Hidradenitis suppurativa is a debilitating inflammatory skin disorder characterized by blackheads and red and tender bumps (lesions) on the skin. The condition adversely affects the apocrine or sweat glands. The bumps often grow bigger in size, breaking open and draining pus. Recurrences of hidradenitis suppurativa may result in scarring.

Although no exact cause of hidradenitis suppurativa has been established so far, it is generally perceived to be an aggravated condition of acne (acne inversa) as it deeply affects the skin around sebaceous glands and hair follicles.

Hidradenitis suppurativa has a tendency of developing after puberty and persisting for the period of years before worsening over the periods. Although no cure is available for hidradenitis suppurativa, it is possible to manage its symptoms and prevent development of new lesions with early diagnosis and treatment.

Signs and symptoms

Following are the signs and symptoms of hidradenitis suppurativa:

Presence of blackheads either in groups or a "double-barrel" pattern on the skin.

Single or several red and tender bumps or lesions containing pus. The bumps, which may be itchy and also accompanied by burning and sweating, start draining pus on becoming larger in size and breaking open.

Growth of painful and hard lumps similar to size of a pea on the skin. Such lumps that may grow larger and cause inflammation may continue to remain on the skin for several years.

Painful bumps or sores on the skin, releasing fluid more often. Such open wounds take a long time to heal and may leave scarring and result in the formation of tunnels under the skin.

The condition in some people continues to grow worse affecting large areas of body. On the other hand it shows mild symptoms in other people. Over weight, tension, hormonal changes, heat or sweating may contribute in worsening of the symptoms.

Causes of hidradenitis suppurativa

Although the exact cause of hidradenitis suppurativa remains unknown, it is believed to be occurring with the blockage of sebaceous (oil) glands and hair follicle openings. The apocrine gland ducts and perifolliculitis surrounding the ducts are obstructed due to follicular occlusion resulting in the condition of Hidradenitis suppurativa.

Some people are thought to be genetically predisposed for the condition. Hidradenitis suppurativa seems to be more commonly affecting women. Hidradenitis suppurative does not usually occur before puberty because the sweat glands do not become active at this age. However, it can occur at any age after puberty. The rate of incidence of hidradenitis suppurative is found to be higher among cigarette smokers than those who don't smoke.

Several factors such as hormonal changes, genetics, cigarette smoking and overweight contribute to the development of the condition. The enlargement of sweat glands, tension, menstrual period, intense heat and excessive sweating are also said to be the factors behind the occurrence of hidradenitis suppurativa. Sometimes it is believed to be associated with several other conditions like Crohn's disease and herpes simplex.

When to seek medical advice

Some self-care measures can be sufficient to treat some mild cases of hidradenitis suppurativa. But if the condition does not go away and continues to persist even after two weeks, affects large part of body or results in pain, you will need to go to a dermatologist. In such cases the condition can be managed through medical treatment like prescription medications or operations.

Screening and diagnosis

In order to diagnose your problem your doctor may look for the symptoms and ask you about medical history besides examining your skin and conducting your blood test. In case of presence of pus or drainage, your doctor may feel a need of carrying out laboratory testing of the fluid sample. Such tests may be required to ensure accurate diagnosis of the condition and rule out conditions like skin tuberculosis or a carbuncle.

Complications

The persistent and severe hidradenitis suppurativa often leads to several other complications such as:

Creation of sinus tracts or tunnels connecting and forming a network under the skin. The tracts not only cause delay in healing of the sores but also give rise to chances of development of more sores.

Severe form of hidradenitis suppurativa may cause the lesions to become thicker and lead to creation of scars and dark patches on the skin.

The condition may restrict your movement particularly when it occurs on armpits or thighs.

The condition may cause some serious bacterial infection with swelling and redness of the skin that may feel hot and spread quickly to other areas of the body. The infection may seem superficial, but it can harm the tissues underlying your skin besides affecting lymph nodes and spreading to bloodstream.

Treatment for Hidradenitis suppurativa

It is always good to go for hidradenitis suppurativain treatment. It the initial stages because any delay may lead to scarring. However, accurate and correct diagnosis is very essential.

