Understanding Hidradenitis Suppurativa
Hidradenitis suppurativa is a long-term (chronic) skin disease. It causes painful bumps and sores (abscesses) to form around a hair follicle. Follicles are the tiny holes from which hair grows out of your skin. The disease occurs on parts of the body where skin rubs together. It most often appears in the armpits, the groin area, and under the breasts. It is more common in women.
How to say it
What causes hidradenitis suppurativa?
This skin disease happens when hair follicles become clogged with keratin. Keratin is the protein that makes up your hair and nails. The follicles then burst and become infected. Pressure or rubbing on the skin can clog the follicles. Or it can further irritate them.
The disease tends to run in families. It’s also more likely to occur in people who are obese, have diabetes, or smoke. Hormones may also play a part.
Symptoms of hidradenitis suppurativa
This skin disease causes one or more painful red bumps on the skin. These bumps become infected and drain pus. They may also itch or burn. In severe cases, sinus tracts may form. These are narrow channels that run under the skin. Blood or a bad-smelling pus may ooze from these bumps or sinus tracts. Bands of scarring often occur.
Treatment for hidradenitis suppurativa
Treatment for this skin disease is most successful when started early. But it may be hard to diagnose. It may be mistaken for other skin conditions. The painful bumps also often return. So stopping new bumps and limiting scarring is important. Treatment options include:
Warm compress. Putting a warm, wet washcloth on the affected skin may help.
Lifestyle changes. Your symptoms may get better if you lose weight or stop smoking, if needed. Also avoid shaving or other irritants, such as deodorant or perfume.
Antibiotics. For mild cases, an antibiotic for the skin (topical) may help. You may need oral antibiotics if you have a severe case. They can help prevent further infection.
Other oral medicines. Over-the-counter pain medicines can ease pain and inflammation. You may need stronger medicines for a severe case. These medicines include corticosteroids or a retinoid. These may cause side effects.
Injected medicines. A steroid may be injected into the bump to ease pain. A biologic may be injected to ease severe symptoms.
Surgery. Surgery can drain and remove the painful bumps. For severe cases, the doctor may cut out the entire area of affected skin or destroy it with a laser.
Complications of hidradenitis suppurativa
Scarring of skin
When to call your healthcare provider
Call your healthcare provider right away if you have any of these:
Fever of 100.4°F (38°C) or higher, or as directed
Redness, swelling, or fluid leaking from your rash that gets worse
Pain that gets worse
Symptoms that don’t get better, or get worse
March 21, 2017
Ferri F. Hidradenitis Suppurativa. In: Ferri F, editor. Ferri's Clinical Advisor 2016. Philadelphia: Elsevier; 2016. p. 619-20., Jemec GBE. Hidradenitis suppurativa. In: Lebwohl MG ea, editor. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 4 ed. Philadelphia: Elsevier; 2014. p. 314-5., Margesson LJ, et al. Pathogenesis, clinical features, and diagnosis of hidradenitis suppurativa (acne inversa). Up To Date. February 10 ed: Up To Date; 2016. p. 27., Margesson LJ, et al. Treatment of hidradenitis suppurativa (acne inversa). Up To Date. November 24 ed: Up To Date; 2015. p. 34.
Berman, Kevin, MD,Ziegler, Olivia, MS, PA