Thomas V. Harmon, MD, FACS
What is hidradenitis suppurativa (HS)?
Hidradenitis suppurativa (HS) is a chronic skin disease. It causes painful, boil-like lumps that form under the skin. It often affects areas where the skin rubs together, such as your armpits and groin. The lumps become inflamed and painful. They often break open, causing abscesses that drain fluid and pus. As the abscesses heal, they can cause scarring of the skin.
What causes hidradenitis suppurativa (HS)?
The lumps in HS form because of blockages of the hair follicles. The blocked hair follicles trap bacteria, which leads to inflammation and rupture. In most cases, the cause of the blockages is unknown. Genetics, environment, and hormonal factors may play a role. Some cases of HS are caused by changes in certain genes.
HS is not caused by bad hygiene, and it cannot be spread to others.
Who is at risk for hidradenitis suppurativa (HS)?
HS usually starts after puberty, usually in the teens or twenties. It is more common in:
What are the symptoms of hidradenitis suppurativa (HS)?
The symptoms of HS include:
- Small pitted areas of skin containing blackheads
- Painful, red, lumps that get bigger and break open. This causes abscesses that drain fluid and pus. They may itch and have an unpleasant odor.
- The abscesses heal very slowly, recur over time, and can lead to scarring and tunnels under the skin
HS can be mild, moderate, or severe:
- In mild HS, there are only one or a few lumps in one area of the skin. A mild case will often get worse, becoming a moderate disease.
- Moderate HS include recurrences of the lumps that get bigger and break open. The lumps form in more than one area of the body.
- With severe HS, there are widespread lumps, scarring, and chronic pain that may make it hard to move
How is hidradenitis suppurativa (HS) diagnosed?
There is no specific test for HS, and it is often misdiagnosed in the early stages. To make a diagnosis, your health care provider will ask about your medical history and your symptoms. He or she will look at the lumps on your skin and test a sample of the skin or pus (if there is any).
What are the treatments for hidradenitis suppurativa?
There is no cure for HS. Treatments focus on the symptoms, but they are not always effective for everyone. The treatments depend on how severe the disease is, and they include:
- Medicines, including steroids, antibiotics, pain relievers, and medicines that flight inflammation. In mild cases, the medicines may be topical. This means that you apply them to your skin. Otherwise the medicines may be injected or taken orally (by mouth).
- Surgery for severe cases, to remove the lumps and scars
It may also help if you can avoid things that can irritate your skin, by: