Hidradenitis suppurativa is a skin condition that affects the apocrine sweat glands, causing inflammation and scarring. Symptoms include blackheads, tender lumps filled with pus, and slowly healing open sores. Treatment includes home remedies for mild cases and medical attention for more serious cases, including antibiotics, surgery, and corticosteroids.
Hidradenitis suppurativa is a disease that develops in the follicles of the apocrine sweat glands, causing inflammation of the sweat glands that can lead to scarring. These glands are found under the arms, under the breasts and inside the thighs, groin and around the anus. This disease, which is considered a severe type of acne, is commonly known as hydradenitis or hidradenitis.
For most people with this skin condition, the first symptoms appear after puberty. This is because it is after the onset of puberty that the apocrine glands begin to develop and mature. Hydradenitis is more common in women and is more likely to develop in people in their 20s. For women, the most common sites of inflammation are the underarm and underbust regions. For men, the perianal region is a more common site for the development of the disease.
Symptoms of hydradenitis develop when sweat gland follicles become clogged with skin oils, dead skin cells, and other material that builds up on the skin. These substances can trigger inflammation when incorporated into the follicles. If bacteria are present in the material embedded in the follicles, an infection can also develop. The underlying factors that make some people susceptible to this disease are unknown, but causative factors could include smoking, hormone levels, and genetics.
Lesions begin as pitted areas of skin where blackheads are prominent. Blackheads can develop into tender, raised lumps filled with pus. As the lumps grow in size, they eventually break open, allowing the pus to drain. In some cases, the lumps grow under the skin without breaking apart. These can stay under the skin for months or years and can become extremely painful. Lesions can also take a third form, that of slowly healing open sores that can cause extensive scarring.
Mild, isolated episodes of hydradenitis can be treated effectively at home. Swelling can be reduced and pain relieved by applying a heating pad or warm compress. Loose clothing helps prevent further skin irritation. Keeping the affected area of skin clean and dry is also important. The skin can be washed regularly with an antibacterial soap to reduce the chances of infection and should be dried thoroughly afterward.
More serious cases require medical attention. For example, if the lesions take more than two weeks to heal, are present in multiple locations, or recur often, medical treatment is needed to help manage the condition. Medications such as antibiotics and nonsteroidal anti-inflammatory drugs are used to help heal the infection, reduce swelling, and manage pain. In very severe cases, corticosteroids might be used to suppress the inflammation.
If the lesions are very deep or do not respond to this treatment, surgical treatment may be required. Deep, pus-filled lesions can be surgically drained to reduce swelling and pain, but this measure is only useful for treating a small area of skin and does not prevent further lesions from forming. Large, severe areas of diseased skin can be completely excised and replaced with grafted skin from unaffected areas. Even this more drastic treatment, however, cannot prevent hydradenitis from recurring in other areas where the sweat glands are located.
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