Hidradenitis Suppurativa (HS) is a chronic, relapsing conditions involving body area like underarms, groin, also sometimes other body folds.
The exact cause of HS is not known, but there are multiple factors involved. It usually starts in teenage or in 20s, more common in women. Genetics with positive family history, hormonal disturbance, metabolic syndrome, immunological dysregulation, with additional infection are thought to play an important role. It basically involves inflammation of hair follicles and sweat glands.
Obesity, smoking, diabetes, stress, heat, humidity are worsening factors.
Usually, the patient complains of red bumps, boils, which are painful, enlarge and rupture pus. Multiple sinus tracts are formed over a period of time, which heal very slowly and leak pus. It often has a foul smell. They are recurrent and heal with scarring. Excessive scarring can lead to contractures, with difficulty in movement. Interference in the lymph drainage system can lead to swelling of arms, legs or genitals. Drainage of pus, foul smell, chronic and recurring nature of the condition affects patient psychologically. It can lead to social isolation, sadness, depression.
- Treatment involves drainage of pus and local wound care, NSAIDs to reduce pain and inflammation, antibiotics, retinoids, steroids, hormonal treatment and new age biologic immunomodulators, depending upon gender and stage of the disease.
- Laser treatment and surgical treatments, at the appropriate stage of the disease.
- Lifestyle modification involves cessation of smoking, losing extra weight (and hence extra folds), no shaving of involved area, avoid deodorant application to reduce irritation of hair. Wear loose-fitting ‘breathable’ fabric clothes, stay in a cool environment to reduce humidity and excessive sweating. Get support from family and friends.
HS can last for years, with exacerbations and remissions. Early treatment lowers the risk of recurrence. Having a positive attitude and keeping up with the lifestyle changes go long way in staying disease free.