Overview

Hidradenitis suppurativa (hi-drad-uh-NIE-tis sup-yoo-ruh-TIE-vuh) is rare, long-term skin condition that features small, painful lumps under the skin. They typically develop where the skin rubs together, such as the armpits, the groin, between the buttocks and under the breasts. The lumps may break open and smell or cause tunnels under the skin.

Hidradenitis suppurativa tends to start after puberty. It can persist for many years and worsen over time, with serious effects on your daily life and emotional well-being. Early diagnosis and treatment can help manage the symptoms, keep new lumps from forming and prevent complications, such as scarring or depression.

Source: http://www.mayoclinic.com

Symptoms

Hidradenitis suppurativa commonly occurs around hair follicles with many oil and sweat glands, such as in the armpits, groin and anal area. It may also occur where skin rubs together, such as the inner thighs, under the breasts and between the buttocks. Hidradenitis suppurativa can affect one spot or multiple areas of the body.

Signs and symptoms of hidradenitis suppurativa include:

• Blackheads. Small pitted areas of skin containing blackheads — often appearing in pairs or a "double-barreled" pattern — are a common feature.
• Red, tender bumps. These bumps often enlarge, break open and drain pus. The drainage may have an odor. Itching and burning may accompany the bumps. They usually appear in areas where skin rubs against skin.
• Painful, pea-sized lumps. These hard lumps, which develop under the skin, may persist for years, enlarge and become inflamed.
• Tunnels. Over time, tracts connecting the lumps may form under the skin. These wounds heal very slowly, if at all, and can leak pus.

Hidradenitis suppurativa usually starts between puberty and age 40 with a single, painful bump that persists for weeks or months. For some people, the disease progressively worsens and affects multiple areas of their body. Other people experience only mild symptoms. Excess weight, stress, hormonal changes, heat or humidity can worsen symptoms. In women, the disease severity may lessen after menopause.

When to see a doctor

Early detection of hidradenitis suppurativa is key to getting effective treatment. See your doctor if your condition:

• Is painful
• Doesn't improve in a few weeks
• Returns within weeks of treatment
• Appears in several locations
• Recurs often

If you've already received a diagnosis of hidradenitis suppurativa, keep in mind that the warning signs of a disease flare (recurrence) are often similar to those that occurred originally. Also pay attention to any new signs or symptoms. These may indicate either a recurrence or a complication of treatment.

Source: http://www.mayoclinic.com

Causes

Hidradenitis suppurativa develops when hair follicles become blocked and inflamed. No one knows exactly why this blockage occurs. Factors that may play a role include hormones, metabolic syndrome, genetics, an irregular immune system response, smoking and excess weight.

Hidradenitis suppurativa is not caused by an infection and can't be transmitted sexually. It's not contagious and is not due to poor hygiene.

Source: http://www.mayoclinic.com

Diagnosis

Your doctor will ask you about your signs and symptoms, examine the affected skin and take your medical history.

No laboratory test is available to diagnose hidradenitis suppurativa. But if pus or drainage is present, your doctor might send a sample of the fluid to a laboratory for testing to rule out a boil infection or other skin disorders.

Source: http://www.mayoclinic.com

Complications

Persistent and severe hidradenitis suppurativa often causes complications, including:

• Infection. The affected area is susceptible to infection.
• Scars and skin changes. The wounds may heal but leave rope-like scars, pitted skin or patches of skin that are darker than normal.
• Restricted movement. Sores and scar tissue may cause limited or painful movement, especially when the disease affects the armpits or thighs.
• Obstructed lymph drainage. The most common sites for hidradenitis suppurativa also contain many lymph nodes. Scar tissue can interfere with the lymph drainage system, which may result in swelling in the arms, legs or genitals.
• Social isolation. The location, drainage and odor of the sores can cause embarrassment and reluctance to go out in public, leading to sadness or depression.
• Cancer. Rarely, patients with advanced hidradenitis suppurativa can develop squamous cell carcinoma in the affected skin.

Alternative medicine

Zinc supplements taken daily may help reduce inflammation and prevent new outbreaks.

Source: http://www.mayoclinic.com

Lifestyle and home remedies

Mild hidradenitis suppurativa may be treated with only self-care measures. But self-care is also an important complement to any medical treatment you may be getting. The following suggestions may help relieve discomfort and speed healing of sores:

• Follow a daily skin-care routine. Gently wash your body with a nonsoap cleanser such as Cetaphil. Use only your hands, not washcloths, loofahs or other items that might irritate the skin. If odor is a concern, try an antibacterial body wash. Then apply an over-the-counter antibiotic cream. It might also help to apply extra absorbent powder or zinc oxide. Using antiperspirants may help keep the skin dry. Stop using any product that irritates your skin.
• Manage your pain. Gently applying a wet, warm washcloth, teabag or other sort of compress can help reduce swelling and ease pain. Keep it on for about 10 minutes. Ask your doctor to recommend the most appropriate pain reliever. And talk with your doctor about how to properly dress and care for your wounds at home.
• Avoid tight clothes and irritating products. Wear loose, lightweight clothes to reduce friction. Some women find that using tampons rather than sanitary pads causes less friction with the skin. Use detergents and other products that are free of perfumes, dyes and enzymes.
• Avoid injuring the skin. For example, don't squeeze the pimples and sores. And stop shaving affected skin.
• Keep a healthy weight and stay active. Not being at a healthy weight can make symptoms worse. Try to find activities that don't irritate your skin.
• Consider altering your diet. In an informal study, 47 people with hidradenitis suppurativa gave up dairy products and processed sugar and flour. Of those, 83 percent experienced reduced symptoms. Also, a study reported on 12 people being treated for hidradenitis suppurativa who avoided beer and other foods containing brewer's yeast or wheat. They all saw their symptoms clear up within a year.
• Avoid all tobacco products. If you smoke, try to quit. Smoking and other tobacco use may play a role in making hidradenitis suppurativa worse.

Source: http://www.mayoclinic.com

Coping and support

One of the greatest challenges of living with hidradenitis suppurativa may be coping with pain and embarrassment. Painful sores might affect your sleep, mobility or sex life. If the sores are draining pus, they can smell, despite good self-care. You might feel anxious and become withdrawn, self-conscious or depressed.

Try to find support among your family and friends. You may also find the concern and understanding of other people with hidradenitis suppurativa comforting. Ask your doctor for a referral to a mental health professional or contact information for a support group.

Source: http://www.mayoclinic.com

Risk factors

Factors that may increase your risk may include:

• Age. Hidradenitis suppurativa most commonly occurs in women between the ages of 20 and 29. An early age of onset may be associated with developing more widespread disease.
• Your sex. Women are more likely to develop hidradenitis suppurativa than are men.
• Family history. A tendency to develop hidradenitis suppurativa can be inherited.
• Having certain other conditions. Hidradenitis suppurativa can be associated with several other conditions, including arthritis, severe acne, obesity, inflammatory bowel disease, Crohn's disease, metabolic syndrome and diabetes.
• Smoking. Smoking tobacco has been linked to hidradenitis suppurativa.

Source: http://www.mayoclinic.com