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hidradenitis suppurativa: Symptoms, causes, Diagnosis & treatment


Hidradenitis suppurativa (hi-drad-uh-NIE-tis sup-yoo-ruh-TIE-vuh) is a condition that causes painful acne-like bumps on the skin as well as boils in the groin, armpits, and pits. Symptoms can include redness, swelling or nodules on the skin. It usually affects areas where there is a lot of friction like under the arms, underarms, and around genitals because sweat glands in those areas are more concentrated than those elsewhere on the body.  There is no cure for hidradenitis suppurativa, but it can be treated.

hidradenitis suppurativa, hs disease, hidradenitis suppurativa causes

 What is hidradenitis suppurativa?

Hidradenitis suppurativa, or HS, is a skin condition that causes painful bumps to develop under the skin in areas of the body where there are a lot of sweat glands. As the condition gets worse over time and as more skin is affected, the bumps may become infected and cause pus to develop under them. If this occurs, pus under the skin may need to be drained. The pus may be difficult to drain even with help from plastic surgical tools. 

hidradenitis suppurativa symptoms:

1. Red, swollen bumps in the skin that tend to form where there is a lot of friction like under the arms and in the groin, armpits, and inner thighs.

2. Bumps may burst and ooze pus.

3. Bumps are tender to touch or may cause itchiness or pain.

4. Surgery is sometimes needed to drain and remove pus from under a bump that has formed but not burst yet.

5. When bumps are infected, they can get bigger and more tender than when they are not infected. This may be painful or even hurt when you walk or move around a lot until your doctor drains the infection out of them through an incision in the skin surface above the bump. 

When to see a doctor?

If you are having trouble using your underarm or groin, armpit, or inner thigh area because of painful bumps that come in the way of normal daily activities, see your doctor to see if you have hidradenitis suppurativa. What does it mean to 'see a doctor'? When it's important to get rid of an infection beneath the skin surface, your doctor may want to examine you and perform tests to decide on treatment. Your doctor may tell you how he or she thinks your condition should be treated. If your treatment plan involves surgery, your doctor will explain why and whether it's something you can do yourself. In some cases, your doctor may decide to recommended a plastic surgeon to do surgery. 

Hidradenitis Suppurativa Causes :

1. No one knows for sure what causes hidradenitis suppurativa, but there are some reasons why it happens.

2. Women tend to get hidradenitis suppurativa more often than men do, at least in the United States and other countries in which HS has been studied by doctors.

3. It is not known yet why women get HS more often than men. Some research suggests that it may be caused by an imbalance of hormones that women have over women and men do not have over men: estrogen over testosterone or vice versa.

4. Hormonal changes during pregnancy and hormonal changes after menopause may affect women more than men.

Hormones like estrogen and progesterone in a woman's body may be released during pregnancy as a way to help the baby develop inside the womb. This can cause some growth of breast tissue in women. It may also cause thick hair in some places of the body as well as swelling up to result in hidradenitis suppurativa.

Dieting and cutting out certain foods, such as sugar and alcohol, from your diet have been seen to have an impact on hidradenitis suppurativa but it is not known yet why this happens.

5. Skin infections caused by bacteria or viruses may cause HS.

6. If HS is caused by friction of the skin from working out in the gym or other activities, it can be caused by damage done to the nerves of the skin when you work out for a long time.

7. Hormonal changes due to pregnancy and menopause can change how your body reacts to toxins in the environment, such as industrial chemicals that are added to paint products, shampoos, soaps and detergents, as well as certain food additives that contain hormones that our bodies absorb into our bloodstreams.

8. Hormones released during pregnancy can change how your body absorbs food sources and change how your hormones develop during puberty. Food sources like sugar may change how your hormones develop as well.

9. Stress may also be a contributing factor to hidradenitis suppurativa.

10. Your family history plays an important role in whether or not you will get hidradenitis suppurativa, but no one knows why it happens to some people and not others.

11. HS may be caused by an autoimmune disease called Sjögren's syndrome. Some experts say that up to 80% of people with hidradenitis suppurativa have Sjögren's syndrome.

12. HS may be caused by an infection of your sweat glands, called pustular acne (poo-stih-KLER huh -uht).

13. The sweating sweat glands can become blocked and clogged with debris, like dead skin cells or hair follicles and look like they are infected. When this happens, they can become inflamed and painful as you exercise, because of the bacteria that live in your armpits causing inflammation to develop.

