Hidradenitis suppurativa is a chronic skin condition that causes blocked sebaceous glands and hair follicles, leading to blackheads and pus-filled lesions. Symptoms can be managed with antibiotics or surgery, but if left untreated, it can cause permanent damage and restrict movement.
Hidradenitis suppurativa is a chronic skin condition similar to severe acne. It occurs when the sebaceous glands or hair follicles become blocked with dead skin cells and sweat gland fluids. If bacteria enters the blocked areas, blackheads and pus-filled lesions appear. The condition is more likely to affect areas containing apocrine sweat glands, such as the groin or armpit, and it can also appear on skin that often rubs, such as the inner thighs or breasts.
One of the most common symptoms of hidradenitis suppurativa are blackheads or small dark dots on the surface of the pores caused by excess sebum. Unlike the blackheads associated with mild acne, these often appear in pairs or are dug into the skin. The skin also typically develops painful red bumps filled with pus or clear fluid known as lesions. They can enlarge before bursting and often resemble open wounds that are slow to heal.
Other symptoms of the condition occur under the skin. Hard lumps, about the size of a pea, often develop under the skin and can enlarge over time. They can become inflamed and painful and can remain under the skin for several years. The sinus tracts can form a network of tunnels under the surface of the skin and prevent any sores from healing.
Hidradenitis suppurativa has no proven cause, but hormone levels and genetics are thought to contribute to the condition. Being overweight or smoking cigarettes can also increase an individual’s likelihood of developing the condition. People who have Graves’ disease, herpes simplex, or Crohn’s disease may also be more at risk. Although hidradenitis suppurativa can occur in anyone, it tends to be more common in women between puberty and 40 years of age.
To determine if a patient has the condition, a doctor will examine the skin and take a sample of any fluid or pus from the lesions. The sample is then sent to a laboratory for microscopic examination to determine if the bacteria present are indicative of hidradenitis suppurativa. He or she may also test a blood sample to rule out other skin conditions.
While there is no permanent cure to prevent recurrence, symptoms can be managed. Blackheads and minor lesions can be washed off with warm water and antibacterial soap. For more severe cases, a doctor may prescribe antibiotics to clear the infection. He or she may also prescribe an oral retinoid to reduce oil gland production and prevent follicle blockage.
If medications don’t relieve symptoms, surgery may be done. A doctor can cut into the lesions and drain any fluid or pus to provide short-term relief. For large networks of tunnels under the skin that prevent wounds from healing, a surgeon may cut through the skin and flesh to uncover the tunnels and allow the skin to heal. In recurring and painful cases, all of the affected skin may be cut off and replaced with a piece of skin from another part of the body that is attached to the area.
Hidradenitis suppurativa can cause permanent damage if left untreated. The breast tracts under the skin can cause lesions to develop repeatedly. Severe cases may restrict movement of affected areas, especially the armpits or thighs. In rare cases, a bacterial infection known as cellulitis can develop and spread to the lymph nodes and bloodstream.
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