What is Hidradenitis Suppurativa?

Hidradenitis suppurativa (also known as acne inversa) is an auto-inflammatory skin disorder that disproportionately affects females of childbearing age, although males and individuals of all ages may experience the condition. All skin areas containing apocrine (sweat) glands may be affected to some degree, including the axillae/armpit regions, groin, and area beneath the breasts. The condition is characterized by abscesses and boil-like nodules that tend to recur. Ultimately, these sores develop a pus-filled discharge and may result in open wounds that are difficult to heal, as well as scar tissue buildup that continues to accumulate over time.

Symptoms of Hidradenitis Suppurativa

The areas most commonly affected by hidradenitis suppurativa include the inner thighs, mons pubis, vulva, perineum, perianal folds, sides of scrotum, armpits, neck, and submammary area. Acne, psoriasis, hirsutism, and related skin disorders tend to be comorbid with this condition. Some of the common signs that may indicate the presence of hidradenitis include:

  • Atrophic and Hypertrophic Scars
  • Open and Closed Comedones
  • Inflammatory Lesions Linked by Draining Sinuses
  • Pyogenic Granulomas
  • Firm, Painful Papules With Larger Nodules
  • Pustules
  • Fluctuant Pseudocysts
  • Abscesses

Risk Factors for Developing Hidradenitis Suppurativa

Allegheny Advanced Dermatology Center in Altoona, PA, offers medical treatments for patients with hidradenitis suppurativa. This condition most often begins at puberty and self-resolves at menopause; however, without treatment, serious complications may arise. Some of the common risk factors for developing hidradenitis include:

  • Inflammatory Bowel Disease (Crohn’s Disease)
  • Obesity
  • Insulin Resistance
  • Metabolic Syndrome
  • Family History
  • Cigarette Smoking
  • Follicular Occlusion Disorders
  • Acne Conglobata
  • Dissecting Cellulitis
  • Pilonidal Sinus
  • PAPA Syndrome
  • PASH Syndrome
  • PAPASH Syndrome
  • Abnormalities of the PSTPIP1 Gene

What Causes Hidradenitis Suppurativa?

The exact cause of hidradenitis suppurativa is not completely understood. The most severe cases tend to occur amongst males, the morbidly obese, those whose perianal and axillary areas are affected, smokers, and patients who have had symptoms for a longer period of time. Several contributing factors have been identified, including:

  • Release of Inflammatory Cytokines
  • Unusual Immune Response to Normal Commensal Skin Bacteria
  • Friction (Clothing, Excess Body Folds, etc,)
  • Abnormal Microbiome in or on Skin Surface
  • Inflammation
  • Rupture of Follicular Walls/Destruction of Apocrine Glands
  • Secondary Bacterial Infections
  • Reaction to Medications

Home Care and Medical Management of Hidradenitis Suppurativa

Generally, patients may experience relief in addition to medical management of hidradenitis suppurativa by following standard long-term home care practices. Your doctor will discuss recommendations with you. These may include weight loss, a plant-based, low-sugar, low-grain, and anti-inflammatory diet, cessation of smoking (dramatic improvements have been noted within months), loose-fitting clothing, unfragranced antiperspirants and body care products, washing the body with antiseptics and/or hydrogen peroxide, bleach baths, application of medical-grade honey (odor control), frequent changing of dressings for draining sinuses, and analgesics (pain control). Your physician may prescribe antibiotics, immunomodulatory treatments, anti-androgens, surgical management, and other techniques prescribed on an individualized basis.

Contact Allegheny Advanced Dermatology Center to schedule an appointment. Call: (814) 944-7109.