Hidradenitis suppurativa (HS) is a painful, long-term skin condition that causes abscesses and scarring on the skin.
The exact cause of hidradenitis suppurativa is unknown, but it occurs near hair follicles where there are sweat glands, usually around the groin, bottom, breasts and armpits.
For reasons that are unknown, more women than men have the condition. It's thought to affect about 1 in 100 people.
The symptoms of hidradenitis suppurativa range from mild to severe.
It causes a mixture of boil-like lumps, blackheads, cysts, scarring and channels in the skin that leak pus.
The condition tends to start with a firm pea-sized lump that develops in one place. This will either disappear or rupture and leak pus after a few hours or days.
New lumps will then often develop in an area nearby. If these are not controlled with medicine, larger lumps may develop and spread. Narrow channels called sinus tracts also form under the skin that break out on the surface and leak pus.
Hidradenitis suppurativa can be very painful. The lumps develop on the skin in the following areas:
around the groin and genitals
in the armpits
on the bottom and around the anus
below the breasts
The abscesses may also spread to the nape of the neck, waistband and inner thighs. Other isolated areas that have been known to be affected include the front or back of the legs, the sides, the back area and the face.
Some of the lumps may become infected with bacteria, causing a secondary infection that will need to be treated with antibiotics.
Many people with hidradenitis suppurativa also develop a pilonidal sinus, which is a small hole or "tunnel" in the skin.
What causes hidradenitis suppurativa?
The exact cause of hidradenitis suppurativa is unknown, but the lumps develop as a result of blocked hair follicles.
Smoking and obesity are both strongly associated with hidradenitis suppurativa, and if you're obese and/or smoke it will make your symptoms worse.
Hidradenitis suppurativa usually starts around puberty, but it can occur at any age. It's less common before puberty and after the menopause, which may suggest that sex hormones play a part. Many people with the condition also have acne and excessive hair growth (hirsutism).
In rare cases, hidradenitis suppurativa may be linked to Crohn's disease, particularly if it develops around the groin area and the skin near the anus. Crohn's disease is a long-term condition that causes the lining of the digestive system to become inflamed.
Hidradenitis suppurativa runs in families in about 1 in 3 cases. It's not infectious and isn't linked to poor hygiene.
Diagnosing hidradenitis suppurativa
There's no definitive test to help diagnose hidradenitis suppurativa.
A GP will examine the affected areas of skin, and they may take a swab of an infected area. This can be helpful in making a diagnosis because the condition is not usually associated with the presence of bacteria that cause skin infections.
Hidradenitis suppurativa could be mistaken for acne or ingrown hairs.
Treating hidradenitis suppurativa
Hidradenitis suppurativa is a lifelong, recurring condition that is often difficult to manage.
It's important to recognise and diagnose the condition in its early stages to prevent it getting worse.
In the early stages, it may be controlled with medicine. Surgery may be required in severe or persistent cases.
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