Hidradenitis suppurativa
Hidradenitis suppurativa occurs in areas where there are sweat glands around hair follicles. It is a condition that often affects the armpits but can also affect the groin, under the breasts, and around the anus, as well as other areas of the body. It is a chronic condition that can cause both abscesses and scarring of the skin. The cause of hidradenitis suppurativa is unknown.
The symptoms are painful lumps ranging from blackheads to boils, cysts, or channels (called sinus tracts) that contain and sometimes leak pus. As it is a long-term recurrent condition that requires ongoing management, it can cause quite an impact on an individual’s everyday life and lead to depression.
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What is the cause?
The exact cause is unknown, but as it involves sweat glands and hair follicles, it is thought to develop due to blocked follicles and not due to poor hygiene.
Smoking, obesity, and diabetes are strongly associated with this condition, and there is even a link between hidradenitis suppurativa and Crohn's disease. For unknown reasons, it happens in women more than men and usually starts around puberty.
When should I see my doctor?
You should see your doctor if you think you have hidradenitis suppurativa. Your doctor will examine the affected area of the skin. If there is any pus or discharge from the area, the doctor may take a sample for it to be sent off to the lab. Your doctor may recommend you stop smoking or lose weight if they think it is helpful.
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What is the treatment?
It can be helpful not to wear tight clothing and avoid shaving or using perfumed or scented products to prevent irritation and inflammation. Instead, antiseptic skin washes/soaps can be used, such as 4% chlorhexidine, which can be applied daily to affected areas alongside other treatments.
Applying a warm washcloth on the lumps regularly will encourage the lump to drain the pus and provide temporary relief to the area daily.
What about prescription treatments
If home self-care treatments do not control your symptoms, there are a range of different treatment options your doctor can recommend. If you notice your symptoms are worse around your periods, then your doctor may consider contraceptives.
Antibiotics may be required if there is any evidence of infection: painful, red, inflamed, discharging lump. If there is any discharge from the area, a sample is taken first and sent off to the lab. Antibiotics can be prescribed anywhere from a few weeks to a few months in duration, depending on the severity of the problem.
Some specialists may prescribe creams, tablets, or injections. Dermatologists may prescribe steroids that can be used to reduce the severity of inflammation. They may also try retinoid creams or immunosuppressive treatments (drugs that suppress the immune system), which can be helpful in some cases. Surgery may sometimes be considered if all other treatment methods have failed or are not suitable.
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