Hidradenitis suppurativa is a chronic skin condition similar to severe acne. It occurs when sebaceous oil glands or hair follicles become blocked with dead skin cells and fluids from sweat glands. If bacteria enters the blocked areas, blackheads and pus-filled lesions appear. The condition is most likely to affect areas containing apocrine sweat glands, such as the groin or armpit, and can also appear on skin that often rubs together, such as the inner thighs or breasts.
One of the most common symptoms of hidradenitis suppurativa are blackheads or small dark dots on the surface of pores caused by excess oil. Unlike the blackheads associated with mild acne, these often appear in pairs or are pitted into the skin. The skin also typically develops painful red bumps filled with pus or clear liquid known as lesions. They may enlarge before bursting, and often resemble open wounds that are slow to heal.
Other symptoms of the condition occur under the skin. Hard, pea-sized lumps often develop under the skin and may enlarge over time. They can become inflamed and painful, and may remain under the skin for several years. Sinus tracts can form a tunnel network beneath the skin’s surface and prevent any sores from healing.
Hidradenitis suppurativa does not have a proven cause, but hormone levels and genetics are thought to contribute to the condition. Being overweight or smoking cigarettes can also increase an individual’s likelihood of developing the condition. People suffering from Grave’s disease, herpes simplex, or Crohn’s diseases may also be more at risk. Although hidradenitis suppurativa can occur in anyone, it tends to be most common in females between puberty and age 40.
To determine if a patient has the condition, a doctor will examine the skin and take a sample of any fluid or pus from the lesions. The sample is then sent to a laboratory for microscopic examination to determine if the bacteria present is indicative of hidradenitis suppurativa. He or she may also test a blood sample to rule out other skin diseases.
Although there is no permanent cure to prevent reoccurrences, the symptoms can be managed. Mild blackheads and lesions can be washed with warm water and antibacterial soap. For more severe cases, a doctor may prescribe antibiotics to get rid of the infection. He or she may also prescribe an oral retinoid to reduce oil gland production and prevent follicle blockage.
If medication doesn’t relieve the symptoms, surgery may be performed. A doctor can cut into the lesions and drain any fluid or pus to provide short-term relief. For large tunnel networks beneath the skin that prevent lesions from healing, a surgeon can cut away at the skin and flesh to uncover the tunnels and allow the skin to heal. In recurring and painful cases, all the affected skin can be cut away and replaced with a piece of skin from another part of the body that is attached to the area.
Hidradenitis suppurativa can cause permanent damage if left untreated. Sinus tracts underneath the skin can cause lesions to repeatedly develop. Severe instances can restrict the movement of affected areas, especially the armpits or thighs. In rare cases, a bacterial infection known as cellulitis may develop and spread to the lymph nodes and bloodstream.