Hidradenitis suppurativa: symptoms, treatment, diet, pictures & more

KEY TAKEAWAYS * Hidradenitis suppurativa is a skin condition that causes painful outbreaks of bumps. These bumps commonly appear in areas where skin rubs together, like armpits and groins.

It affects up to 2% of the population. * Treatment options include antibiotics, biologics (like Humira), steroids, pain medications, and surgical procedures to help reduce pain and improve

symptoms, though there is currently no cure. * Management strategies include lifestyle changes like quitting smoking, maintaining a moderate weight, following an anti-inflammatory diet

(avoiding dairy and sugar), and working with healthcare professionals to prevent flare-ups and complications. Hidradenitis suppurativa (HS) is a skin condition that takes many forms,

including small, pimple-like bumps, deeper acne-like nodules, or boils. The lesions are usually painful and appear in areas where skin rubs together, such as your armpits or groin. After

these lesions heal, scars and tracts can develop under your skin. HS can worsen over time, and without treatment, it can affect your quality of life. This chronic condition affects up to 2%

of the population. Read on to learn more about HS and how you can manage its symptoms. Symptoms The main symptom of HS is a painful skin breakout that commonly occurs on any of the following

areas: * armpits * groin * anus * inner thighs * under the breasts * between the buttocks Signs of an HS breakout include: * pimple-like bumps * pain * deep nodules or cysts * boils *

nodules that leak or drain If HS is left untreated, symptoms can worsen, and you may develop: * tunnels, which are tracts or channels that connect lumps and form under your skin * painful,

deep breakouts that go away and come back * bumps that burst and leak a foul-smelling pus * scars that thicken * scars that form as persistent breakouts * infections HIDRADENITIS SUPPURATIVA

VS. PIMPLES, BOILS, AND FOLLICULITIS HS bumps are often mistaken for pimples, boils, or folliculitis. You can recognize an HS breakout because it typically causes bumps on opposing sides of

your body that tend to return in specific locations, such as your armpits and groin. Pictures of Hidradenitis suppurativa Stages Doctors commonly use the Hurley clinical staging system to

assess the severity of HS and determine a treatment plan. The three Hurley stages are: * STAGE 1: single or multiple lesions (nodules and abscesses) with little scarring * STAGE 2: single or

multiple lesions with limited tunnels and scarring * STAGE 3: many lesions across an entire area of the body, with extensive tunnels and scarring Other tools that may be used to determine

the severity of your HS include the following: * SARTORIUS HIDRADENITIS SUPPURATIVA SCORE: This counts and assigns scores to lesions based on tunnels, scarring, and their distance from each

other. * DERMATOLOGY LIFE QUALITY INDEX (DLQI): This is a 10-question questionnaire. * HIDRADENITIS SUPPURATIVA SYMPTOM ASSESSMENT: This is a questionnaire that assesses HS symptoms. * ACNE

INVERSA SEVERITY INDEX (AISI): This is a measurement tool that assesses the severity of HS symptoms. Causes Doctors aren’t always sure what causes HS. What’s known is that HS isn’t

contagious and isn’t caused by poor hygiene or any type of infection. A family history is reported in one-third of people with the condition, suggesting that there may be a genetic link.

Mutations in specific genes are thought to be a possible cause, but more research is still needed. HS usually occurs shortly after puberty, so hormones are also likely involved in the

development of the condition. RISK FACTORS Risk factors that may increase your chances of developing HS include: * being assigned female at birth * taking certain medications * being

overweight or having obesity * having a family history of HS * having severe acne, arthritis, IBD (such as Crohn’s disease), metabolic syndrome, or diabetes * being a current or past smoker

According to research, HS occurs more frequently in African American people compared with other ethnic groups. One reason for this may be health inequities, such as a lack of research into

how this condition appears on dark skin tones and access to quality care. Diagnosis Getting diagnosed early on is important to help make sure you receive effective treatment. This may

prevent scarring and limitations of mobility, which can occur after ongoing breakouts. If you suspect you have HS, it’s a good idea to see a dermatologist. They’ll examine your skin closely

and may swab some of your lesions if they’re leaking fluid. You should see a dermatologist if you develop breakouts that: * are painful * don’t improve within a few weeks * appear in several

locations on your body * return often Treatment While there’s no cure for HS, effective therapies are available. Treatment can: * improve pain * reduce the severity of breakouts * promote

healing * prevent complications A doctor may recommend the following treatments: * ANTIBIOTICS: These oral and topical medications can reduce inflammation, treat bacterial infections, and

stop new breakouts. A doctor may prescribe tetracyclines or a combination of clindamycin (Cleocin) and rifampin (Rifadin). * BIOLOGICS: Biologic drugs work by suppressing your immune system.

