Understanding Hidradenitis Suppurativa

A Comprehensive Guide to Managing This Chronic Skin Condition

Dermatology

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Last updated: Mar 24, 2025

What is Hidradenitis Suppurativa?

Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that causes painful lumps to form under the skin in areas where skin rubs together. These areas typically include:

  • Armpits
  • Groin area
  • Under the breasts
  • Between the buttocks
  • Inner thighs

Key Symptoms

  • Painful bumps or boils that may break open and drain
  • Blackheads, often appearing in pairs
  • Tunnel-like tracts under the skin
  • Scarring
  • Recurring flare-ups in the same areas

Stages of HS

  1. Hurley Stage I: Single or few isolated abscess formations without scarring or sinus tracts
  2. Hurley Stage II: Recurrent abscesses with tract formation and scarring
  3. Hurley Stage III: Diffuse involvement with multiple interconnected tracts and abscesses

Risk Factors

  • Family history
  • Obesity
  • Smoking
  • Hormonal changes
  • Age (usually starts after puberty)
  • Gender (more common in women)

Treatment Options

Medical Treatments

  • Topical antibiotics
  • Oral antibiotics
  • Anti-inflammatory medications
  • Biologics (for severe cases)
  • Hormonal therapy

Lifestyle Changes

  • Maintaining healthy weight
  • Smoking cessation
  • Wearing loose-fitting clothing
  • Regular gentle cleaning of affected areas
  • Avoiding skin irritants

Surgical Options

  • Incision and drainage (for acute flares)
  • Deroofing procedures
  • Excision of affected areas

Living with HS

Pain Management

  • Over-the-counter pain relievers
  • Warm compresses
  • Proper wound care

Support Resources

  • Support groups
  • Mental health counseling
  • Regular dermatology follow-up

When to Seek Medical Care

  • New or worsening symptoms
  • Signs of infection
  • Significant pain
  • Impact on daily activities

Prevention Strategies

  • Regular skin hygiene
  • Weight management
  • Stress reduction
  • Avoiding tight clothing
  • Following prescribed treatment plan

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