For the benefit of our readers, Hidradenitis suppurativa (HS) is when recurring inflamed nodules (small, solid lumps) and cysts (fluid-filled mass) form in the armpits and groin. These may also be found under the breasts and around the nipples and anus.
As to causes - the lesions start as plugged pores in the sweat and oil glands. Material builds up under the skin. The body's inflammatory system attacks these materials. This causes nodules and cysts to form. These lesions can burst under the skin and form an abscess. The area may have a bad smell and may heal and leave a scar.
It is rare to have another infection in these lesions. When it does occur, the bacterium is typically Staphylococcus aureus ("staph"). But, HS is different from true staph infections that cause unrelated conditions (eg, boils , carbuncles). Pilonidal cysts may be seen with HS, but may also occur alone.
These factors increase your chance of developing HS:
Genetics
Obesity alone or with polycystic ovarian syndrome (PCOS) , insulin resistance, or syndrome X
Androgen dysfunction (excess male hormone)
Crohn’s disease and related conditions
Acne
Dissecting cellulitis of the scalp
Medications (eg, lithium )
Smoking (interferes with healing)
In terms of treatment - talk with your doctor about the best treatment plan for you. There are various options. Some are more effective than others.
Hot Packs
This treatment is uncertain. Hot packs or warm baths may be used to soften the skin and allow the abscess to drain.
Antibiotics
Long-term use of antibiotics may help stop inflammation. Taking antibiotics this way, though, could lower your resistance to infections.
Cortisone
Cortisone , taken orally for a few days, has shown to be effective in the short-term. Because of side effects, this drug should not be used over the long-term. Cortisone can also be injected or applied to the skin, which may reduce some of the side effects
Male Hormone (Androgen) Suppression
Controlling the male hormone (androgen) may also help. Examples include:
Cyproterone acetate—used either alone or combined with ethinyl estradiol , can suppress acne in women and has improved HS (not available in the US)
Drospirenone (available as a birth control pill)
Flutamide
Finasteride
Dutasteride
Spironolactone
Surgery
Small lesions can be treated in the doctor's office, which could require several visits. If your condition is severe, then a wide area may need to be removed. In these cases, a skin graft may be needed.
Laser Ablation
During this treatment, a laser is used to remove the lesions.
Biologic Medications
Infliximab and etanercept are called "biologic medications." They are used to treat a inflammatory conditions, such as rheumatoid arthritis . These drugs have shown some promise in treating severe HS. Although, they must be injected under the skin and can cause serious side effects.
Prevention
To help reduce your chances of getting HS, take the following steps:
If you smoke, quit .
Maintain a healthy weight .
Talk to your doctor about avoiding dairy products. Hormones in dairy products may worsen HS.
I hope this has helped and that these symptoms can be alleviated for you.
Best,
Susan
Comment Reply
Hello Anon
Thank you for writing.
For the benefit of our readers, Hidradenitis suppurativa (HS) is when recurring inflamed nodules (small, solid lumps) and cysts (fluid-filled mass) form in the armpits and groin. These may also be found under the breasts and around the nipples and anus.
As to causes - the lesions start as plugged pores in the sweat and oil glands. Material builds up under the skin. The body's inflammatory system attacks these materials. This causes nodules and cysts to form. These lesions can burst under the skin and form an abscess. The area may have a bad smell and may heal and leave a scar.
It is rare to have another infection in these lesions. When it does occur, the bacterium is typically Staphylococcus aureus ("staph"). But, HS is different from true staph infections that cause unrelated conditions (eg, boils , carbuncles). Pilonidal cysts may be seen with HS, but may also occur alone.
These factors increase your chance of developing HS:
Genetics
Obesity alone or with polycystic ovarian syndrome (PCOS) , insulin resistance, or syndrome X
Androgen dysfunction (excess male hormone)
Crohn’s disease and related conditions
Acne
Dissecting cellulitis of the scalp
Medications (eg, lithium )
Smoking (interferes with healing)
In terms of treatment - talk with your doctor about the best treatment plan for you. There are various options. Some are more effective than others.
Hot Packs
This treatment is uncertain. Hot packs or warm baths may be used to soften the skin and allow the abscess to drain.
Antibiotics
Long-term use of antibiotics may help stop inflammation. Taking antibiotics this way, though, could lower your resistance to infections.
Cortisone
Cortisone , taken orally for a few days, has shown to be effective in the short-term. Because of side effects, this drug should not be used over the long-term. Cortisone can also be injected or applied to the skin, which may reduce some of the side effects
Male Hormone (Androgen) Suppression
Controlling the male hormone (androgen) may also help. Examples include:
Cyproterone acetate—used either alone or combined with ethinyl estradiol , can suppress acne in women and has improved HS (not available in the US)
Drospirenone (available as a birth control pill)
Flutamide
Finasteride
Dutasteride
Spironolactone
Surgery
Small lesions can be treated in the doctor's office, which could require several visits. If your condition is severe, then a wide area may need to be removed. In these cases, a skin graft may be needed.
Laser Ablation
During this treatment, a laser is used to remove the lesions.
Biologic Medications
Infliximab and etanercept are called "biologic medications." They are used to treat a inflammatory conditions, such as rheumatoid arthritis . These drugs have shown some promise in treating severe HS. Although, they must be injected under the skin and can cause serious side effects.
Prevention
To help reduce your chances of getting HS, take the following steps:
If you smoke, quit .
Maintain a healthy weight .
Talk to your doctor about avoiding dairy products. Hormones in dairy products may worsen HS.
I hope this has helped and that these symptoms can be alleviated for you.
August 8, 2017 - 4:51amBest,
Susan
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