Disease: Hidradenitis suppurativa

Hidradenitis suppurativa

Also called acne inversa

What is hidradenitis suppurativa?

Hidradenitis suppurativa (HS) is a disease that usually begins as pimple-like bumps on the skin. The pimple-like bumps tend to develop in places that everyday pimples do not appear. HS is most common on the underarms and groin.

Some people say that their HS looks like one of these skin conditions:

  • Pimples
  • Deep-acne like cysts and blackheads
  • Folliculitis (looks like swollen pimple with a hair in the center)
  • Boils

Getting treatment for HS is important. Early diagnosis and treatment can prevent HS from worsening.

If HS worsens, the pimple-like bumps can grow deep into the skin and become painful. They can rupture, leaking bloodstained pus onto clothing. This fluid often has a foul odor.

As the deep bumps heal, scars can form. Some people develop tunnel-like tracts under their skin. As the skin continues to heal and scar, the scars thicken. When thick scars form in the underarm, moving the arm can be difficult. Thick scars in the groin area can make walking difficult.
If you have folliculitis that does not go away with treatment or breakouts that look like boils in your groin area, you may have HS.Because HS can look lot like acne, folliculitis, or boils, it is best to see a dermatologist for a diagnosis. To a dermatologist’s trained eye, the differences between HS and other skin diseases are subtle but obvious. Proper treatment depends on an accurate diagnosis.

To learn more about what this disease looks like, go to Hidradenitis suppurativa: Signs and symptoms.

Source: https://www.aad.org

Signs and symptoms

If you have this skin disease, you may notice breakouts on your skin that look like pimples or boils. Your skin may clear for a while, but you notice new breakouts develop in the same area.

Unlike everyday pimples, hidradenitis suppurativa (HS) forms in areas where skin touches skin. HS is most common in these areas:

  • Underarms (one or both)
  • Groin (genitals, around the anus, and surrounding area)
  • Buttocks
  • Upper thighs
  • Women’s breasts (underneath and sometimes on the breasts)

Although rare, a few studies have found HS near an ear or around the bellybutton. There have also been a few cases of HS appearing on the face, neck, or back.

Women tend to get breakouts on their genitals and upper thighs. Men are more likely to have HS on their genitals and around the anus.

Some people develop breakouts in the exact same spot each time. For others the breakouts appear in the same area, but never seem to be in the exact same spot.

Early signs and symptoms

When people first get hidradenitis suppurativa (HS), they often see:
  • One (or several) breakouts that look like pimples or boils.
  • Breakouts may stay on the skin; sometimes, they clear and reappear.

Later signs and symptoms

Without treatment, HS can worsen. If this disease progresses, the person may develop:
  • Painful, deep breakouts that heal and reappear.
  • Breakouts that rupture and leak a foul-smelling fluid.
  • Scars that form as breakouts repeatedly heal and reappear.
  • Scars that become thicker with time.
  • Skin that begins to look spongy as tunnel-like tracts form deep in the skin.
  • Serious infections.
  • Skin cancer (rare).

Signs and symptoms can change

The signs and symptoms of HS can change quickly. One week, a person may have a foul-smelling fluid leaking from breakouts. The next week, the breakouts have cleared and scars are the only sign of HS.

Some people always have breakouts on their skin.

Skin cancer risk

HS develops on skin that tends to get little or no direct sunlight. Yet, a few people have developed squamous cell carcinoma, a common type of skin cancer, where they had HS breakouts and scarring for years. Most cases developed in men who had long-standing HS on their genitals or around their anus.

Treatment helps prevent long-standing HS.

Quality of life affected

Without treatment, HS can continue its cycle of breakouts and healing. As the breakouts clear, scars form. Continual healing and scarring can cause hollow passages called fistulas to develop inside the body. Fistulas can be painful and require surgery to repair.

People who have a foul-smelling liquid draining from the breakouts can feel embarrassed. They may feel too embarrassed to see a doctor. Dermatologists understand this. You should not feel embarrassed to see a dermatologist about this problem.

Some people are more likely to develop HS. To learn who is most likely to develop it, read Hidradenitis suppurativa: Who gets and causes.

Source: https://www.aad.org

Who gets and causes

Who gets hidradenitis suppurativa?

Hidradenitis suppurativa (HS) is most common in:

  • Overweight or obese people.
  • Smokers.
  • Women (3 times more common in women than men).

HS usually begins around puberty. Few people develop HS before 11 years of age. When HS appears before 11 years of age, the child is usually experiencing early puberty. Getting HS after menopause or 55 years of age is rare.

What causes hidradenitis suppurativa?

No one knows for sure what causes HS. Because it occurs after puberty, hormones likely play a role. The person’s immune system also seems to play a role.

It is possible that HS develops when the person’s immune system overreacts. HS begins in the hair follicles (where hair grows out of the skin). Like everyday acne, HS forms when the hair follicles clog with bacteria and other substances. It is possible that HS develops in people who have an immune system that overreacts to the plugged hair follicle.

Lifestyle also seems to play a role. It seems that smoking, being overweight, or taking lithium may trigger HS. These things do not cause HS. If a person is susceptible to getting HS, any of these could make HS appear for the first time or worsen existing HS.

Although the exact cause is still unknown, dermatologists have learned the following from studying HS:

  • It is not contagious.
  • Poor hygiene does not cause HS.
  • About one-third of people who get HS have a blood relative who has HS.

You can learn how dermatologists diagnose and treat this condition at Hidradenitis suppurativa: Diagnosis, treatment, and outcome.

Source: https://www.aad.org

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