Hidradenitis Suppurativa (Acne Inversa) Causes, Symptoms, Treatments

Introduction

Hidradenitis suppurativa (HS) - also known as acne inversa - is a common chronic skin disease characterized by clusters of abscesses or subcutaneous boil-like infections that most commonly affects apocrine sweat gland bearing areas, such as the underarms, under the breasts, inner thighs, groin and buttocks. The lumps associated with hidradenitis suppurativa are often times painful and might break open and drain bad-smelling pus. In some cases, tunnels connecting the lumps form under the person's skin. Hydrant's suppurativa is not contagious. There are indications that it is hereditary among certain ethnic groups and autoimmune in nature. HS onset is most common in the late teens and early 20's.

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Recent regional and insurance database studies indicate that diagnoses of hidradenitis suppurativa (HS) are rare, with fewer than 200,000 affected patients in the United States. These findings are at odds with the generally accepted prevalence of approximately 1%.

Symptoms of Hidradenitis Suppurativa

Hidradenitis suppurativa usually occurs around a person's hair follicles, where a number of sweat and oil glands are found such as in the person's groin, armpit and anal area. It might also happen in areas where the person's skin rubs together such as under a person's breasts, on their inner thighs, or between their buttocks. Hidradenitis suppurativa may affect one area of the person's body, or it may affect several areas. The signs and symptoms of the condition can include the following:

• Pea-sized and Painful Lumps: The hard lumps, which develop underneath the person's skin, might persist for years. They may enlarge and become inflamed.
• Blackheads: Small, pitted areas of a person's skin containing blackheads, many times appearing in pairs or a, 'double barreled,' pattern are a common feature of the condition.
• Leaking Sores or Bumps: The open wounds heal at a very slow pace, if at all, often times leading to the development of tunnels underneath the person's skin and scarring.
• Tender Red Bumps: The bumps, or lesions, often times enlarge, break open and drain pus. The drainage might have an unpleasant odor. Burning itching and excessive sweating might accompany the bumps.

Hidradenitis suppurativa often begins after a person reaches puberty with a single, painful bump that persists for weeks or even months. For some, the disease progressively worsens and affects a number of areas on their body. Others experience mild symptoms. Extra weight, hormonal changes, stress, excessive perspiration and heat may worsen a person's symptoms. Mild instances of hidradenitis suppurativa may be treated with self-care measures. Contact your doctor if the condition:

• Is painful
• Recurs often
• Appears in several areas
• Does not improve in a few weeks
• Returns within weeks of treatment

Causes

Hidradenitis suppurativa develops when hair follicles become blocked and inflamed. It is not known why this blockage happens, yet a number of factors to include genetics, hormones, cigarette smoking and extra weight might all play a role. Hidradenitis suppurativa affects approximately one percent of the population. Factors that might increase your risk can include:

• Age: Hidradenitis suppurativa most commonly affects young adults.
• Family History: A tendency to develop hydradenitis suppurativa can be inherited.
• Your Gender: Women are more likely to develop hidradenitis suppurativa than men.

Complications

Hidradenitis suppurativa often times causes complications when the disease is severe and persistent. The complications might include the following:

• Skin Changes and Scarring: Severe hidradenitis suppurativa can leave rope-like scars, patches of skin that are darker than usual, as well as pitted skin.
• Restricted Movement: Scar tissue and open sores may cause painful or limited movement, particularly when the disease affects a person's thighs or armpits.
• Social Isolation: The location, drainage and odor of the sores, singly or in combination, may cause embarrassment and a reluctance to appear in public, which may then lead to depression.
• Obstructed Lymph Drainage: The most common sites for hidradenitis suppurativa also contain a number of lymph nodes. Scar tissue may interfere with the lymph drainage system, which may then result in swelling in the person's legs, genitals, or arms.

Testing, Diagnosis, Treatment and Medications

A diagnosis of hidradenitis suppurativa may be achieved by examining the affected person's skin. If drainage or pus are present, a doctor may send a sample of the fluid to a laboratory for testing. There is no cure for hidradenitis suppurativa, although early treatment can help manage the symptoms and might prevent new lesions from developing. Where medications are concerned, a doctor might suggest trying one or more of the following types of medications:

• Antibiotics: Long-term use of antibiotics may help to prevent the disease from becoming worse and may reduce the risk of future outbreaks. The drugs can come in pill form or in a cream or ointment to spread on the affected skin.
• Corticosteroids: Injecting steroid medications directly into the tender nodule may reduce inflammation. Oral steroids such as prednisone may help as well. Yet long-term use of prednisone has a number of side-effects, to include osteoporosis.
• Tumor Necrosis Factor (TNF) Alpha Inhibitors: Medications such as infliximab and adalimumab show promise in the treatment of hidradenitis suppurativa. The drugs; however, may increase the risk of infection, certain types of cancers and heart failure.

For severe or persistent instances, or for deep lesions, surgery might become necessary. What follows are descriptions of some of these procedures.

• Incision and Drainage: Surgical drainage might become an option when the disease involves a single small area. The treatment; however, is generally used for short-term relief.
• Uncovering Tunnels: Known as, 'de-roofing,' the procedure cuts away the skin and flesh that cover any interconnected tunnels linking separate lesions. The disease; however, might still return in the treated area, or another area of the person's body.
• Surgical Removal: Surgical treatment of recurrent or severe symptoms involves removal of all of the skin that is involved. A skin graft might be needed in order to close the wound. Full surgical removal of the affected areas can treat the disease that is present, yet does not prevent the disease from occurring in other areas of the person's body.

Home Remedies

There are some different home remedies you can pursue in order to relieve discomfort, speed healing and prevent the infection from spreading. For example; you can apply warm compresses. A warm washcloth or compress can help to reduce the swelling. Other things you can do at home include:

• Zinc Supplements: Zinc supplements taken each day might help to reduce inflammation and to prevent new outbreaks.
• Keep the Affected Area Clean: Gently was the affected areas with antibacterial soap. After washing, apply an over-the-counter antibiotic.
• Wear Loose-Fitting Clothing: Loose clothing and underwear might help to prevent skin irritation. When clothing is tight or synthetic, it may irritate your skin.
• Weight Loss: Extra weight increases the number of areas where a person's skin rubs together. For example; between skin folds. Rubbing skin causes friction, increases perspiration and bacterial growth. While weight loss will not cure the disease, it may very well improve a person's symptoms.

Support and Coping

Hidradenitis suppurativa can be unsightly, painful and - if the lesions are draining, foul smelling. The ongoing persistent nature of the disease and the treatment challenges simply add to the person's burden. They may feel anxious or embarrassed about their symptoms and become self-conscious or withdrawn. They might be frustrated or upset by the reactions of others.

Family members and friends can help a person with this disease greatly as they go through a difficult time. At times though, support from others may not be enough. A professional counselor may be able to suggest different coping strategies to help the person feel better about their situation. A person with this disease may find the concern and understanding of others with the disease to be particularly comforting. Online support groups can connect an affected person with others who are living with hidradenitis suppurativa.

Information and Page References

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Cite This Page (APA): Langtree, I. C. (2015, July 8 - Last revised: 2020, September 16). Hidradenitis Suppurativa (Acne Inversa) Causes, Symptoms, Treatments. Disabled World (DW). Retrieved January 15, 2025 from www.disabled-world.com/health/dermatology/skin/hs.php

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