Hidradenitis suppurativa (HS)

• Hidradenitis suppurativa can cause painful lumps, skin tunnels, and scars.
• Hidradenitis suppurativa needs to be treated early on to prevent complications and further spread of the condition.
• Hidradenitis suppurativa mainly occurs in regions with sweat glands, such as the armpit, groin, bottom, and breasts

Hidradenitis suppurativa (HS) is a chronic skin condition that affects about 1 in 100 people. It can be the cause of painful lumps on the skin which can lead to abscesses and scars. It’s essential that this condition gets detected early on to prevent the further spread of the lumps on your body. This guide by Ada’s medical team will explain more about the condition, how you can recognize it, and the different possibilities for hidradenitis suppurativa treatment. 

Hidradenitis suppurativa (HS) is a skin condition that’s also known as acne inversa or Verneuil disease. This skin condition causes lesions of the skin which can become painful. The lesions of this condition can mainly be found in skin folds and regions with sweat glands present. Thus, you can notice hidradenitis suppurativa in the armpit region, the groin, the genital region, and underneath the breasts. This condition can be very painful and can also have an impact on mental health. Hidradenitis suppurativa is a chronic condition that occurs for an extended period. 1 2

Hidradenitis suppurativa is a progressive disease and can be divided into stages, depending on the severity of the skin lesions: 1

• Stage 1 hidradenitis suppurativa: presence of one or more bumps, but without any tunnels or scars
• Stage 2 hidradenitis suppurativa: presence of multiple bumps with tunnels and scars
• Stage 3 hidradenitis suppurativa: presence of multiple bumps with interconnecting tunnels and scars in a large area of your body

Hidradenitis suppurativa symptoms can range from moderate to severe and can be noticed on the skin. The condition causes deep nodules to form, as well as abscesses and hidradenitis suppurativa tunnels, which are small channels underneath the skin that are also called sinus tracts. They can break on the surface of the skin and can leak pus. The skin lesions can cause scarring in later stages, and are also very painful. 1

The exact cause of hidradenitis suppurativa is unknown. However, a few factors can increase your likelihood of developing the condition. Research shows that about 33 to 40% of people with hidradenitis suppurativa have a close relative with the condition, indicating that genetics play a crucial role. In addition, environmental factors and personal habits contribute significantly to the risk of developing hidradenitis suppurativa. Smoking and obesity are 2 known contributing factors. Painful lumps associated with hidradenitis suppurativa develop from the blockage of hair follicles, and it's important to note that Hidradenitis suppurativa is not caused by an infection or poor hygiene. 1 2

Hidradenitis suppurativa often starts with a few blackheads that develop in one place. These lesions can disappear on their own or rupture and leak puss after a few days. After this, they’ll go away. You may notice new lumps appearing in an area nearby. If hidradenitis suppurativa treatment doesn’t start in the early stages, then the condition will continue to spread. This makes early detection of this condition highly important. 

Hidradenitis suppurativa is a lifelong condition that needs to be managed with appropriate treatment. In the earlier stages, management is easier, and symptoms can improve or even disappear. In later stages, hidradenitis suppurativa surgery may be necessary. 2

Hidradenitis suppurativa can sometimes be mistaken for other common conditions, such as acne or ingrown hairs, since it’s diagnosed clinically without any definitive tests. Your physician will ask about your medical history and examine the affected areas of your skin. If there's uncertainty about the condition causing your skin lesions, your physician may take a swab from an affected area and send it to the laboratory for further analysis. 2

Hidradenitis suppurativa treatment depends on the stage of the condition and the symptoms you’re experiencing. Your physician may recommend you: 2

• Antibiotics if you have a bacterial infection or to prevent inflammation of the lumps
• Antiseptic washes, which you need to apply to affected areas
• Retinoids
• Contraceptives if there’s a noticeable link between your hidradenitis suppurativa symptoms and your period
• Immunosuppressive treatments for severe cases of hidradenitis suppurativa
• Steroids to reduce severely inflamed skin
• Surgery in severe cases of hidradenitis suppurativa where medication doesn’t offer a solution

There’s no permanent cure for hidradenitis suppurativa, although the symptoms can improve or even go away if treatment starts early on. 

Hidradenitis suppurativa can cause quite some complications, especially in the later stage, when the condition affects a large part of your body. You may experience: 1 2

• Bacterial infections of some of the lumps
• Development of a small tunnel in the skin of the buttocks called a pilonidal sinus
• Chronic pain
• Contractures of the skin
• Decreased range of motion due to the many abscesses 
• Scarring
• Swelling of the limbs due to obstruction of the lymphatic vessels
• Anemia
• Increased risk of squamous cell carcinoma
• Psychological complications such as depression and social isolation

Hidradenitis suppurativa is a painful, chronic skin condition that should be detected as soon as possible. Hidradenitis suppurativa treatments can help prevent severe complications and the spread of the condition to larger parts of the body. 

Q: Is hidradenitis suppurativa contagious? 
A: Hidradenitis suppurativa is not a contagious condition. It can not spread from one person to another through physical contact. 

Q: What is the main cause of hidradenitis suppurativa? 
A: The main cause of hidradenitis suppurativa isn’t known, although scientists think that a combination of genetic factors with your environment and habits may cause the condition. 

Q: How do you get rid of HS boils fast? 
A: Hidradenitis suppurativa treatment creams can help reduce the inflammation of the boils. You can also use an antiseptic skin wash or apply warm flannel to the lumps to drain the pus. It’s important to consult with your doctor for a personalized treatment plan. 

Q: Who treats hidradenitis suppurativa? 
A:  Hidradenitis suppurativa can be treated by your dermatologist, a doctor specialized in skin conditions.