What is Hidradenitis Suppurativa?
Hidradenitis suppurativa happens when painful bumps form under the skin when hair follicles get blocked. This causes the skin in these areas to swell and hurt. These painful bumps are often found in the areas of the body where there are hair and sweat/oil glands. These areas can include the armpits, groin, inner thighs, around the anus, below the breasts and between the buttocks. While it is known that hidradenitis suppurativa is caused by blocked hair follicles, it is unknown why these hair follicles become blocked.
What are Signs and Symptoms of Hidradenitis Suppurativa?
Blackheads – Blackheads, often seen in pairs, usually occur in skin folds.
Painful, pea-sized bumps – Hidradenitis suppurativa usually starts with one small, painful bump under the skin that can last for weeks or months. More bumps can be noticed over time and typically are found in areas where skin rubs together.
Leaking sores – Some of the small, painful bumps can grow larger, eventually breaking open and draining pus with foul odor.
Tunnels – Over time, the painful bumps can form tunnels under the skin and become connected.
What Are Risk Factors for Developing Hidradenitis Suppurativa?
Some things that may cause the lumps or make them worse include:
- Family history: It is often seen in family members so it may be tied to genes.
- Gender: Girls see the lumps more often than boys.
- Age: Teenagers and young adults see it more than younger children or older adults.
- Oral contraceptives: There may be a connection with the use of hormonal contraceptives.
- Smoking: Smoking slows healing.
- Stress: Stress often causes sweating. This can worsen the symptoms.
- Heat and humidity: This increases sweating, which can worsen symptoms.
- Elevated weight / obesity: Extra body weight makes body parts rub together. This can make pain worse.
- Clothing: Tight fitting, non-breathable, heavy-weight fabric causes pressure and sweating. This may make symptoms worse.
What Causes Hidradenitis Suppurativa?
Hidradenitis suppurativa is caused by a clogged or inflamed hair follicle. We don’t know what causes the clog.
How is Hidradenitis Suppurativa Diagnosed?
Patients will often see a dermatologist, a doctor who specializes in skin disorders, to diagnosis and treat hidradenitis suppurativa. Your dermatologist will talk with you to find out your medical history and the type of symptoms you are having. The dermatologist will also examine your skin. Through this skin examination and by understanding your symptoms, the dermatologist will be able to make a diagnosis of hidradenitis suppurativa.
How is Hidradenitis Suppurativa Treated?
Treatment for hidradenitis suppurativa is not a cure. It may improve symptoms and keep things from getting worse. Treatment may include:
- Improved hygiene: You need to wash the area(s) well once or twice daily with soap and water.
- Warm compresses: You can decrease some of the swelling and pain with warm, moist heat.
- Loose fitting, breathable clothing: You should not wear clothes that are too tight or too warm.
- Weight loss and staying at a healthy body weight: You can reduce friction between body parts.
- Antibiotics by mouth and on the skin: Antibiotics help to decrease the amount of bacteria on the skin. They can also help decrease the amount of inflammation in the body, helping to prevent and treat the bumps.
- Topical steroids: Steroid creams, lotions or gels can be applied to the bumps to help decrease the pain and redness.
- Systemic medications: Injectable medications or IV (intravenous) medications may also be prescribed. These medications help to target specific inflammatory pathways in the body that have been tied to hidradenitis suppurativa.
- Laser hair reduction: Laser light targets and destroys hair follicles. By destroying hair follicles, this prevents them from becoming blocked.
- Steroid injections: If you have a large, inflamed bump, your dermatologist can inject it with a steroid. This will give quick relief of pain and redness, as it reduces inflammation.
- Surgery: Surgery is not recommended as cutting into and draining the inflamed areas can cause them to happen again. The procedure should be limited to situations where immediate relief of severe pain is needed and treatment with other techniques is not possible.
