcus aureus. Shaving the pubic area can irritate hair follicles and make them more prone to infection and inflammation. Using dull razors or shaving too aggressively can worsen folliculitis.
Ingrown hairs can also lead to infected and inflamed follicles. Wearing tight clothing and excessive sweating can contribute to folliculitis as well.
Symptoms of folliculitis include:
- Itchy, painful red bumps in the pubic area
- Pus-filled pimples around pubic hairs
- Swollen lymph nodes in the groin
- Mild fever in some cases
Boils
Boils are red, swollen bumps that are tender to the touch. They form when the hair follicles or oil glands in the skin become infected by bacteria. Boils can develop anywhere on the body, including the pubic mound.
Causes of boils in the pubic area include:
- Plugged sweat glands
- Ingrown hairs
- Friction from clothing or exercise
- Poor hygiene
- Weakened immune system
Boils often start as reddened, tender lumps. They grow larger and more painful over days and eventually open up and drain pus. Symptoms include:
- A red, swollen, painful lump
- Pus draining from the boil when it opens
- Fever and body aches in some cases
Cellulitis
Cellulitis is a common bacterial skin infection that can affect the pubic area. It is caused by bacteria like Streptococcus and Staphylococcus getting under the top layers of skin.
Risk factors for developing cellulitis include:
- Cracks in the skin of the pubic area
- Insect bites
- Minor injuries that break the skin
- Leg swelling or poor circulation
- Weak immune system
- Prior cellulitis infection
Cellulitis causes the skin to become swollen, red, and painfully tender. Other symptoms can include:
- Skin feeling tight or warm to the touch
- Red streaks spreading from the affected area
- Swollen lymph nodes in the groin
- Fever, chills, and headache
Less Common Causes
While folliculitis, boils and cellulitis are more frequent causes, other less common possibilities for a sore pubic mound include:
Abscess
An abscess is a collection of pus that builds up under the skin. Abscesses are caused by bacterial infections of hair follicles, oil glands, or small wounds in the pubic area.
Abscesses typically appear as painful, red lumps that gradually get bigger and more painful. Eventually they rupture and drain pus. Symptoms include:
- A tender, warm lump with overlying skin redness
- Throbbing pain that worsens as the abscess grows
- Fever and feeling generally unwell in some cases
Cysts
Cysts are fluid-filled lumps that can develop under the skin. Common types of cysts include epidermoid and pilonidal cysts. They often form due to obstructed glands, hair follicles or pores. Cysts may become red, inflamed and tender if they get infected.
Symptoms of a cyst can include:
- A firm, swelling lump under the skin that feels smooth or spongy
- Mild or moderate pain, especially if the cyst is inflamed or infected
- Redness and warmth over the cyst
- Drainage of fluid from the cyst
Pubic Bone Bruising
Injuries to the pubic area from accidents, trauma, or vigorous sexual activity can lead to bruising of the pubic bone. This causes pain and tenderness directly over the pubic mound. Other symptoms can include:
- Mild swelling around the injured area
- Visible discoloration of the skin from bleeding under the skin (hematoma)
- Difficulty bearing weight on the affected leg
- Pain when touching the pubic area
Hidradenitis Suppurativa
Hidradenitis suppurativa is a chronic skin condition that causes painful, boil-like lumps to form in areas with apocrine sweat glands. These include the armpits, groin, anal area, and under the breasts. It can occasionally cause bumps and abscesses around the pubic mound as well.
Symptoms include:
- Clusters of red bumps or pus-filled abscesses in the pubic area
- Pain and swelling around the lumps
- Nodules under the skin that enlarge, break open, and drain
- Scarring in the affected areas
Bartholin Gland Cyst
The Bartholin glands are located on each side of the vaginal opening. They can sometimes develop cysts – fluid-filled sacs that cause swelling and tenderness. A Bartholin cyst may feel like a tender lump at the bottom of the pubic mound.
Symptoms include:
- A round, tender swelling near the vagina
- Pain that worsens with walking, exercise or sexual activity
- Redness and warmth over the cyst
- Fever if the cyst becomes infected
When to See a Doctor
In most cases, minor soreness or tenderness around the pubic mound will go away on its own. But see your doctor if you have:
- Severe pain that worsens or persists for more than a few days
- Fever over 101°F (38°C)
- Red streaks extending from the affected area
- Pus draining from a boil or abscess
- Difficulty walking or sitting
- Swollen lymph nodes in the groin
- Multiple lumps or growths around the pubic area
Prompt medical treatment is needed for infections like cellulitis to prevent them spreading. Abscesses also require drainage and antibiotics. See a gynecologist for evaluation of cysts or other vulvovaginal sources of pubic pain.
