Hidradenitis Suppurativa

Definition

Hidradenitis suppurativa (HS) is a disease that results in deep and painful lumps under the skin, often in the armpits or groin. They may also be found under the breasts and between the buttocks.

Skin, Hair, Hair Follicle

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Causes

HS happens when hair follicles become blocked. It is not known why this happens.

Genes, the environment, and problems with the immune system may also play a role.

Risk Factors

HS is more common in women. Other things that may raise the risk are:

• Having family members who have HS
• Smoking —present or past
• Obesity
• Diabetes
• Metabolic syndrome
• High cholesterol

Symptoms

The problem often starts when a person is in their 20s. Problems may be:

• Burning, itching, or painful lumps in the armpits, groin, under the breasts, or between the buttocks
• Pus leaking from breaks in the lumps
• Scarring

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done. It will focus on your skin. This is often enough to make the diagnosis.

Treatment

The goal of care is to control outbreaks. Options are:

• Lifestyle changes, such as maintaining a healthy weight, not smoking, and wearing loose clothing
• Medicines, such as:
  • Antibiotics
  • Corticosteroids
  • Biologic agents
  • Retinoids
  • Hormonal therapy

People with severe symptoms may need a surgery or procedure to remove the painful lumps.

Prevention

There are no known guidelines to prevent this problem.