The mild to moderate cases can initially be treated with topical therapy such as topical retinoid. Moist heat or incision can be sufficient to treat simple cases.

The treatment of severe cases with scarring may necessitate use of surgical method to take out scars and underlying diseased tissues. The operated areas are often left to recover without the necessity of skin grafting. In some severe cases, the involved area may be cut out and replaced with skin of other area of body through grafting.

Treatment may include the following:

Topical Antibiotics can be prescribed for quick recovery from condition of hidradenitis suppurativa.

Systemic antibiotics are required when the condition flares up and a patient undergoes severe case of hidradenitis suppurativa. Antibiotics, if used for a long time, may avoid further aggravation of the condition and help check its recurrence in future.

Sometimes surgery is needed for draining out infected areas or removing the scarred tissues or large part of skin affected by the condition.

Higher doses of systemic steroids can be used as additives to antibiotics. Such steroids can help reduce the inflammatory process effectively.

Use of oral retinoid medications can be a good choice to check oil gland functions and prevent hair follicles from getting plugged.

Nonsteroidal anti-inflammatory drugs can be used to get relief from pain and reduce swelling.

Corticosteroids or immunosuppressant drugs can also be used for speedy recovery from the condition.

Add your Home Remedy below..

Comments

Use Ivory soap or Lever 2000 original version without the vaseline. These soaps will clear up the puss filled boils. There will be a scar but the puss,blood and height of the boil will be gone. I have been using these for 1 year now and my outbreaks are gone. Try it. Both are sold at Walmart and they are cheap. For some reason these soaps work.

#1 - Rebecca - 05/04/2010 - 15:14

I have struggled with HS for years. My Doctor verified that I have mild HS (I consider myself lucky) I sympathized with those that are still trying to find a solution and the pain (physical and emotional) that one has to deal with. After doing long research, it seems that while one solution might work for some, it may not work for others. I have finally found something that has worked for me, so I figure that it would be appropriate to share it. I follow a strict 40% protein. 40% carb. 20% fat. diet. (BE SURE TO CHECK THE DIET WITH A DOCTOR FIRST AS SOME PEOPLE MAY NOT BE ABLE TO HANDLE THE DIET WITH CERTAIN MEDICAL CONDITIONS). There are catches too, on this diet, the following is not allowed:NO PASTA, NO RICE, NO BREAD, NO ALCOHOL, NO POTATOES, NO CAFFEINE, NO BEEF, NO SUGAR OTHER THAN WHAT IS NATURALLY CONTAINED IN FRUITS AND VEGETABLES. NO ARTIFICIAL SWEETENERS. I get my protein mainly from chicken and fish, although cottage cheese, protein shakes work as well. Also, eat the amount of calories that is right for your body, your doctor should be able to tell you this. I found out about this diet as a by-product of trying to get in shape. I do work out as well 3 times a week with cardio followed by weights, although it seems that the diet controls my HS more than the workouts or the [@]ociated weight loss. I have been on the diet for over a year, it took about 3 months of strictly following the diet for the HS to really clear up. I have had 2 set backs witch appear to [@]ociated with falling off the diet (one time going back to simple sugars, the other my protein/Carb/Fat ratios were well out of line), about a week after falling off my diet the "pre-boil bumps" started to re-appear, but would go away within a couple of weeks of getting back on the diet. It is important to chart what you eat to ensure the percentage ratios are correct on a daily basis, other wise it is very easy to fall off course and not realize it. The diet is tedious, but for me, it was worth it. Oh, of note, it took me about 3 weeks for my cravings for junk food to go away (but the clock would reset if I cheated on my diet hence I waited another 3 weeks from the last point for them to go away). Please keep in mind, I had Stage I HS, nothing more, so while I had several boils, it was never categorized as severe. While I do not know if this diet will work for others like it did for me, I wanted to at least put it out there in hopes that if a least one other person gets the relief that I have found in this, it would be worth it.

