Frequently Asked Questions About Hidradenitis Suppurativa


Paige Greenfield

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Hidradenitis suppurativa (HS), also called acne inversa, is a skin condition that produces pimple-like bumps that can become painful and problematic. Just as with any other condition, it helps to be prepared and to know what you’re dealing with. Here are eight frequently asked questions about acne inversa that can arm you with the knowledge you need to better understand the condition and what you can do to control it.

What is hidradenitis suppurativa?

Hidradenitis suppurativa is a skin disease that causes bumps resembling pimples or boils to form in places you wouldn’t normally expect them, such as your underarm, groin, buttocks, upper thighs, and under the breasts. These are typically areas where your skin touches your skin.

What are the symptoms of HS?

At first you may notice a breakout. It may resemble acne, but it is recognizable because it can be found in any of those unexpected areas listed above. Left untreated, acne inversa can progress and cause more serious problems. The bumps can be painful; rupture; and leak a bloody, foul-smelling fluid. They can also cause thick scars as they heal. If the scars form in certain places, the scars themselves can cause problems. For instance, scars on your underarm can restrict your ability to move your arms freely and scars in your groin can make it difficult to walk.

Who gets HS?

HS is three times more likely to affect women than men. It’s more common after puberty, which suggests that hormones may play a role. It could also happen to you if your immune system overreacts to a clogged hair follicle. Other factors that contribute to developing acne inversa include:

  • Being overweight or obese

  • Genetics—about 30% of people with acne inversa have a close relative with the condition, too

  • Smoking

  • Taking lithium

What should I do if I think I might have HS?

If you notice pimples or bumps in unexpected areas, make an appointment with your dermatologist. Diagnosing and treating the condition early can prevent it from getting worse and causing serious issues, such as permanent scarring.

How is HS diagnosed?

Diagnosing acne inversa is a fairly straightforward process. Your dermatologist will examine your skin and may ask you some questions. For example, your doctor may ask whether you’ve noticed any fluid leaking from the bumps and if it has an odor. Sometimes, your doctor may perform a blood test when diagnosing the condition.

How is HS treated?

There are many different treatment options. Many medications that are used to treat other diseases can be helpful for treating acne inversa. Different treatments work best for different people. Your doctor may recommend one treatment or several. Some examples include:

  • Medications. Antibiotics, acne treatments, and steroid injections work in different ways to fight the problem. For more severe cases, your doctor may recommend biologics, which are medications that target your immune system’s response.

  • Surgery. For acne inversa that affects deeper layers of your skin, surgery may be necessary. Laser surgery is one option; the surgery destroys hair follicles and may help clear existing breakouts and prevent future breakouts. Another surgical technique is called excision. This involves surgically cutting out the affected area.

What can I do to prevent an HS flare-up?

You can make a difference. Making certain lifestyle changes can prevent flare-ups or make your acne inversa less severe. Here are some things you can do:

  • Lose weight. It’s easier said than done, but dropping just 10% of your body weight can make a difference. Reducing your calories by just 500 to 1,000 calories a day can help you lose one to two pounds per week.

  • Don’t shave during breakouts. Shaving can irritate your skin and make things worse.

  • Wear loose-fitting clothes. This includes your underwear! You’ll reduce the amount of friction on your skin, which can cause a flare-up.

  • Discuss your antiperspirant with your dermatologist. Antiperspirant can be helpful because it controls sweating. However, some antiperspirants are too harsh for people with acne inversa. Talk with your doctor about which one may work best for you.

How can I reduce the pain during a flare-up?

Be sure to talk with your doctor if you experience a breakout or pain. If you need relief quickly, applying heat to the affected area can help. You could try making tea with a teabag. After the teabag sits in hot water for about a minute, place the teabag on the painful spot for about 10 minutes, being careful not to burn yourself. You could also create a warm compress. Hold a clean washcloth under hot water and then place it on your skin for 10 minutes.

Key Takeaways

  • Hidradenitis suppurativa is a skin disease that causes painful bumps resembling pimples or boils to form in places you wouldn’t normally expect them—typically areas where your skin touches your skin.

  • HS can progress and cause serious problems if it’s left untreated.

  • If you notice pimples or bumps in unexpected areas, make an appointment with your dermatologist.

  • Treatment options include medication, surgery, and lifestyle changes.

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PHYSICIAN CONTRIBUTOR cotton-pads-and-peroxide

How Doctors Approach Treatment for Hidradenitis Suppurativa

The goals of treatment are to clear and prevent breakouts, and get rid of scars.
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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Sep 1, 2017

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Medical References

  1. What is healthy weight loss? Centers for Disease Control and Prevention.
  2. Hidradenitis suppurativa. American Academy of Dermatology.
  3. Hidradenitis suppurativa: diagnosis, treatment, and outcome. American Academy of Dermatology.
  4. Hidradenitis suppurativa: Signs and symptoms. American Academy of Dermatology.
  5. Hidradenitis suppurativa: Tips for managing. American Academy of Dermatology.