What Is Hidradenitis Suppurativa (HS): Causes And Treatment

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What Is Hidradenitis Suppurativa And How To Treat It?

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Hidradenitis Suppurativa is quite a mouthful! An appropriate name for a rare disease, it is long term skin ailment that can cause a lot of worry if not treated immediately. If you notice any strange lumps that are painful to touch, then you may need to visit a doctor. The dermatologist would diagnose and determine the root cause of the condition, and prescribe an effective course of treatment ahead.

What Is Hidradenitis Suppurativa?

Hidradenitisis suppurativa is also known as acne inversa. It is an unusually rare, long term skin disease that consists of small, painful and pimple-like lumps under the skin. It can appear similar to acne, boils and cysts. The occurrence of hidradenitis suppurativa happens wherever the skin rubs together i.e. groin, breast, armpit and between the buttocks. These lumps can break open and bleed, often accompanied by foul odour.
It generally starts after puberty and can persist for many years. Hidradenitis suppurativa worsens with time so it must be treated soon after its first appearance. It can cause an emotional upheaval and have serious consequences in your daily life. Early diagnosis along with proper treatment can help manage the disease and prevent further complications from arising. It can leave deep scars and also cause depression.

Also Read: How To Find The Best Dermatologist For Acne Treatment?

Who Is Prone To Hidradenitis Suppurativa?

HS being an uncommon skin infection, it only affects certain types of people. Patients who develop HS include 

1. Women – Unfortunately this disease is more likely to affect women than men.
2. Age – Since its starts after puberty, HS mainly occurs amongst women between the ages of 20 to 30.
3. Hereditary HS has a tendency to be passed from one generation to the next. Beware if your parent or close relatives had it, chances are that you might get it as well.
4. Smoking – Nicotine present in cigarettes has been linked to HS.
5. Certain health conditions – If you are someone who is suffering from inflammatory bowel syndrome, diabetes, severe acne, obesity or Crohn’s disease then there are high chances of contracting HS.

Hidradenitis Suppurativa Stages

HS develops in 3 stages and each stage comes with its own symptoms. Look out for the following signs

Stage 1 (Mild)
• Single or multiple abscesses along with pea-sized nodules that are firm and painful.
• Bumps, abscesses and pustules occur under the breasts, area around the anus inner thigh, groin and armpit.
Stage 2 (Moderate)
• Sinus tract is formed with recurring pustules, bumps and abscesses in multiple areas. Scars are left behind as a result of recurring bumps in the same area multiple times.
Stage 3 (Severe) 
• There is widespread occurrence of pustules, spots, abscesses and bumps with multiple intertwined sinus tracts.
• Abscesses become very painful, to a point where moving limps can be difficult and arduous. These spots can split open and ooze out foul smelling odour and pus.

Also Read: Papule – Causes, Symptoms, Treatments & Primary Tips

What Causes Hidradenitis Suppurativa? 

HS is caused when hair follicles become blocked and this hindrance can lead to inflammation. No exact reason is given behind this occurrence. Although there are speculative reasons behind HS that include –

1. Genetics – HS can trigger if someone in your close family has this disease. Be cautious if there is someone who had or has HS
2. Irregular immune system – Poor immune system can affect the blood circulation and weaken the body. Maintain regular health check-ups and avoid certain habits that can compromise your immunity
3. Smoking – Puffing cigarettes not only affects your lungs but can also cause the body to produce excessive amounts of sebum. Sebum can clog hair follicles allowing HS to rise
4. Obesity – Excess body fat has been closely linked to HS. To avoid this skin disease, maintain a healthy diet and exercise regularly
5. Hormones – HS usually starts after puberty but it can also occur at any age. The least chances of contracting HS are before puberty and after menopause, which means sex hormones are to blame for this skin problem.
6. Crohn’s disease – If Crohn’s disease stars to develop near the groin and anus, then there are chances that HS can develop alongside. Crohn’s is a long term health problem that starts due to poor stomach lining, which gets inflamed.
NOTE: HS is not an infectious disease nor is it caused due to poor hygiene.

What Are The Symptoms Of Hidradenitis Suppurativa?

