Hidradenitis Suppurativa

Hidradenitis suppurativa is a skin condition where there are hard, pea-sized reddened areas in parts of your body where you have lots of hair and sweat / oil glands. These lumps are painful. You may find them under your arms, in your groin area, at you inner thighs, around your anal area or between your buttocks. You may even find them under your breasts.

If the red, hardened lumps become pus filled, they are infected. These areas can also have tunnel-like tracts that join two or more lumps. The lumps look like facial acne. But you find them in places where you don’t usually see acne.

Hidradenitis suppurativa is caused by a clogged or inflamed hair follicle. We don’t know what causes the clog.

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 increases sweating. This can worsen the symptoms.
  • Heat and humidity: They increase 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-weighted fabric also causes pressure and sweating. This may make symptoms worse.

Your doctor will talk with you to find out about your medical history and the type of symptoms you are having. They will also do a physical exam to help make a diagnosis.

Treatment for hidrandenitis 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 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.
  • Medications: May help treat some of the symptoms, including pain, swelling and infection. 
  • Surgery: You may need surgery to open and drain the infection or to remove the hardened lump.

Last Updated 05/2020

Reviewed by Anusua (Roshni) Dasgupta, MD, MPH, and Victor Garcia, MD, FACS, FAAP

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