Next Steps After a Diagnosis of Hidradenitis Suppurativa

By

Sarah Handzel, BSN, RN

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female doctor comforting female patient

According to recent estimates, only 1% of the people in the United States have hidradenitis suppurativa (HS).Also known as acne inversa, HS is a rare skin condition that causes painful bumps on and under your skin, usually resembling pimples or boils. These bumps typically occur in places where your skin rubs together, and they can become infected if left untreated.

Following an HS diagnosis, you might have concerns about managing your skin condition, especially since HS tends to be something that reoccurs. Fortunately, there are several things you can do to help make controlling your HS easier. Talk to your doctor about which options might be best to manage your symptoms.

Starting Treatment

Since early treatment of HS can help promote healing of the areas of your skin affected by breakouts, it’s important to ask your doctor as soon as possible after your diagnosis about what treatment options might be best for you. If left untreated, it’s possible for HS to cause complications like infection, skin changes and scars, limited movement because of a buildup of scar tissue, and, in some cases, cancer.

The symptoms of HS breakouts are common among people diagnosed with the condition. If you have HS, your symptoms might include:

  • Pimple or boil-like breakouts that clear and then reappear.

  • Painful breakouts resembling pea-sized lumps under your skin.

  • Scars that form as a result of repeated breakouts.

  • Tunnels that form under your skin, connecting lumps to each other.

  • Skin infections.

  • Foul-smelling fluid leaking from your breakouts.

Because there is no cure for HS, your doctor might suggest one or a combination of treatments, including medications or surgery. There are many options to help you take control of your HS, including:

  • Antibiotics and Pain Medications – you might find successful management of your symptoms can be achieved by taking certain medications. Your doctor might recommend antibiotics if your HS has caused an infection under your skin. It’s also common for doctors to suggest pain medications if your HS is uncomfortable.

  • Hormones – some studies suggest people with HS, especially women, might benefit from taking certain medications that help regulate hormone levels.

  • Anti-inflammatories – these can be given in oral or injectable form, and they can help reduce inflammation at the location of your flare-up.

  • Biologic targeted therapy – injectable drugs are FDA-approved for use in severe, refractory cases when previous efforts fail.

  • Surgery – occasionally, HS can cause tracks, known as tunnels, to form from bump to bump under your skin. This type of tunneling can be very painful, can become infected, and be very slow to heal. If your HS is severe, or if you have tunneling or wounds in certain areas of your body, your doctor might recommend surgery to clear the infection and allow your body to heal.

What You Can Do at Home

After you talk with your doctor, there are several things you can do at home to help manage your HS symptoms. It’s important to establish a daily skin-care routine that will help prevent your HS from getting worse or becoming more painful. You should avoid the use of washcloths, loofahs, or other bathing tools that can irritate your skin. Also, try to avoid any skin irritating products, like certain deodorants, cleansers that contain soaps, or shaving creams.

Your skin-care routine should include taking steps to prevent further injury to your skin. If you have HS, don’t squeeze any pimples or sores you might develop. If you shave, be sure to avoid areas that are affected by your HS.

Certain lifestyle changes might also help your manage your HS. Some studies have shown losing weight can help reduce the severity of your symptoms and might even prevent flare-ups from occurring. It’s also possible that changing your diet by giving up dairy, processed sugar and flour, and wheat, could help clear up your HS symptoms.

Watch for Signs of Flare-ups

Many signs of an HS flare-up are similar to the first symptoms you noticed. Let your doctor know if you begin to experience any symptoms, since flare-ups might mean your HS is getting worse or affecting a new area of your body. Flare-up signs and symptoms might include:

  • Breakouts, usually in areas of your body where skin touches skin. These breakouts might look like pimples or boils, and can be painful. They might also keep coming back, regardless of your current treatment.

  • Red, tender bumps that get bigger, are itchy or burn, or drain pus.

  • Pea-sized lumps that form under your skin.

  • Scars that form as your breakouts repeatedly heal and then come back.

  • Signs of tunneling under your skin, or other indicators of infection, such as foul-smelling drainage, tender skin, redness or swelling, or increased pain.

Even though HS is a life-long condition for many people, it’s still possible to effectively manage your symptoms. Early treatment can help HS sufferers avoid pain and discomfort while encouraging the skin to heal. With your doctor’s help, you can find which HS treatments work best for you, and which will help you achieve the best health possible.

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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: May 24, 2017

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Medical References

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