Hidradenitis Suppurativa

What is Hidradenitis suppurativa

Hidradenitis suppurativa is a long term, recurrent, and painful disease in which there is inflammation (redness, tenderness and swelling) in areas of skin containing apocrine sweat glands. These glands are found mainly in the armpits, breasts, groin, abdomen folds and buttocks. Within HS there is a blockage of the hair follicles. This causes a mixture of boil-like lumps, areas leaking pus, and scarring. Hidradenitis suppurativa tends to begin around puberty. It is more common in women and in people with skin of colour. It is estimated to affect about 1% of the population.

Hidradenitis suppurativa (HS) is an inflammatory disorder of hair follicles, most commonly in the armpits, groin, under the breasts, and in between the buttocks.

Symptoms of hidradenitis suppurativa?

Symptoms depends upon the stage of disease. It may present as any one or all of the following -

• One or multiple abscesses that may or may not be painful.
• The pain may make it uncomfortable to sit or make normal body movements.
• Pus discharge.
• Nodules
• Scars
• It can sometimes be associated with inflammation of the joints (arthritis).

Hidradenitis suppurativa can have a severe psychological effect such as stress, anxiety, depression, etc.

In the early stages of HS, there are a mixture of blackheads, pus spots or red lumps which look like boils or cysts (also known as abscesses).

In the later stages of HS, tunnels may form under the skin that leak pus with wounds that may not heal easily. As time goes by, more and more scarring appears.

Commonly affected regions

Hidradenitis suppurativa mainly affects -

• armpits
• groin
• genital and pubic regions
• skin around the anus, buttocks, thighs and breasts can also be affected.

Causes of Hidradenitis suppurativa

It is still not clear why some people get this disease, but it is thought the inflamed spots or lumps develop when there is a blockage of the hair follicles. As the fluid or pus in the spots and lumps cannot escape, the hair follicles may swell up and burst causing the area to become inflamed or form abscesses and become severely infected.

Contributory factors may include the following:

• Hormones may be involved in the control of apocrine sweat glands and might play a part in the disease. In women, HS may be worse before menstrual periods. Some patients may benefit from hormone treatments.
• Bacteria (germs) that normally live on the skin may become trapped in the blocked gland or hair follicle. It is not clear whether this causes the disease or just contributes to the inflammation.
• The immune system is involved in producing inflammation and treatments that reduce the immune system activity may be helpful.
• In some people with HS there is a link to the bowel conditions such as Crohn’s disease and ulcerative colitis. It is important to seek medical attention if you develop any symptoms such as persistent diarrhoea, blood in the stools, unexplained weight loss or persistent abdominal pain.
• There may be a link with acne, dissecting scalp cellulitis (scarring and inflammation of the scalp) and pilonidal sinus (a chronic abscess at the base of the spine).
• Smoking and obesity are linked with HS (up to 60% of patients with HS are smokers), but the condition can also affect non-smokers of normal weight.
• People with HS are at increased risk of developing other disorders such as high cholesterol, high blood pressure and diabetes. These do not cause HS but your doctor may consider checking your weight, blood pressure and blood tests for your sugars and cholesterol.
• Poor hygiene does not cause hidradenitis suppurativa.

Home care tips for Hidradenitis suppurativa

The following measures may be beneficial:

• If you are overweight, reduce your weight and maintain a healthy body mass index (BMI).
• Quit smoking now.
• Washing with mild herbal medicinal soaps.
• Avoid wearing tight clothing
• Avoid stress.
• Consider joining a support group

Common questions on Hidradenitis suppurativa.

Is hidradenitis suppurativa hereditary?

Hidradenitis suppurativa may run in the families. Means if anyone in your family hidradenitis suppurativa then you are also prone to get it.

Is hidradenitis suppurativa contagious?

No, hidradenitis suppurativa is NOT contagious. It can not be passed on from one person to another through physical contact. 

How will hidradenitis suppurativa be diagnosed?

The diagnosis is usually made by a doctor examining the area, and the history and symptoms described by the patient. There is no specific test on which the diagnosis can be made. The condition is often misdiagnosed initially as an infection or inflammation of the hair follicles which can result in delayed treatment and progression of the disease with scarring.

Can hidradenitis suppurativa be cured?

Hidradenitis suppurativa usually persists for many years, but can become inactive in many cases. Kshar Sutra Treatment is very effective in treating sinuses, abscesses and underskin fistula caused by hidradenitis suppurativa.