Adalimumab (Humira) is currently the only HS treatment approved by the Food and Drug Administration (FDA). Others, such as infliximab (Remicade), etanercept (Enbrel), and golimumab

(Simponi), may be used as well in what is known as off-label drug use. * STEROIDS: Oral or injected steroids can reduce inflammation and improve your symptoms. Low doses of corticosteroids

and systemic steroids, such as prednisone, may be prescribed for people with moderate to severe symptoms. Long-term use may lead to serious side effects. * PAIN MEDICATIONS: Over-the-counter

(OTC) pain relievers, such as acetaminophen (Tylenol) and lidocaine (ZTlido), a topical anesthetic, may help relieve discomfort caused by skin breakouts. * ACNE WASHES OR TOPICAL

MEDICATIONS: While these products may not clear your symptoms on their own, they may be a useful addition to your treatment regimen. * ZINC: Some people report improvement in symptoms from

taking zinc supplements. However, further research is still needed to understand the effectiveness. * LASER HAIR REMOVAL (LHR): LHR treatment early in the disease course may prevent disease

progression. SURGICAL OPTIONS If you have severe, recurring HS, surgery may be suggested to drain or remove lesions that grow deep in your skin. After surgery, the disease may return to the

same or a different area of your body. Surgical options include the following: * unroofing, which cuts away the skin that covers tunnels * limited unroofing, which removes one nodule, which

is also called punch debridement * electrosurgical peeling, which removes damaged skin tissue * wide local excision, which removed a tumor or abnormal lesion Other procedures to clear

lesions include radiation and laser therapy. Management There are many ways you can manage symptoms of HS, such as: DIET What you eat may have an effect on your HS. Some foods may trigger

flare-ups, while others can help prevent them. While there’s currently no recommended diet for people with the disease, small studies and anecdotal evidence suggest that some may find relief

by avoiding the following foods: * DAIRY PRODUCTS: Dairy may raise the levels of some hormones. Examples include butter, ice cream, and cow’s milk. * SUGARY FOODS: These foods can increase

blood glucose and cause inflammation. Examples include cookies and candy. * BREWER’S YEAST: This may cause an immune system reaction in people predisposed to wheat intolerance. Examples

include fermented foods like sourdough bread and soy sauce. Some foods may help relieve the symptoms of HS, including: * FOODS HIGH IN FIBER: They may aid in balancing hormone and blood

sugar levels. Examples include avocados, blackberries, and oats. * FOODS CONTAINING OMEGA-3 FATTY ACIDS: They may aid in reducing inflammation. Examples include salmon, sardines, and

walnuts. Get more information about diet and its effect on HS. LIFESTYLE MEASURES To better manage HS, making some key changes in your lifestyle may be helpful and necessary. This includes:

* QUITTING SMOKING: Up to 90% of people with HS currently or used to smoke cigarettes. Nicotine may create plugs on the skin’s follicles. If you currently smoke, consider talking with a

doctor about support in stopping. * MAINTAIN A MODERATE WEIGHT: According to a 2019 article, more than 75% of people with HS have overweight or obesity. Achieving and maintaining a moderate

weight may improve symptoms and chances of remission. LIVING WITH HIDRADENITIS SUPPURATIVA There’s no cure for HS, but it’s possible to manage the disease so you can maintain your quality of

life. Flare-ups of HS can last for a couple of weeks. You may experience more pain during these flare-ups. It’s important to take any prescribed medications to help relieve this discomfort

and resolve the flare. Although flare-ups are generally unpredictable, possible triggers may include: * stress * hot weather * foods containing dairy or sugar Some people experience

flare-ups before their menstrual periods. When nodules burst and the fluid inside them leaks out, an unpleasant odor may be released. Gently washing the area with an antiseptic soap can

remove the smell. In some cases, wearing loose clothing that doesn’t rub against the nodules can also help. Find out what you should ask your doctor about living with HS. Complications

Untreated or severe cases of HS can cause complications, such as: * SCARRING: Scars can form where breakouts heal and then reappear. They can thicken over time. * IMMOBILITY: Painful sores

and scars may restrict your movement. * INFECTION: Areas of your skin that drain or ooze can become infected. * LYMPH DRAINAGE PROBLEMS: Bumps and scars typically occur on areas of your body

that are near lymph nodes. This can affect lymph drainage, which may cause swelling. * SKIN CHANGES: Certain areas of your skin may darken or appear pitted. * DEPRESSION: The skin breakouts

and unpleasant odor from drainage can lead to self-induced social isolation. As a result, some people may become depressed. IF YOU’RE LIVING WITH HIDRADENITIS SUPPURATIVA, YOU CAN FIND

SUPPORT WITH MANY ORGANIZATIONS, SUCH AS: * HS FOUNDATION: This foundation offers resources, like plain language summaries, for those living with the condition. * NATIONAL ORGANIZATION FOR

RARE DISORDERS: This organization runs annual community support groups and programs. Takeaway Hidradenitis suppurativa (HS) is a skin condition that can cause painful outbreaks of bumps on

your skin. They commonly appear on certain body areas, including the armpits and inner thighs. Living with HS can be challenging, but effective therapies may help reduce pain and improve

your condition. While there’s no cure for HS, it’s possible to manage the disease so you can maintain your quality of life. Consider speaking with a doctor about your treatment options and

what lifestyle measures may help.