Hidradenitis Suppurativa Treatment

Hidradenitis Suppurativa, or HS, is a form of skin condition that results in painful lumps and bumps under the skin. These painful areas are located in the roots of hair follicles, near sweat glands.

What is Hidradenitis Suppurativa?

As a skin condition, Hidradenitis Suppurativa is not deadly or serious, but it does cause ongoing pain and requires consistent treatment and care to reduce or relieve the symptoms.

There is no currently known cure for Hidradenitis Suppurativa, but there are a variety of different options available for the management of this condition. This can include different medical and home treatments, as well as other lifestyle changes. These coping and management methods can reduce, cut down or relieve flare-ups and ongoing pain.

It is theoretically suggested that this painful condition is caused by the blockage of the hair roots and follicles in the skin. As Hidradenitis Suppurativa often occurs in areas with larger volumes of hair, this theory may be the most accurate reason for this condition. Areas often affected include but are not limited to:

  • Under the arms
  • In the groin area
  • Between or around the buttocks

As well as areas with high volumes of hair, this condition can also affect areas where skin often rubs. This could include between the thighs or in women, under or between the breasts.

As well as causing pain and uncomfortable conditions of the skin, Hidradenitis Suppurativa can also become infected. In this case, the bumps may become swollen with pus in small pockets under the skin. This may lead to a bad smell should the pockets break or pop. Scars may also result from infected Hidradenitis Suppurativa. It’s important to get treatment as soon as possible for infected skin conditions, including this one.

Hidradenitis Suppurativa isn’t just painful; it is also a long-term condition that features regular and ongoing flare-ups, which may also lead to effects on the emotion and behavior. Because of the lack of a cure for this condition, mental health concerns should be considered in those diagnosed with this condition, in particular depression.

What causes Hidradenitis Suppurativa?

There isn’t a defined and confirmed cause of Hidradenitis Suppurativa, and doctors are still not sure of the exact origin of this condition. The problems within the skin are often triggered or start in areas where hair follicles and roots become blocked. Often, these symptoms appear in the 20s or even the teen years.

Hidradenitis Suppurativa is a more common condition in women than men. It is also more common in people who regularly smoke, or are overweight. Though it is not known if genetics play a role in the diagnosis of Hidradenitis Suppurativa, up to a third of those with this condition also have a relative with the same symptoms.

As well as little knowledge of what causes Hidradenitis Suppurativa, scientists do not have an understanding of what does not cause this condition. It does not appear to result from lack of hygiene and washing, or from using specific deodorants and powders. Shaving any area of the body doesn’t appear to have an effect on the appearance of this condition. Additionally, Hidradenitis Suppurativa cannot be caught by someone else - it is entirely non-contagious.

What are the symptoms of Hidradenitis Suppurativa?

The first symptoms that many people experience with Hidradenitis Suppurativa is often a single bump that is painful and usually inflamed. This bump can persist for a few days through to multiple months. Following on from this first appearance, this bump may repeatedly flare up in the same place or area.

Following the appearance of the first lump or bump, if the area becomes infected a pocket of pus may develop under the skin. These pockets may leak, burst and smell bad. Feelings of itching may also occur in and around the area.

As more bumps appear, some may be deeper than others. These bumps may become scars over time. Tunnel-type areas under the skin may also appear, known as sinus tracts. These appear when different areas of outbreaks occur that are connected.

Both the bumps and pus-filled areas are likely to leave and return multiple times, and in some cases, these areas may not even fully heal between flare-ups.

There are many different severities of Hidradenitis Suppurativa. A doctor will be able to identify and diagnose the severity of your particular condition, based on a list of questions and the symptoms you are displaying.

Treatment for Hidradenitis Suppurativa

There are a variety of different treatment options available for Hidradenitis Suppurativa. These can help to relieve the symptoms of this condition, as well as reduce infection and otherwise prevent the seriousness of the pus-filled pockets and bumps that are experienced as part of this condition.

Though there is no known cure for Hidradenitis Suppurativa, these different treatments may alleviate this pain, itching or other symptoms.

Warm compresses can provide relief for mild forms of Hidradenitis Suppurativa. Either using specifically made heating pads or patches can be effective, as well as a home remedy compresses made from a washcloth run under hot water.

NSAIDs, or nonsteroidal anti-inflammatory drugs, including aspirin and ibuprofen, may be used as a medication to ease the pain caused by Hidradenitis Suppurativa. It can also reduce the swelling in the area. It’s important to confirm with your doctor if this medication is suitable for you before taking it.

A doctor may give you antibiotics as a treatment for the pus pockets, or infected areas, during a Hidradenitis Suppurativa flare up. These could be prescribed as a pill, or as a lotion and cream to be spread on affected areas. This may prevent the worsening of symptoms and also reduce the chance of Hidradenitis Suppurativa scarring the skin. A doctor will be able to prescribe the correct antibiotics to fit your needs.

Corticosteroids may also be prescribed by a doctor as an effective method to ease swelling, pain and reduce inflammation. This may be taken in pill form by mouth or alternatively injected into the affected area.

Retinoid medication, which is often used as a form of acne treatment, can also be used to improve high severity cases of Hidradenitis Suppurativa. This is taken as a pill, and both acitretin and isotretinoin can be prescribed.

Hormone therapy, such as the birth control pill, can also be used to manage Hidradenitis Suppurativa in women.

Finally, biologic medication can also be used as an effective treatment for Hidradenitis Suppurativa. These medicines work on the immune system, can be given as a shot or injection, or via IV in a hospital or medical center.

The biologic drugs that can be used for the treatment of Hidradenitis Suppurativa include:

  • Humira, or Adalimumab - a medication that is approved by the FDA to treat HS.
  • Remicade, or Infliximab - often used by doctors to treat Hidradenitis Suppurativa
  • Anakinra - most often used for severe or resistant Hidradenitis Suppurativa conditions. The full effectiveness of this medication is not fully researched.

For particularly serious or painful forms of Hidradenitis Suppurativa, surgery may be required to help treat this condition. This is especially the case for bumps that are deep within the skin and can include anything from laser treatments to cutting open the pockets of pus within the skin.

Deroofing can also be used as a surgical technique to reduce painful lumps and pockets of pus into scar tissue that won’t hurt. Even with the most severe forms of surgery, Hidradenitis Suppurativa may reoccur even in the same locations.

Prevention of Hidradenitis Suppurativa

Though there is no cure for Hidradenitis Suppurativa, there are multiple ways that patients can help themselves to cope with the condition. This may include losing extra weight to reduce the amount of skin rubbing together, quitting smoking or preventing touching or shaving the skin, particularly in troublesome areas where this condition reoccurs often.

Loose-fitting clothing and good hygiene also help to prevent the symptoms of this condition and to reduce the pain during a flare-up. Keeping a cool body temperature is also important to minimize warmth and sweating, combined with an effective antiperspirant.

A doctor will be able to advise you on the best lifestyle changes to match your symptoms and severity of your condition, as well as the correct treatments and medications to match your exact needs.