What causes boils on the skin? Discover the symptoms, common sites, diagnosis, stages, and treatment options for hidradenitis suppurativa, a chronic inflammatory condition that leads to painful skin bumps.

Understanding Hidradenitis Suppurativa

Hidradenitis suppurativa (HS) is a chronic inflammatory condition that causes painful bumps under the skin in areas with hair follicles and sweat glands. Also known as acne inversa, this condition can lead to the formation of pus-filled pockets under the skin that may break open and release a foul-smelling discharge. While there is no cure for HS, various treatments and lifestyle changes can help manage the symptoms and reduce the frequency of flare-ups.

Causes of Hidradenitis Suppurativa

The exact cause of hidradenitis suppurativa is not fully understood, but it is believed to be due to a combination of genetic, hormonal, and environmental factors. HS is more common in women than in men, and it is also more likely to occur in individuals who are overweight, smoke, or have a history of acne. Approximately one-third of people with HS have a close relative with the condition.

Symptoms of Hidradenitis Suppurativa

The primary symptoms of hidradenitis suppurativa include the development of painful, inflamed bumps under the skin, often in areas where the skin rubs together or where there are hair follicles and sweat glands. These bumps can turn into pus-filled pockets, which can break open and release a foul-smelling discharge. In severe cases, the condition can lead to the formation of tunnels (sinus tracts) under the skin, connecting different areas of the HS outbreaks.

Common Sites of Hidradenitis Suppurativa

Hidradenitis suppurativa typically affects areas where the skin rubs together, such as the underarms, groin, buttocks, thighs, under the breasts, and the nape of the neck. These areas are prone to the development of the characteristic bumps and pus-filled pockets.

Diagnosing Hidradenitis Suppurativa

To diagnose hidradenitis suppurativa, your doctor will examine your skin and ask about your symptoms, such as when they started, how often you experience them, and if any close relatives have had similar issues. In some cases, the doctor may take a sample of the pus from the affected area and send it to a lab for testing to rule out other types of infections.

Stages of Hidradenitis Suppurativa

Hidradenitis suppurativa is divided into three stages, known as the Hurley stages, based on the severity of the condition:

• Hurley stage I: A single or multiple isolated bumps with no sinus tracts
• Hurley stage II: Multiple bumps with some sinus tracts and scarring
• Hurley stage III: Multiple bumps with a lot of sinus tracts and scars, involving an entire area of the body

Treating Hidradenitis Suppurativa

The treatment for hidradenitis suppurativa will depend on the severity of your case. Your doctor may start with conservative treatments, such as warm compresses or over-the-counter anti-inflammatory medications, and then progress to more advanced therapies if needed. These can include:

• Antibiotics: Oral or topical antibiotics to fight infections
• Corticosteroids: Injections or oral steroids to reduce inflammation and pain
• Oral retinoids: Medications like acitretin or isotretinoin to improve severe cases
• Topical resorcinol: A cream applied to inflamed areas
• Surgery: In some cases, surgical procedures may be necessary to remove affected skin or sinus tracts

Lifestyle Changes to Manage Hidradenitis Suppurativa

In addition to medical treatment, making certain lifestyle changes can help manage the symptoms of hidradenitis suppurativa and reduce the frequency of flare-ups. These may include:

• Maintaining a healthy weight
• Quitting smoking
• Avoiding irritation or friction in the affected areas
• Practicing good hygiene and keeping the skin clean
• Managing stress and anxiety, which can worsen HS symptoms

While hidradenitis suppurativa is a chronic condition that can be challenging to manage, the combination of appropriate medical treatment and lifestyle modifications can help improve your quality of life and reduce the impact of this condition.