#2 - Jeff - 10/04/2010 - 10:31

Thanks Jeff. I got off of my total raw food self and noticed that the legions came back on me. And I did forget to use the antibotics (Golden Seal). I'm starting back. Thank you and I do know that it works for me.

#3 - Carol - 11/03/2010 - 19:27

I've tried everything and nothing works for me as a cure but I can give you a tip for speeding up recovery of the boils.

Get a high grade (+16%active ingredient) Manuka Honey from New Zealand and mix it with milk powder to a thick paste. Apply with a gauze and tape or similar over the whole thing! The milk powder draws out the puss and the Manuka heals the wound. This remedy is faster than anything I have tried over the last 25 years.
Hope this helps :)

#4 - Pete - 11/04/2010 - 21:44

I will try all these suggestions. I had surgery 2 years ago. The place where they removed the area and left it to heal on its own is fine. But the areas where the surgeon cut out and sewed up just recently came back. So i have several open wounds that wont heal.

#5 - Linda - 01/26/2011 - 16:23

I have been suffering with HS for more than 15 yrs. By accident I used Thursday plantation. Tea. Tree medicated. Gel. For. Acne. And found total relief. Even from the smell in hot weather ...... Please try it it really works. I do not know why...

#6 - Judith - 01/27/2011 - 02:39

I was diagnosed with HS during a m[@]ively stressful period in my life. I was also diagnosed with IBS the same month. My acne was cystic on my face and back and I was plain miserable. I visited my dermatologist and he put me on a strict regiment of Accutane for 11 months. My golf ball legions (in all three major areas and under my knee) completely disappeared within 5 weeks. My major side effects of the Accutane included severe dry skin and chapped lips, slight depression and I couldn't wear contacts. Within 6 months, my acne was completely gone. I stayed on the accutane for an entire year because I was terrified the HS would come back. I couldn't handle another emergency visit to drain another abscess....I am writing this mostly to say that Accutane works and there is hope. It has been seven years and I have not had a single legion or cyst anywhere on my body.

#7 - Amy - 01/28/2011 - 20:43

I have suffered with Hs for 16 years, I have went to several doctors and even the er to see if there was anything anybody could do. well they tested it at the dr. and at the er and told me i had staff so they gave me antibiotics which did not work only made it worst. I finally went to a dermatologist in houston and they told me I had hidradinitis.. I was like what in the world is that? They explained it well for about 2 years I have gone to the dermatologist to get steroid shots where the boils were or open sores.. Well they thought that would cure it well they were definantley wrong. So now the fun part begins I am now waiting to meet a plastic surgeon to to skin grap surgery.. that is where my disease had led me.. So for all of you who is suffering like me take my advice and speak to a plastic surgeon because they can cut out where the infection is where your hair grows and it has really helped it really wasn't painful at all .. thanks for listening and I hope this has helped some of you out there looking for some kind of a answer.

meranda from Texas

#8 - Meranda - 02/12/2011 - 15:12

so after sergery is the hs gone?

#9 - mya - 06/29/2011 - 17:57

ive suffereed with this disease for about 13 years and was only recently diagnosed,,,i hate it,:((.
i have it under my arms under my breasts (very painfull with a bra on all the time!) and on my inner thighs.
i ALWAYS have at least 1 boil on the go,,and have lots of scarring and weeping wounds that wo9nt heal.
the only thing that helps me is using anti bacterial soap and babys antiseptic nappy cream (sudocrem or zinc and castor oil),,i have 3 kids and the condition always gets better (well,to some extent) when im pregnant,,it gets worse when im menstruating and has got a lot worse over the last year which im putting down to unbelievable levels of stress due to being homeless. I can cope with HS at the level it is now (well,its depressing and embarrasing and painful!),,but ive seen pictures and stories online where people are much worse than me,,,im very scared that its going to progress into a disease that i cant control since theres no cure and such little research done about it,it makes me very upset.
if anyone out there knows if the HS always progresses into a serious disease that needs surgery and such or can you stay at stage 1 forever?,,im very confused and very alone,,i havent told anyone about having HS.

dolly from kent,england,xx

#10 - dolly - 09/29/2011 - 18:59

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