Hidradenitis Suppurativa: Causes, Diagnosis, Symptoms & Treatment

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Hidradenitis Suppurativa – Introduction

Hidradenitis suppurative (HS) is a chronic, inflammatory skin disease that affects the apocrine sweat glands. It is a rare and poorly understood condition, with a prevalence of less than 1% in the general population. The cause of HS is unknown, but it is thought to be a combination of genetic and environmental factors. The disease is characterized by recurrent, painful boils and blackheads in the armpits, groin, and other areas where sweat glands are concentrated. The lesions often rupture, leading to drainage, scarring, and chronic inflammation. There is no cure for hidradenitis suppurativa, but treatment can help to manage the symptoms.

There is no cure for hidradenitis suppurativa, and treatment is typically focused on managing the symptoms and preventing disease progression. Treatment options include topical and systemic therapies, as well as surgical interventions.

Causes of Hidradenitis Suppurativa

There are many potential causes of HS, but the exact cause is unknown. Some experts believe that genetic and environmental factors cause HS. Here are three possible reasons for HS:

  1. Genetics

There is strong evidence that genetics plays a role in the development of HS. The condition is more common in people with a family member with HS.

  1. Hormonal factors

HS is more common in women than men, often worsening ring puberty, pregnancy, and menopause. This suggests that hormones may play a role in the development and progression of HS.

  1. Immune system abnormalities

People with HS often have abnormalities in their immune systems. This may contribute to the inflammation and pus formation seen in HS.

While the exact cause of HS is unknown, there are three possible causes. If you have HS, could you talk to your doctor about treatment options to help relieve your symptoms?

Symptoms of Hidradenitis Suppurativa

There are four main symptoms of hidradenitis suppurativa:

  1. Small, painful bumps typically form in areas where the skin rubs together, such as the armpits, groin, and buttocks. They are often filled with pus and can break open, bleed, and crust over.
  2. Recurring infections: The bumps can become infected with bacteria, leading to pain, redness, and swelling. The conditions can be challenging to treat and may come back.
  3. Scarring: The bumps can leave behind scars, which can be permanent.
  4. Quality of life: The symptoms of hidradenitis suppurativa can have a significant impact on quality of life, causing pain, embarrassment, and anxiety.

See your doctor for an evaluation if you think you may have hidradenitis suppurativa. The condition can be challenging to treat, but options are available to help manage the symptoms.

Diagnosis of Hidradenitis Suppurativa

Early diagnosis and treatment are essential to preventing the progression of the disease.

The first step in the diagnosis of HS is a thorough physical examination. Your doctor will look for characteristic signs and symptoms as described in the above heading. Your doctor may also order one or more of the following tests to confirm the diagnosis:

  • Blood tests – to rule out other conditions with similar symptoms
  • Skin biopsy – to confirm the presence of HS
  • MRI or CT scan – to assess the extent of the disease

Treatment of hidradenitis suppurativa

The treatment goals for hidradenitis suppurativa are to reduce the number of flare-ups, improve quality of life, and prevent disease progression. Several different treatments can be used, depending on the severity of the disease. Treatment options include:

  1. Topical treatments: These are applied to the skin and can include antibiotic ointments, corticosteroid creams, and retinoids.
  2. Oral medications: These are taken by mouth and can include antibiotics, hormonal drugs, and immunosuppressants.
  3. Surgical treatments: These are used to remove affected areas of skin and can include excisions, laser surgery, and skin grafts.

How is Hidradenitis Suppurativa managed long-term?

Working with a dermatologist or other skin care specialist is essential to develop a treatment plan for you. Treatment plans will likely need to be adjusted over time as t progresses.

In addition to medical treatment, many self-care measures can help manage the symptoms of hidradenitis suppurativa. These include:

  • Wearing loose-fitting, breathable clothing
  • Avoiding tight-fitting clothing and shoes
  • Avoiding irritating fabrics, such as wool
  • Using mild soaps and cleansers
  • Avoiding hot showers and baths
  • Using over-the-counter pain relievers


Hidradenitis suppurativa is a chronic, recurrent, and often debilitating disease that affects the axillae, groin, and anogenital region. The pathogenesis is not fully understood but is thought to be due to a combination of genetic, immunologic, and microbial factors. Treatment is often complicated, and medical therapy is often ineffective. Surgery is the only definitive treatment, but it is associated with significant morbidity.

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