Hidradenitis Supperativa (HS)

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Hidradenitis suppurativa (hy drah duh NY tiss supp yoo ruh TY vuh) or HS is a long-term (chronic) skin condition. Plugged pores and red, tender bumps or boils begin deep in the skin around hair follicles that contain specific sweat glands called apocrine glands. The tender bumps often enlarge, break open and drain pus. These lesions can be very painful. They can cause scarring.

HS is not contagious (is not spread from person to person). It tends to start after puberty and can continue for years. HS can come and go but may worsen over time.

Causes

Treating Hidradenitis Supperativa

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HS is caused by plugging of the sweat gland opening (apocrine duct) in the hair follicles. There may also be a bacterial infection. HS most often occurs in areas where skin rubs together and at the location of the apocrine glands:

  • Armpits
  • Groin
  • Inner thighs
  • Under the breasts
  • Between the buttocks

Complications

If HS lasts a long time or becomes very bad it can cause other problems (complications):

  • Tracts. The inflammation and infection can form tunnels under the skin. The tracts prevent the sores from healing and cause more sores to develop.
  • Scars and skin changes. Severe HS may leave thick raised scars, pitted skin or patches of skin that are darker than normal.
  • Restricted movement. The condition may cause limited or painful movement, especially when it affects the armpits or thighs.
  • Cellulitis. Cellulitis is a bacterial infection of the skin that leads to swollen, red skin that feels hot and tender. This can occur in addition to the HS painful bumps.

These things may make symptoms worse:

  • Stress
  • Excess weight
  • Heat
  • Hormonal changes

Diagnosis and Treatment

A doctor can often diagnose HS during a physical exam. If there is concern for a bacterial infection, the doctor may swab a lesion to be tested by the lab.

There is no cure for HS and it can be difficult to treat. Treatment is aimed at managing the symptoms and preventing new lesions from developing.

  • Mild cases can be treated with antibacterial skin washes or cleansers. Occasional boils can be soothed by holding warm, damp washcloths on the bumps several times a day.
  • Moderate cases often require medicines. Some medicines are rubbed onto the skin and others are taken by mouth. These may reduce inflammation and prevent the plugging of hair follicles. They are also used to fight an infection, if present. The doctor may prescribe several medicines. It is important to follow instructions carefully.
  • Severe and persistent cases can require surgery or medicine given by infusion (IV) or injection (shots).

What to Do at Home

These suggestions may help relieve discomfort, speed healing and prevent more sores:

  • Apply warm compresses. A warm washcloth or compress can help reduce swelling.
  • Wear loose-fitting clothes. Tight-fitting clothes may irritate the skin. Loose clothes and underwear can help prevent skin irritation.
  • Avoid shaving. Shaving can irritate affected areas.
  • Lose excess weight. Having fewer areas where skin rubs together decreases friction, sweating and bacterial growth. Though weight loss will not cure the disease, it may improve it significantly.

Hidradenitis Suppurativa (HS) (PDF)

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