14. The sweat glands in your underarms and groin, armpits, and inner thighs are more concentrated than they are on the rest of your body. This is why HS tends to develop in those areas of your body. 


Your doctor will look at your skin and may perform a biopsy of any bumps that are visible. A biopsy means that your doctor will take a piece of your skin and look at it under a microscope to see if there is anything wrong with it. He or she will also check the sample for certain kinds of bacteria.

In addition to this test, your doctor may do a DNA test on you, which looks for immune system responses that cause HS.

If tests rule out other causes of the bumps like pustular acne (poo-stih-KLER huh -uht), your doctor may send off a sample of the bumps to look for infection.


hidradenitis suppurativa complications:

1. When you have bad acne, whiteheads and blackheads may appear.

2. If the infection is left untreated, it can turn into a boil (a bump beneath the surface of your skin filled with pus).

3. If your inflamed skin has a lot of hair follicles, white blood cells and bacteria trapped beneath your skin's surface, these things can travel through the surface of your skin leading to a hardened scar where the bump or boil used to be. This can cause keloids or hypertrophic scars, which are harder and more noticeable than normal scars.

4. Hidradenitis suppurativa can be a risk factor for developing some other skin problems like acne, or cause redness or bleeding in places such as your armpits, under your breasts, groin and inner thighs.

5. Non-invasive treatments that are available to treat hidradenitis suppurativa may not cure HS completely. If you stop taking the medications, many of the symptoms of HS may come back. 


You can find hidradenitis suppurativa by looking for bumps in your armpits, groin or around your anus or nipples. There are some pictures of HS on this page. You can also ask your doctor about whether you should see a dermatologist for further testing. Other medical conditions may cause the same type of bumps and inflamed areas as well. To treat these other disorders, your doctor will need to know what they are so he or she can decide on the best treatment plan for you. Your body may make too much sebum, which is an oily substance that your skin produces naturally to keep it from getting dry and itchy. If this is the case and you have excess sebum, you may see a rash on your skin.

hidradenitis suppurativa treatment:

Treatments for HS are designed to fight an infection that causes the condition. The most common treatment for HS is antibiotics. Your doctor may also prescribe other antibiotics, such as clindamycin (Cleen-dah-mye'-sin) or doxycycline (Doh-see-si-cline). Antibiotics kill bacteria and fungi in your body either by killing them directly or by stopping them from spreading in your body and causing infection. The medication that is best to treat HS depends on how severe your health conditions or medications may be affecting it.

Treatment for HS can include: 

medication; surgery; injections; and physical therapy.

1. Your doctor may prescribe antibiotics to help treat HS. They affect your whole body and can stop the infection from spreading in your skin, which helps to shrink the bumps and prevent them from getting worse. One of the most common antibiotics used is clindamycin (Klin-dah-mye'-sin), which comes in a cream or ointment form that you apply to your skin every day for at least several weeks or months, depending on your symptoms.

2. Your doctor may recommend that you try a retinoid. Retinoids work to unclog your pores, which are like the openings in your skin. They also keep your skin from producing too much oil.

3. A combination of oral corticosteroids and antibiotics can treat the inflammation around the bumps and boils caused by HS, which can reduce painful symptoms.

4. Injections of steroids into the pores of your skin help to shrink or clear up some bumps associated with HS by reducing inflammation and reducing how much oil is produced by certain glands within the body.

5. Surgery to remove large, deep boils and draining areas of pus may be required to cure HS. As a last resort, your doctor may recommend that you have surgery to drain or shave your armpits and groin.

6. Your doctor may suggest injections of steroids like fluocinonide (floo-oh-kee-NOH' -yuhn) alone if a topical steroid doesn't work for you.

7. Physical therapy can help improve the circulation in your body and improve how much movement you have in your armpits, groin, inner thighs, and buttocks.


1. You may be able to prevent and treat HS by keeping your skin clean and dry. You can do this by showering and washing your armpits, groin, inner thighs, buttocks, and nipples every day with warm water and mild soap. Dry these areas well after you have washed them.

2. If you are overweight or obese, try to lose weight to see if that improves your symptoms.

3. Clothing made of loosely woven fabrics help air to circulate around the skin more easily so you're less likely to sweat as much as you would wearing something tight on your body like jeans or a belt.

4. You may also try using powder to help prevent the skin from getting too moist and humid.

5. Gently pulling whiteheads and blackheads off your skin can help prevent them from becoming hidradenitis suppurativa bumps.



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