Hidradenitis Suppurativa

Medically reviewed by The Dermatologists and written by Dr. Alexander Börve

Hidradenitis suppurativa is a skin condition that occurs when the follicles of the hair become blocked or in some way inflamed. This results in a series of red, painful bumps that appear like pimples.

These pimple-like bumps develop in places that everyday pimples do not appear. Symptoms can be exacerbated by weight gain, smoking, stress and exposure to excessive heat.

Hidradenitis suppurativa is an inflammatory skin disease affecting an estimated 1-4% of the world population. It usually starts around puberty (before the age of 11). The condition is most common in overweight or obese people and smokers. Women are 3 times more likely to get it than men.

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Symptoms

The most common locations are the armpits and the groin, where the skin rubs together. It is also common in buttocks, upper thighs and under the breasts. Women tend to get breakouts on their genitals and upper thighs. Men are more likely to have it on their genitals and around the anus.

The lesions are small and painful. Your condition may clear for a while and then develop new breakouts in the same area. It can last for months and get worse over time.

They can form into blackheads, hard lumps under the skin, and large red bumps that open and excrete pus. These bumps can be itchy and burn. They can rupture, leaking bloodstained pus onto clothing. This fluid often has a foul odor.

The healing of hidradenitis suppurativa form scars. This causes tunnel-like tracts under their skin. These tracts then thicken as the skin continues to heal and scar. This can make moving the arm or walking difficult, depending on where the skin condition is located.

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What can I do?

Attention to personal hygiene, weight reduction and loose-fitting clothing may improve the situation. You can also apply a warm compresses with sodium chloride solution or Burow solution to the affected areas.

Should I seek medical care?

Hidradenitis suppurativa can resemble acne, so you should seek care in order to distinguish it from other conditions. Also seek care if the condition worsens or persists, long-standing inflammation may lead to skin cancer.

Early diagnosis and treatment can prevent it from worsening.

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Treatment

Antibiotics can prevent the condition from worsening, and corticosteroids can reduce inflammation. Antibiotics, corticosteroids, antiandrogens, immunosuppressants, estrogen derivatives, 5-Alpha-reductase inhibitors and retinoids are often used to reduce symptoms.

Wide surgical excision, with margins well beyond the clinical borders of activity, remains the most definitive surgical therapy, however, there is no ultimate cure.

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Source:
American Academy of Dermatology. Hidradenitis Suppurativa. Available at: https://www.aad.org/public/diseases/painful-skin-joints/hidradenitis-suppurativa

Hidradenitis Suppurativa Foundation, Inc. Available at: http://www.hs-foundation.org/