What is 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 your inner thighs, around your anal area or between your buttocks. You may even find them under your breasts.

Signs and Symptoms

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.

Causes

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

Contributing Factors

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: 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-weighted fabric also causes pressure and sweating. This may make symptoms worse.

Diagnosis

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

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.
• Medications: May help treat some of the symptoms, including pain, swelling and infection.
• Surgery: Patients with hidradenitis suppurativa should establish care with a dermatologist so intralesional triamcinolone can be administered to inflamed nodules to decrease inflammation. Incision and drainage may promote lesion recurrence and is not advised for the routine treatment of acute lesions of hidradenitis suppurativa. The procedure should be limited to situations where immediate relief of severe pain from an inflamed, fluctuant nodule is necessary and treatment with other techniques is not feasible.