7 Complications of Hidradenitis Suppurativa

Medically Reviewed By William C. Lloyd III, MD, FACS
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Hidradenitis suppurativa (HS), also known as acne inversa, is a scarring skin condition that affects up to 4% of the population. Women are three times more likely to have acne inversa than men. And the condition usually starts in puberty or the early 20s and can last for years.

Acne inversa often begins with red, tender, pimple-like bumps on the skin in your armpits, breasts, genitals, and upper thighs that can lead to oozing sores and scarring. Although the condition isn’t rare, it’s not so common that all doctors are familiar with it. It can be mistaken for acne or a staph infection.

Why Treatment Is Key

If you have symptoms of HS, see a doctor. Getting the right diagnosis early on may help prevent acne inversa from becoming worse. Here are seven complications that can occur if you don’t begin treatment promptly.

  1. New skin sores can form. Acne inversa breakouts can spread and affect an entire area of your body, making them more difficult to manage.

  2. Pain and odor can develop. The sores that form can break open and leak blood and foul-smelling pus onto your clothes.

  3. Thick scars can appear. As the sores heal and reappear, deep, tunnel-like scars can develop in your body. Over time, they can thicken and make moving your arms, walking, sitting, and doing other everyday activities difficult. You may need surgery to repair them.

  4. Staying at a healthy weight can be a challenge. As the disease progresses, you may stop exercising because it’s too uncomfortable. If you become overweight from being sedentary, it can cause chafing, which can irritate your skin and cause acne inversa to flare up.

  5. Your mental health may suffer. Depression is common with acne inversa if it becomes severe enough to affect your quality of life. You might avoid getting together with friends or even going to work because of the condition. Women lose an average of 2 to 7 days of work per year because of acne inversa.

  6. Your risk of liver cancer may rise. People with acne inversa have a 50% increased risk of liver cancer. Seeking solace from cigarettes or alcohol may be the reason.

  7. Other health problems can occur. Acne inversa that’s not well controlled can increase your risk of infection, skin cancer, and other health issues, such as pain and scarring in the anus and rectum, which can be disabling.

Seeking Help

Although there’s no cure for HS, treatment is available for every stage of the condition. For mild cases, home remedies, such as using warm compresses, washing with antibacterial soap, wearing loose clothing, and taking anti-inflammatory drugs, such as Aleve (naproxen) may help reduce redness and swelling and keep the disease at bay. Not smoking and maintaining a healthy weight can also help.

For more serious cases, oral and topical antibiotics and other prescription medication may be needed. Some cases require surgery and skin grafts.

Treating acne inversa is different for everyone. What works for one person may not work for someone else. Don’t give up. Be prepared to team up with your doctor to find a treatment plan that works for you.

Key Takeaways

  • Complications of HS include painful breakouts that spread and develop into thick, tunnel-like scars.

  • As the disease progresses, you may find it uncomfortable to exercise or do everyday activities. This can lead to problems such as weight gain and depression.

  • HS that’s not well controlled can increase your risk of infection, liver or skin cancer, and pain and scarring in the anus and rectum.

  • Although there’s no cure, treatment is available for every stage of the condition. Getting the right diagnosis early on may help prevent HS from becoming worse.

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  1. Hidradenitis suppurativa. American Osteopathic College of Dermatology. http://www.aocd.org/?page=HidradenitisSuppura
  2. Lynette J. Margesson, MD, et al. Hidradenitis suppurativa. Best Practice & Research Clinical Obstetrics and Gynaecology. 2014: 28: 1013-1027. http://www.sciencedirect.com/science/article/pii/S1521693414001369
  3. Hidradentitis suppurativa. National Organization for Rare Disorders. https://rarediseases.org/rare-diseases/hidradenitis-suppurativa/
  4. Hidradenitis suppurativa. American Academy of Dermatology. https://www.aad.org/dermatology-a-to-z/diseases-and-treatments/e---h/hidradenitis-suppurativa
  5. Hidradenitits suppurativa: Signs and symptoms. American Academy of Dermatology. https://www.aad.org/dermatology-a-to-z/diseases-and-treatments/e---h/hidradenitis-suppurativa/signs-...
  6. How dermatologists can help lessen the burden of hidradenitis suppurativa. American Academy of Dermatology. https://www.aad.org/members/publications/member-to-member/2013-archive/december-20-2013/how-dermatol...
Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Sep 26
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