Hidradenitis suppurativa, also known as acne inversa, is a condition that causes small, painful lumps to form underneath the skin. These lumps usually develop in areas such as the armpits, the groin, buttocks, and breasts where the skin rubs together.
Hidradenitis suppurativa starts after puberty and usually before the age of 40. It can last for many years, worsening over time.
Hidradenitis suppurativa can affect one or more areas of the body, with several signs and symptoms, including:
- Blackheads- small, pitted areas of the skin that often appear in pairs
- Painful pea-sized lumps that form under the skin in areas where more sweat and oil glands are present, or where the skin rubs together, that can last for weeks or months
- Leaking bumps or sores that can get bigger, break open, and drain pus with an odor
- Tunnels that form under the skin. These tunnels connect lumps and heal slowly, and drain blood and pus
Some people who have hidradenitis suppurative experience only mild symptoms; however, the course of the disease varies extremely. Excess weight and smoking are associated with worse symptoms, but people who are thin and smoke can also experience severe symptoms of the disease.
Hidradenitis suppurativa occurs when hair follicles become blocked. The cause of the blockage isn’t known; however, experts think it may be connected to hormones, genetic predisposition, cigarette smoking, or excess weight.
Several risk factors can increase the chance of developing hidradenitis suppurativa. They include:
- Age
- Sex
- Race
- Family history
- Certain conditions
- Smoking
Severe and persistent hidradenitis can cause complications, including:
- Infection in the affected area
- Restricted movement due to sores and scar tissue
- Skin cancer, such as squamous cell carcinoma, has been reported with long-term hidradenitis suppurativa
- Scars and skin changes after wounds have healed, leaving pitted skin and rope-like scars
- Swelling in the arms, legs, or genital area, due to scar tissue caused by hidradenitis that blocks the lymph nodes in those areas from draining
- Psychological effects and social isolation, such as depression, anxiety, or not wanting to go out in public due to the location, drainage, and odor of the sores
- Lifelong pain
Hidradenitis suppurativa can often be mistaken for acne or pimples. A healthcare provider can make a diagnosis based on signs and symptoms, skin appearance, and medical history. Hidradenitis suppurativa can be difficult to diagnose and requires specialized care, so a healthcare provider may refer a patient to a dermatologist.
There aren’t any laboratory tests available to diagnose hidradenitis suppurativa; however, if there is pus or drainage present in the wounds, samples may be taken for testing.
Treatment for hidradenitis suppurativa can include medications, surgeries, or both to help control symptoms and prevent complications of the condition.
Medications used to treat hidradenitis suppurativa can include:
- Antibiotics
- Steroid injections
- Hormonal therapy
- Biologics
- Retinoids
- Pain medicine
Surgical procedures used to treat hidradenitis suppurativa include:
- Uncovering the tunnels under the skin by removing tissue to expose them
- Punch debridement, which removes a single inflamed bump
- Laser therapy
- Surgical removal of all the infected skin
If you or a loved one is suffering from hidradenitis suppurativa, you can visit Jamaica Hospital Medical Center’s Division of Dermatology. To make an appointment, please call (718) 206- 6742.
All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.





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