Hidradenitis Suppurativa

What is hidradenitis suppurativa?

The term itself means purulent inflammation of sweat glands; however, it also involves hair follicles. Sometimes health care providers also call it “acne inversa”, since it usually occurs in skin folds. It is a chronic (very long lasting) disease of unknown cause with recurrent, painful, and draining boils (abscesses), usually occurring in skin folds such as the armpits, under the breasts, buttocks and groin. It is NOT a contagious disease. Hidradenitis suppurativa has understandably very negative impact on the mood of the patients. Many people with hidradenitis suppurativa have relationship and work related problems due to this disease.

How does hidradenitis suppurativa look like?

People with hidradenitis suppurativa develop recurrent, painful, and draining boils (abscesses) usually in skin folds such as the armpits, under the breasts, buttocks and groin that can heal with scars. These boils may merge; forming large inflamed area and tunnels under the skin.  Almost always there are blackheads (comedones) in the area, which is helpful to distinguish it from other diseases such as folliculitis.

Should I see my health care provider?

Absolutely! There are medicines that can help make the disease milder or even inactive, but there is no permanent cure as of yet other than excising the entire involved area, which leaves large scars.

What are available treatments for hidradenitits suppurativa?

We usually treat it with benzoyl peroxide wash or CLn wash (shower gel with bleach: http://www.clnwash.com) and clindamycin solution or lotion. Also, sometimes we add oral doxycycline pill, or some other antibiotic depending on results of bacterial culture.  Inflamed bumps can be injected with intralesional triamcinolone acetonide. Larger bumps that do not want to go away we excise. In addition, the FDA has recently approved AbbVie’s HUMIRA® (adalimumab) for the treatment of moderate to severe hidradenitis suppurativa. HUMIRA is now the first and only FDA-approved therapy for adults with hidradenitis suppurativa. Very rarely our patients opt for extensive surgery with the complete excision of the entire involved areas. In females, birth control pills may help as well. Weight loss, smoking cessation, as well as avoidance of tight-fitting clothes are also very helpful.


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