Hidradenitis Suppurativa

Hidradenitis suppurativa (HS) is a chronic skin disease characterized by painful, boil-like lumps that form under the skin, often in areas where skin rubs together.

What is hidradenitis suppurativa (HS)?

Hidradenitis suppurativa (HS), also known as acne inversa, is a chronic skin disease. It causes painful, boil-like lumps that form under the skin, frequently affecting areas where skin rubs together, such as the armpits and groin. These lumps become inflamed and painful, often breaking open to form abscesses that drain fluid and pus. As these abscesses heal, they can cause scarring of the skin.

What causes hidradenitis suppurativa (HS)?

The lumps in HS form due to blockages of the hair follicles. These blockages trap bacteria, leading to inflammation and rupture. While the exact cause of these blockages is often unknown, contributing factors may include:

• Genetics
• Environmental factors
• Hormonal factors
• Changes in certain genes

HS is not caused by poor hygiene, and it cannot be spread to others.

Who is more likely to get hidradenitis suppurativa (HS)?

HS typically begins after puberty, usually during the teens or twenties. It is more common in the following groups:

• Women
• People who are Black
• People with a family history of HS
• People who are overweight or have obesity
• People who smoke

What are the symptoms of hidradenitis suppurativa (HS)?

Symptoms of HS include:

• Small pitted areas of skin containing blackheads
• Painful, red lumps that enlarge and break open, causing abscesses that may itch, drain fluid and pus, and have an unpleasant odor
• Abscesses that heal slowly, recur over time, and can lead to scarring and tunnels under the skin

Disease Severity

HS is categorized by its severity:

• Mild HS: One or a few lumps in one area of the skin; often progresses to moderate disease.
• Moderate HS: Recurrent lumps that enlarge and break open, appearing in more than one area of the body.
• Severe HS: Widespread lumps, scarring, and chronic pain that may impede movement.

Due to the challenges of managing the disease, individuals with HS are at risk for depression and anxiety.

How is hidradenitis suppurativa (HS) diagnosed?

There is no specific test for HS, and it can be difficult to diagnose in early stages as it may resemble pimples or acne. To make a diagnosis, a health care provider will:

• Ask about your medical history and symptoms
• Examine the lumps on your skin
• Potentially take a sample of the skin or pus for laboratory testing

Your provider may refer you to a dermatologist for diagnosis or treatment.

What are the treatments for hidradenitis suppurativa?

There is no cure for HS, and treatments focus on managing symptoms. Effectiveness varies by individual and disease severity. Options include:

• Medicines: Steroids, antibiotics, pain relievers, and anti-inflammatory medications. These may be topical (applied to the skin), injected, or taken orally.
• Procedures or surgery: Interventions to remove lumps and scars or to resolve sores.

Lifestyle Precautions

Avoiding skin irritation may help manage the condition:

• Wear loose-fitting clothing
• Maintain a healthy weight
• Quit smoking
• Avoid heat and humidity
• Take care to avoid injuring your skin