What is Hidradenitis Suppurativa?

 

Hidradenitis Suppurativa (HS) is a debilitating skin disorder characterized by the recurrent development of painful, inflamed lumps, abscesses, and tunnels (tracts) beneath the skin. These painful lesions typically occur in areas where skin rubs together, such as the armpits, groin, buttocks, and under the breasts. Although it primarily affects the skin, HS can have a profound impact on a person's overall quality of life.

 

The Causes of Hidradenitis Suppurativa

 

The exact cause of HS remains unclear, but several factors contribute to its development. These factors include:

 

Genetics: HS tends to run in families, suggesting a genetic predisposition.

Inflammation: Inflammation plays a significant role in HS. It is believed that the hair follicles become blocked, leading to the formation of painful lumps and abscesses.

Immune System Dysfunction: An overactive immune system may contribute to the development of HS.

Hormones: Hormonal fluctuations, particularly in women, can trigger or exacerbate HS.

Lifestyle and Environmental Factors: Smoking, obesity, and excessive sweating may increase the risk of developing HS.

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What are the risk factors for HS?

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A family history of HS (40% of patients have a family history)

Obesity

Insulin resistance

Cigarette smoking

Follicular occlusion syndrome (acne, dissecting cellulitis, pilonidal sinus)

Inflammatory bowel disease eg Crohn's disease

Drugs: lithium

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Recognizing the Symptoms

 

Hidradenitis Suppurativa presents a range of symptoms, which can vary in severity. Common signs and symptoms include:

 

Painful lumps and abscesses: These often occur in the armpits, groin, buttocks, and under the breasts.

Tunnels or tracts: Over time, tunnels or tracts may form beneath the skin, connecting the abscesses.

Scarring: Repeated flare-ups can lead to scarring, which can be disfiguring and emotionally distressing.

Pain and discomfort: HS can cause significant pain and discomfort, making everyday activities challenging.

Reduced mobility: In severe cases, HS can limit a person's mobility and overall quality of life.

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Classification of HS by severity

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Stage I: Solitary or several isolated abscesses. No sinus tracts or scarring

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Stage II: Recurrent abscesses, single or multiple, widely spaced with sinus tract formation

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Stage iii:  Diffuse involvement, recurrent abscesses

Treatment Options

 

While there is no cure for Hidradenitis Suppurativa, various treatment options can help manage the condition and provide relief from its symptoms. Treatment plans are tailored to each individual and may include:

 

Lifestyle changes: Adopting a healthy lifestyle by quitting smoking, maintaining a healthy weight, and practicing good hygiene can help reduce the frequency and severity of flare-ups.

Topical and oral antibiotics: Antibiotics may be prescribed to control infection and inflammation.

Corticosteroids: These medications can help reduce inflammation and pain when applied topically or injected into affected areas.

Biologics: Newer treatments, known as biologics, can target specific aspects of the immune system and may be recommended for severe cases.

Surgery: In advanced cases, surgery may be necessary to remove affected tissue or drain abscesses.

Laser therapy: Some individuals find relief from laser treatments, which can reduce inflammation and improve the appearance of scars.

Living with Hidradenitis Suppurativa

 

Hidradenitis Suppurativa is a chronic condition that requires ongoing management. It's essential for individuals with HS to work closely with dermatologists and healthcare providers to develop a personalized treatment plan. Support groups and counselling can also be valuable resources for managing the emotional and psychological aspects of the condition.

 

Hidradenitis Suppurativa is a challenging skin disorder that can significantly impact a person's life. However, with the right treatment and support, individuals with HS can lead fulfilling lives and manage their symptoms effectively. If you or someone you know is experiencing symptoms of HS, seek medical attention promptly to begin the journey toward relief and improved quality of life.

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USEFUL LINKS

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Further reading: https://dermnetnz.org/topics/hidradenitis-suppurativa/

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HS_Foundation:  

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South African support group: