Hidradenitis suppurativa (HS) is a condition where painful red bumps or boils form on the body in places where the skin rubs together. At times, the skin may erupt into tunnels under the skin that connect bumps together. Common locations include in the armpits, groin area, inner thighs, buttocks, or around the anus. The bumps can also occur on or under the breasts.
HS is not a gynecologic condition; however, many women feel more comfortable talking about these symptoms with a women’s healthcare provider because the bumps often occur in sensitive areas. Women sometimes feel embarrassed about the bumps and do not know what the condition is called. HS is much more common in women, although men can develop HS as well. This condition often goes undiagnosed because there is not much awareness of it.
HS is caused by too much inflammation inside the body that can affect deep layers of the skin. The pressure can build up to become an abscess, or swollen, fluid-filled area, that can be painful and can rupture. HS is not caused by poor hygiene, and it is not a sexually transmitted infection. HS is not contagious.
The bumps caused by HS can be very painful and can drain pus or blood. The pus can sometimes cause a bad odor when it drains. The skin can harden and scar around the bumps. HS is a chronic condition and requires treatment. HS can range in severity from mild cases to more severe lesions with extensive scarring. The severity of the condition will determine treatment options.
For milder cases of HS, usually antibiotic topical medications are used. Antibiotic pills that you take by mouth can also help reduce flares of HS and cause the lesions to subside. More severe cases of HS may require injections of steroid medication or a biologic medication that works on your body’s immune system. Some individuals can experience restricted movement of arms and legs if scarring occurs in the armpits or inner thighs. Sometimes minor surgery may be needed.
It is not clear why some people develop HS. There is evidence that shows genetics play a role. Approximately 40 percent of people with HS have a first-degree family member who also has symptoms of the condition. There is some thought that hormones may play a role because HS is much more common after puberty and less common after menopause. Women who are overweight or who smoke do seem to be more affected by the condition. If you are overweight, losing weight can sometimes help the symptoms. It is also recommended to quit smoking if you smoke as this can also improve symptoms.
Although there is some association with weight and smoking, many women who do not smoke and are not overweight can develop HS. When bumps do appear, using an antibacterial soap can help. Using warm compresses can help as well. Tight-fitting clothing can sometimes make rubbing worse and lead to more bumps, so opt for loose clothing. The key to proper treatment starts with an early diagnosis. Seek a consult with your medical provider if you have lumps or bumps that are painful and do not improve over a few weeks. Additionally, if symptoms make mobility difficult or appear frequently or return after initial treatment you should talk to your healthcare provider.
HS can have a great impact on quality of life, so if you think you may have this condition, speak with your healthcare provider. He or she can diagnose the condition and start treatment or refer you to a provider who specializes in the treatment of HS.