Patient education: Hidradenitis suppurativa (The Basics)

What is hidradenitis suppurativa? — 

Hidradenitis suppurativa, or "HS," is a condition that causes swollen, painful areas of skin. The most common body parts for HS are the armpits, but HS can happen in other body areas.

HS is not an infection. But sometimes, skin with HS can get infected.

What are the symptoms of HS? — 

The main symptoms are swollen, painful, abscess-like areas on the skin. These often last for weeks or months and keep coming back. Smaller areas of HS can sometimes look like a type of skin infection called a "boil."

Skin with HS can drain pus or blood that has an unpleasant smell. Also, HS can cause so much pain that it makes it hard to move.

Common body locations include:

●Armpits (picture 1)

●On or under the breasts

●Groin area

●Inner thighs

●Buttocks

●Around or near the anus

The skin problems caused by HS last a long time and get worse over time. Often, the skin hardens and scars around the swollen areas. Sometimes, tunnels form under the skin (figure 1).

Should I see a doctor or nurse? — 

Yes. If you have symptoms of HS, see a doctor or nurse. They might be able to tell if you have HS. Or they might send you to a doctor that can figure out if HS is the cause of your symptoms. If possible, it can help to see a skin doctor, called a "dermatologist." The HS Foundation also has a list of specialty clinics on their website: www.hs-foundation.org/hs-specialty-clinics.

Many people have a hard time dealing with their HS. It can make them feel embarrassed and worried. Sometimes, the condition can even cause problems in relationships or at work. Tell your doctor or nurse if you are struggling. They can help.

It's also important to see your doctor regularly if you have HS. People with HS have a higher chance of getting other health problems, too, such as diabetes and heart disease. Your doctor can check for these problems and suggest treatment if needed.

How is HS treated? — 

Some treatments include:

●Antibiotic pills, which you might need to take for a few months or longer

●Other pills (examples include birth control pills, spironolactone, and metformin)

●"Biologic" medicines (examples include adalimumab, secukinumab, and infliximab)

●Injections of steroid medicines to bring down inflammation

●Surgery

●Medicines you put on your skin

There are other medicines and treatments that might help people with HS. People with severe HS can have a type of surgery that removes the skin with HS.

Is there anything I can do on my own to feel better? — 

Yes. First, know that you did not do anything to cause your condition. It is not your fault. You did not cause it by being unclean. Also, HS is not contagious, and you cannot spread it to other people.

If you are feeling sad or depressed, it might help to get support. Talk to your doctor or nurse. For some people, seeing a therapist or finding a support group might help. The HS Foundation has more information: www.hs-foundation.org/support-groups.

Some doctors think that stopping smoking (if you smoke) and losing weight (if you have excess body weight) might help HS. But there isn't a lot of evidence about this.

How can I learn more about HS? — 

More information is available online from these organizations:

●The HS Foundation (www.hs-foundation.org)

●Hope for HS (www.hopeforhs.org)

●HS Connect (www.hsconnect.org)

These are also good resources if you are looking for support from other people living with HS. It can help to talk to people who are going through similar things.