Delving Into the Root Causes of Hidradenitis Suppurativa
It is common for hydradenitis suppurativa to occur in areas with skin-to-skin contact, namely the armpits, groin, buttocks, and breasts. It causes painful, leaking, recurring boils that form deep pockets of infection (abscesses) and cause scarring over time.
Doctors aren’t sure what causes HS, but it may be linked to hormones, being overweight, or smoking, and is more common in women than men. It’s not caused by poor hygiene and isn’t contagious.
Causes
People with HS have painful, recurrent abscesses and scarring on areas of their skin that contain apocrine sweat glands. These glands are found in areas of the body where the skin rubs together, such as the armpits, groin, belly folds, and breasts. HS can cause boil-like lumps, areas that leak pus, and channels under the skin filled with odorous pus. Some people may go years without receiving a diagnosis because this ailment can be challenging to diagnose.
Some people with HS develop a single painless, pea-sized lump under the skin, but the condition can progress to multiple painful lumps or hard bumps filled with pus and bleeding when touched. Often, the lesions appear on areas of the body where the skin rubs against clothing or other items, like the underarms, groin, belly folds, or breasts. The painful lumps may form over weeks or months and recur several times. They can also grow and break open, then heal with extensive scarring.
Experts don’t know what causes hidradenitis suppurativa, but it appears to be an autoinflammatory condition affecting the hair follicles in these body areas. The condition tends to start around puberty and is more common in women and people with skin of color. Researchers are investigating the role of specific genes in the development of hidradenitis suppurativa.
Symptoms
Hidradenitis suppurativa causes painful boil-like lumps called nodules to form under the skin. The nodules can rupture, creating abscesses that drain pus and cause scarring over time. The condition can affect anyone, but it’s more common in women, especially those whose sex hormones change during puberty or before menopause. It can also be more complicated to diagnose than other skin conditions.
Although the etiology of hidradenitis suppurativa is unknown, it is believed to be brought on by clogged and irritated hair follicles. Some researchers think it might be linked to genetics, certain medications, cigarette smoking, or being overweight. It isn’t caused by infection or poor hygiene and can’t be spread to others.
HS can be very painful and embarrassing, but there are ways to manage it and prevent future flare-ups. The first step is to visit your doctor, who may suggest a dermatologist who is an expert in identifying and treating skin conditions. They suggest you avoid consuming dairy, sugary foods, and brewer’s yeast, which may help reduce symptoms. Keeping affected areas clean, especially during flare-ups, can help to keep them clear. The AAD says that placing a warm washcloth over your abscesses can reduce swelling and help you feel more comfortable.
Treatment
The pain and pus-filled lumps of hidradenitis suppurativa can make it hard to live normally, especially if they keep forming. They often occur in the armpit, groin, or around the buttocks. But they can form in other areas, too. They may look like boils, cysts, or pockets of infection (abscesses). They can grow and break open over time, leaving scars. Getting treatment as soon as possible is essential because recurrences can lead to severe scarring and long-term problems.
There’s no specific test for hidradenitis suppurativa, so doctors usually diagnose the condition by looking at the lumps and talking to the patient about their symptoms. The doctor may also take a sample of the skin or pus to test it for bacteria (Staphylococcus aureus, commonly called staph).
Treatment options include antibacterial washes that contain chlorhexidine, benzoyl peroxide (10%), or zinc pyrithione. Soaking in a highly diluted bleach bath can also help kill bacteria and prevent future infections. Avoid picking or squeezing the lesions, boils, and draining tunnels. Wash the affected area daily with an antiseptic cleanser and often change sterile, absorbent dressings.
Keeping to a healthy weight and quitting cigarette smoking can reduce HS symptoms. Medications such as metformin, a type of diabetes medicine, and birth control pills that regulate hormone fluctuations can reduce symptoms, too. Adalimumab may be effective because it quiets the body’s immune response and eases inflammation.
Prevention
It’s unclear what causes hidradenitis suppurativa, but it may result from dysfunctional apocrine glands or hair follicles, an overactive immune system, or a combination of factors. People with a family history of the condition or certain health conditions are more likely to develop it, including Crohn’s disease and type 2 diabetes. It’s more common in African Americans than whites and usually appears around puberty, although it can also happen in adults. Women are three times more likely to get it than men. It’s not contagious, but the sores are painful and can leave scars.
Treatment options include gentle skin care, pain relievers, antibacterial washes, and oral medications that help reduce infection, heal HS wounds, and prevent flare-ups. The condition known as hidradenitis suppurativa can be identified and treated by a dermatologist a medical professional who focuses on the skin, hair, and nails.
You can manage the symptoms by using gentle soaps and moisturizers, moisturizing with a thick lotion after showering or bathing, and taking an over-the-counter (OTC) nonsteroidal anti-inflammatory drug (NSAID), such as aspirin* or Motrin (ibuprofen). But if OTC treatments don’t help, your doctor might prescribe more vital medication. Oral medications that help reduce inflammation and infection include a class of antibiotics called tetracyclines. Doctors also might recommend the type 2 diabetes drug metformin (Glucophage), which can reduce fluid retention, and hormone therapy, including spironolactone and birth control pills.