Identifying HS can be difficult but once it is diagnosed, the disease can be controlled and monitored. HS can show the following symptoms –

1. Blackheads – These blackheads appear in pairs, one next to the other or “double- barrelled” formation
2. Red bumps/ pimples – The initial stages will see a large number of red bumps that often enlarge and break open. After opening, it releases a strong odour often accompanied by itching and burning sensation
3. Pea sized lumps – The small lumps start small and slowly grow bigger. They persist for years becoming larger and inflamed
4. Tunnels – Tracts connecting the lumps can develop over time. These ruptures and wound heal very slowly and can leak pus. Such tunnel/ tracts leave deep pitted scars that are often thick and difficult to erase
5. Difficulty in moving – With HS attaching the inner thighs and under arm region, it can become very difficult to walk and move

Also Read: How To Get Rid Of  Back Acne – Causes, Treatment & Prevention

Hidradenitis Suppurativa Treatment In India

Unfortunately, there is no medical cure or effective treatment that can completely heal HS. However, certain drugs can be used orally and topically to control the disease –

1. Oral medications – Anti-inflammatory pills such as Naproxen, Celebrex and Advil have shown positive results on HS. Oral retinoid (e.g. isotretinoin) have also been used to calm the symptoms. Corticosteroid pills along with injection helps in reducing the inflammation and redness providing relief as well as preventing future breakouts
2. Laser therapy – Laser uses heat and light energy to penetrate the deeper layers of skin. The treatment works on HS as it gently exfoliates the upper layers of the skin, allowing the abscesses, bumps and blackheads to heal without aggravating the disease. Laser provides deep cleaning of the skin and has proven to be effective in removing HS causing hair follicles
3. Hormone stabilizing pills – Women suffering from HS have found comfort after taking birth control pills. These pills can stabilize hormonal fluctuation, reduce fluid drainage and decrease the pain
4. Draining, incision and excision – The dermatologist drains 2 or more lesions or cuts them out entirely. The next step would be to cover the missing skin by using skin grafting procedure (skin taken from another part of the body). This procedure is done only if HS is severe and all other options have been unsuccessful
5. Other – Warm baths, topical cleansing, hydrotherapy and wound dressing are some of the simpler alternatives in dealing with HS
Before starting on any treatment, the dermatologists would discuss about the pros and cons of the treatment. Thorough insight is required as improper care can be hazardous to your health.

Also Read: Cystic Acne: Causes, Symptoms & Treatment Options


Is Hidradenitis Suppurativa Contagious?

No, HS is not a contagious disease. Since it is a chronic inflammatory disease, this means it is brought on by an individual’s own body irregularities and immune system.

Difference Between MRSA And Hidradenitis Suppurativa

MRSA (methicillian-resisitant Staphylococcus aureus) is a bacterial infection that affects the skin and is contagious unlike HS. MRSA is 100% treatable, curable and does not come back. In the case of HS, it does reoccur and cannot be cured completely.

HS Flare Ups During Menstrual Cycle

Yes, unfortunately. HS is known to be hormonal disease affecting women more than men. It does flare up and symptoms aggravate during the menstrual cycle.

What Lifestyle Changes Should I Make To Improve My Illness?

There are many ways to improve your HS condition. Losing weight will definitely help along with quitting cigarettes and eating healthy, wholesome diet.

Is HS Disease Deadly?

HS is a fatal disease if left undiagnosed and untreated. It is chronic and inflammatory condition that has no treatment but can be controlled using various oral and topical medications.

How Mild Or Severe Is My Hidradenitis Suppurativa?

It entirely depends on your diagnosis. Visit your dermatologist and find out the degree or stage of your HS. The sooner you contact your doctor, the easier it will be to control HS.

Since Hidradenitis suppurativa looks similar to boils or acne, it is necessary to visit a dermatologist for a thorough diagnosis. Ignoring such a disease can aggravate it and lead to bigger problems in the future. Make an appointment today, before it’s too late.

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About The Author

Kushneet Kukreja

Kushneet Kukreja

A postgraduate in Biotechnology from Kingston University and an ISSA Certified Specialist in Fitness & Nutrition, Kushneet Kukreja is a passionate writer who works in close association with the dermatologists at our head office to generate valuable and scientifically accurate content for our blog.

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