Diagnosis
The doctor will begin by asking about your symptoms, medical history, and risk factors. They will perform a physical exam of the pubic area to check for signs of infection or skin conditions.
Possible diagnostic tests include:
- Blood tests to check for elevated white cell count with infections
- Skin culture to identify the bacteria causing an infection
- Skin biopsy for evaluation of chronic cysts or rashes
- Pelvic exam to check for Bartholin gland cysts
- Imaging like CT scan or MRI for suspected pubic bone injury
Based on the exam findings and test results, the doctor can determine the underlying cause and recommend appropriate treatment.
Treatment
Treatment depends on the cause of the pubic mound soreness. Options may include:
Antibiotics
Antibiotics are used to treat bacterial skin infections like cellulitis and abscesses. Oral antibiotics or antibiotic creams can also treat infected folliculitis and boils. Common antibiotics for these conditions include cephalexin, dicloxacillin, clindamycin, and erythromycin.
Warm Compresses
Applying warm, wet compresses to the affected area can help promote drainage and healing of boils, abscesses and inflamed cysts. This helps relieve swelling, pain, and tenderness.
Incision and Drainage
Larger, more painful abscesses usually need to be drained by making a small incision. The pus is drained and the wound packed with sterile gauze.
Cyst Removal
Bartholin gland cysts that are very painful or keep recurring may be surgically removed. This is done either by marsupialization to unroof the cyst or complete excision to remove the entire cyst.
Medications
Over-the-counter pain relievers like ibuprofen can relieve mild pain and swelling. Antibacterial creams and ointments may be prescribed for infected folliculitis and boils. Hidradenitis suppurativa is often treated with anti-inflammatory drugs, retinoids, or hormone therapy.
Lifestyle Changes
Good hygiene can help prevent bacterial and fungal infections of the pubic area. Showering after exercise, keeping the area clean and dry, and avoiding tight clothing can help. For folliculitis, stop shaving and switch to hair removal creams instead.
Home Treatment and Prevention
You can try the following self-care tips to treat a sore pubic mound at home and prevent recurrences:
- Take over-the-counter pain medication like ibuprofen or acetaminophen for pain relief.
- Apply warm compresses to the area 2-3 times a day to ease swelling and tenderness.
- Soak in warm baths to help soothe irritation and promote drainage of infected follicles or cysts.
- Use an antibacterial soap when bathing and keep the area clean.
- Avoid wearing tight underwear and pants that rub against the pubic area.
- Gently wash with mild soap and water after exercise or sweating.
- Let the area air dry fully after washing.
- Use an electric razor instead of blade razors for hair removal to prevent folliculitis.
- Wear loose cotton underwear to avoid irritation.
- Apply over-the-counter antibiotic cream after shaving if needed.
See your doctor if symptoms don’t improve within a few days using conservative self-care. Also get prompt medical attention for signs of infection like fever, red streaks, and swollen groin lymph nodes.
Outlook and Recovery
With appropriate treatment, most causes of a sore pubic mound will clear up within a few weeks. Mild infections like folliculitis often resolve with antibiotic creams and good hygiene. More severe cellulitis requires about 1-2 weeks of oral antibiotics.
Abscesses may take up to 2-3 weeks to heal after draining. Surgical removal of Bartholin cysts has a high success rate, with most women recovering fully within 4-6 weeks.
Avoiding tight clothing, shaving carefully, and keeping the area clean can help prevent recurrent folliculitis and boils. Chronic conditions like hidradenitis suppurativa may have periodic flare-ups though.
When to See a Doctor
- Severe, worsening pain
- Fever over 101°F (38°C)
- Pus or red streaks spreading from affected area
- Difficulty walking or sitting
- Swollen lymph nodes in groin
- No improvement after 3-5 days of self-care
- Multiple recurring cysts or lumps
See your doctor promptly if you have any of these signs and symptoms. You may need antibiotics or drainage of an abscess. For chronic or recurrent cysts, see your gynecologist or dermatologist for evaluation and treatment.
Conclusion
Soreness or pain in the pubic mound region has a number of potential causes. Common reasons include folliculitis, boils, cellulitis, abscesses, and Bartholin gland cysts. Less frequent possibilities are epidermoid cysts, pubic bone bruising, and hidradenitis.
See your doctor for severe pain, signs of infection, or multiple recurrent cysts or lumps in the pubic area. With appropriate diagnosis and treatment, most causes of a sore pubic mound can be cured or well-managed.