Hidradenitis Suppurativa

Hidradenitis Suppurativa (HS) is an inflammatory skin disorder which presents with recurrent infected cysts (abscesses) that discharge pus. Hidradenitis is more common in people who have had acne. It is believed to be a related disorder to Acne.

This condition is slightly more common in women, especially Blacks. The cysts are always multiple and usually occur in locations where there is hair and sweat glands. HS is most common in the armpits, groins, breasts and underneath breast (esp. in women with large sagging breasts). The disorder can also occur on the waist, buttocks and anal area. Most individuals present with pain of varying intensity.

Hidradenitis is often seen in obese individuals, but even after losing weight the condition persists. It is always worsened by stress. The condition is not related to hygiene or diabetes

What causes Hidradenitis Suppurativa?

No one knows why HS occurs but is believed to be due to plugging of the hair and sweat follicles. Once these glands or follicles are blocked, the oil collects in the glands. With time the oil putrefies in the cysts and then causes pain. Often the cysts rupture and extrude a fluid. The classic features of HS are numerous cystic ulcers which are draining pus.

HS is three times more common in women than men. The disorder is usually seen in between the 2-4 decade of life. The disorder rarely occurs before puberty or after menopause.

Possible causes

Hereditary: HS is more common in families who have a history of the disorder. The disorder usually affects multiple members in a family

Hormones: Some claim that excess levels of male sex hormones may lead to this condition.

Endocrine factors
: It is believed that hormones which cause weight gain and excess hair growth may be linked to HS.

Smoking: HS is generally more common in smokers

What are the signs and symptoms of Hidradenitis Suppurativa?

Hidradenitis usually begins as a small tender nodule in the groin or armpit. Within a few hours, several more nodules may occur and will be associated with pain. Soon this is followed by drainage from the cysts. When the condition subsides, scarring is common. Many individuals try home made remedies for this condition which often results in poor treatment and worsening of the scars. The condition comes and goes for many years.

HS can vary in severity. The typical features of the disorder include

- initially small pustules resemble acne

- numerous cysts varying in size

- cysts with oozing of pus

- large gold ball size cysts

- involvement of entire skin are

- recurrent pus pockets

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