Hidradenitis suppurativa is a chronic inflammatory skin disease that appears as a combination of blackheads, sores, small-reddened tender bumps or larger abscesses that may open and drain pus-like fluid.
It commonly affects apocrine sweat-bearing areas of the body such as in the armpit, groin or under the breasts. Scarring is common with hidradenitis suppurativa, and sinus tracts can develop under the skin in between abscesses, making treatment and healing difficult. Hidradenitis suppurativa is considered to be a severe form of acne.
Causes of Hidradenitis Suppurativa
It is unclear as to what actually causes hidradenitis suppurativa, but there seems to be disturbance around the openings of the hair follicles and sebaceous glands, which become blocked with dead skin cells and secretions of the sweat (apocrine) glands. Bacteria are then trapped and grow, causing infections in skin.
Various factors are thought to contribute to the development of hidradenitis suppurativa. Hidradenitis suppurativa seems to occur in families, so genetics are thought to play a role. Hormone or endocrine factors may stimulate it, and hidradenitis suppurativa occurs more often in cigarette smokers.
According to Dermnetnz.org, women are affected three times more often then men, and the most common age of occurrence is between puberty and the age of 40.
Treatments:
After a doctor examines you, he may order blood tests or send off any drainage from skin lesions to be cultured for bacteria.
Mild cases of hidradenitis suppurativa may be treated with warm compresses and antibacterial soap washings.
Moderate cases may additionally require the use of medications. Antibiotics, topical or oral, may be needed for ongoing treatment to prevent worsening of the condition or further outbreaks. Oral retinoids can help reduce plugging of hair follicles.
NSAIDs may help with pain and swelling. Corticosteroids may be used, which are stronger medications that reduce inflammation. Birth control pills or other hormone suppressing medications such as spironalactone may be tried.
Severe cases may need surgery to open tunneled tracts and drain pocketed areas full of pus discharge. Surgical removal of involved skin areas may require more extensive repair afterwards, with use of a skin flap to cover the opened area, or a skin graft from another part of the body.
Unfortunately, surgery does not prevent a recurrence of hidradenitis suppurativa.
General Prevention
Though hidradenitis suppurativa cannot be prevented, various life style changes may reduce discomfort and help in healing.
- Use warm compresses when you feel inflammation is starting in an area.
- Wash affected areas with antibacterial soaps and apply topical antibiotics such as Neosporin if your doctor recommends it.
- Wear loose clothing so the skin is able to have better air circulation.
- Avoid shaving, which can irritate the skin.
-Stop smoking and try and lose weight if needed, so that skin surfaces do not rub against one another, trapping sweat.
According to Mayoclinic.com, “zinc gluconate supplements (zinc salts) taken daily may help reduce inflammation and prevent new outbreaks”.
Hidradenitis suppurativa can be an especially distressing condition. People feel embarrassed or anxious due to foul odor of the draining lesions and so do not seek medical care. It is important for these people to reach out for help, despite feeling self-conscious.
Support for those who suffer from hidradenitis suppurativa here in the United States can be found at the Hidradenitis Suppurativa Foundation, Inc. http://www.hs-foundation.org/
They have a section to help find a doctor and have information about current research and treatments. HS-USA, at http://www.hs-usa.org/index.htm is also working on developing an online forum, and they have a 24 hr support line.
Other support groups from other countries are listed at the end of the #2 source below.
Sources:
1. Hidradenitis suppurativa. Mayoclinc.com. Web. April 14, 2012.
http://www.mayoclinic.com/health/hidradenitissuppurativa/DS00818/METHOD=...
2. Hidradenitis suppurativa. DermNet NZ. Web. April 14, 2012.
http://dermnetnz.org/acne/hidradenitis-suppurativa.html
Michele is an R.N. freelance writer with a special interest in woman’s healthcare and quality of care issues. Other articles by Michele are at www.helium.com/users/487540/show_articles
Edited by Jody Smith