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September 2005

Bullous Impetigo of the Face After Epilation by Threading

Arch Dermatol. 2005;141(9):1174-1175. doi:10.1001/archderm.141.9.1174

Threading is an ancient method of manually removing unwanted hair using a loop of thread that is passed over the skin. We describe what is to our knowledge a previously unreported complication of this aesthetic procedure.

An otherwise-healthy 33-year-old woman complained of an asymptomatic eruption of erosions and bullae on the face (Figure). Three weeks earlier she had undergone a threading procedure performed by a local aesthetician for removal of hairs on the forehead and cheeks. The eruption had appeared 4 days after the threading. She was treated with a 10-day course of cefadroxil for suspected impetigo. She was also prescribed prednisone for possible autoimmune blistering disease and to try to minimize the postinflammatory dyspigmentation that was anticipated. Cultures from several erosions grew Staphylococcus aureus, confirming a diagnosis of impetigo. Within 1 week of beginning the treatment, all of the active lesions had resolved, leaving severe postinflammatory hyperpigmentation.

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