Hidradenitis suppurativa (HS), also called acne inversa, is a chronic skin disease that causes painful, boil-like lumps under the skin.
- Where: often where skin rubs together, such as the armpits and groin.
- What happens: the lumps become inflamed and painful, and often break open into abscesses that drain fluid and pus. As they heal they can leave scars.
Causes
The lumps form when hair follicles become blocked. The blocked follicles trap bacteria, leading to inflammation and rupture.
- In most cases the cause of the blockage is unknown; genetics, environment and hormones may play a role, and some cases come from changes in certain genes.
- HS is not caused by poor hygiene, and it is not contagious.
Who gets it
HS usually starts after puberty, typically in the teens or twenties. It is more common in:
- women;
- people who are Black;
- people with a family history of HS;
- people who are overweight or have obesity;
- people who smoke.
Symptoms
- Small pitted areas of skin holding blackheads.
- Painful, red lumps that grow and break open into abscesses, which drain fluid and pus, may itch and smell unpleasant, and heal very slowly.
- Lumps that come back over time, leaving scars and tunnels under the skin.
| Severity | What it looks like |
|---|---|
| Mild | One or a few lumps in one area of skin; often worsens to moderate |
| Moderate | Recurring lumps that grow and break open, in more than one area of the body |
| Severe | Widespread lumps, scarring, and chronic pain that can make it hard to move |
Living with HS is difficult, and people with it are at higher risk of depression and anxiety.
Diagnosis
There is no specific test, and early HS can look like pimples or acne. Your health care provider will:
- ask about your medical history and symptoms;
- look at the lumps;
- possibly send a sample of skin or pus to a lab.
You may be referred to a dermatologist (skin doctor).
Treatment
There is no cure; treatment targets the symptoms and doesn't work equally well for everyone. It depends on severity:
- Medicines: steroids, antibiotics, pain relievers, and medicines that fight inflammation — applied to the skin (topical) in mild cases, otherwise injected or taken by mouth.
- Procedures or surgery to remove lumps and scars or clear the sores.
Avoiding irritation
- Wear loose-fitting clothing.
- Stay at a healthy weight.
- Quit smoking.
- Avoid heat and humidity.
- Take care not to injure your skin.
Sources
Based on "Hidradenitis Suppurativa," MedlinePlus, U.S. National Library of Medicine; a work of the United States government in the public domain.
Licence: CC0 1.0 (public domain) · Adapted from medlineplus.gov
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