Recognizing and Treating Hidradenitis Suppurativa

Experts do not know exactly why people develop hidradenitis suppurativa (HS), though most presume a relationship between the condition and the sweat glands and hair follicles. They have identified some risk factors that make it more likely for someone to develop HS. The condition is most common in young adults between the ages of 18 and 29, and affects more women than men. Genetics may also play a role. Other risk factors include obesity, smoking, and the presence of a family history of hidradenitis suppurativa.

People with hidradenitis suppurativa develop pea-sized lumps under the skin. As they grow, they also begin to spread throughout the body, usually in areas with many hair follicles and sweat glands, and where skin rubs together. For this reason, HS lumps tend to localize in the armpits, groin, and anal area.

Hidradenitis suppurativa lumps can develop a bad smell, which intensifies if a rupture begins and in hot or humid conditions. Some women notice the smell fluctuates with their periods.

As more lumps form underneath the skin, tunnels develop to connect separate growths. These tunnels begin to swell; the larger lumps and tunnels become, the more likely they will rupture.

As the lumps continue to grow in number and size, they become more and more uncomfortable and can even begin to restrict movement. At first, the pain might be felt in one or two areas; however, over time, this discomfort spreads throughout the body.

One of the most common symptoms of hidradenitis suppurativa is the formation of blackheads. The dark spots develop when dirt and other substances collect in the pores. In people with HS, blackheads tend to cluster in areas such as the armpits and groin, exclusively.

There is no laboratory test available to diagnose hidradenitis suppurativa. Instead, the doctor takes a detailed history and thorough physical exam. He or she may ask the patient whether they have any of the risk factors or symptoms of HS and examine any lumps or blackheads. If the diagnosis is confirmed, a few treatment options are available.

One of the first treatments of hidradenitis suppurativa involves the use of topical creams and lotions containing antibiotics. For many people, this is enough to control most of the symptoms. If the lumps are more widespread, a doctor may also prescribe oral antibiotics to prevent bacteria from infiltrating the bloodstream.

One of the most significant symptoms of hidradenitis suppurativa is pain. Doctors will likely recommend over-the-counter pain relievers initially, to avoid the potential side effects of prescription NSAIDs. If the former proves insufficient, the individual may need a prescription opioid or narcotic pain medication.

Sometimes, those with widespread hidradenitis suppurativa are going to need to undergo surgery. In this procedure, a trained surgeon is going to remove tissue to expose tunnels underneath the skin that connect the lumps together. In some cases, surgeons might also cut into the lumps and drain the pus. Finally, as a last resort, surgeons might also remove the infected skin entirely. After this procedure, patients may need a skin graft.