Hidradenitis suppurativa (HS) is a long-term skin condition that causes painful lumps, boils, or abscesses under the skin. Often referred to as acne inversa, it’s different from typical acne. These lumps usually form in hair follicles in areas where skin rubs against skin, like the inner thighs, groin, armpits, and under the breasts. It’s important to seek treatment if you notice new bumps because, if untreated, they can turn into pus-filled abscesses that might leak, scar, and cause pain.
The exact cause of HS isn’t fully understood yet, and there’s no cure at the moment. However, many treatments are available to help manage symptoms. Although HS affects about 1 in 100 people, it’s not as widely recognized as other skin conditions, leading many people to live with it for years before seeking help. Current research is focused on understanding more about HS to develop better treatments.
HS typically shows up as lumps or bumps that resemble pimples. These can cause pain or stinging before breaking through the skin. Sometimes the bumps go away for a while only to return in the same spot, and over time, more bumps might appear, adding to the discomfort. As the condition progresses, these lumps can merge into larger, painful nodules, fill with pus, and develop into boils or abscesses. In advanced stages, repeated episodes can form tunnels under the skin, known as sinus tracts, which can become infected and lead to permanent scarring. People with HS often have nodules, abscesses, and scars which fluctuate over time, and advanced stages can lead to significant pain and mobility issues.
Research is ongoing to pinpoint the exact cause of HS. Early theories suggest that it’s triggered by a mix of biological and environmental factors, starting when hair follicles get clogged and infected, causing inflammation. This often occurs in areas prone to friction, like between the thighs or under the breasts and arms. Genetics might also play a part, as nearly half of those with HS have a close relative with the condition. While a specific test for HS hasn’t been developed, healthcare providers usually diagnose it by examining the skin and may conduct other tests to rule out other conditions. Diagnosing HS can be tricky; dermatologists, experts in skin health, are generally more knowledgeable about it, but sometimes it’s misdiagnosed as a boil or furuncle. Many individuals live with HS for years before getting correctly diagnosed.
The severity of HS is classified into three stages using the Hurley staging system. Without treatment, it can progress to more advanced stages. Although there’s no cure, effective treatments focusing on symptom management, reducing flare-ups, and preventing condition worsening are available. Once diagnosed, you’re often referred to a dermatologist specializing in HS to tailor a treatment plan. This may include medications, wound care, skincare, and certain medical procedures.
Medications for HS can be either topical or oral. The only FDA-approved medication is Humira (adalimumab), but other off-label drugs might be prescribed. Wound care is crucial for HS because of its slow-healing nature, and dermatologists can suggest best practices like soaking wounds, using antiseptic washes, and changing dressings regularly. Some skincare products can irritate the skin further, so switching to gentle products is advisable. In some cases, severe HS might require surgery, though many procedures are done in-office.
While there’s no certain way to prevent HS, taking steps to reduce flare-ups is beneficial. Dermatologists suggest some lifestyle changes to help manage this. Living with HS can be emotionally taxing as well, often leading to depression due to chronic pain and stress. This condition can affect sensitive areas like the groin, under the breasts, and around the anus, potentially causing feelings of frustration or embarrassment. If emotional well-being is impacted, seeking advice from a healthcare or mental health professional can be helpful.
Managing HS can be tough, so it’s important to acknowledge your feelings when diagnosed and focus on your overall well-being. Unfortunately, it can take years to receive an accurate diagnosis, which might worsen symptoms. Seeking early medical advice if you notice unusual skin bumps and consulting with a dermatologist can aid in managing symptoms sooner. Regardless of when diagnosed, treatments can reduce pain and the frequency of symptoms.
