Hidradenitis suppurativa

Hidradenitis suppurativa is an inflammatory condition. It particularly affects skin where there are sweat glands. These include the:

• armpits
• groin
• bottom
• under the breasts.

Hidradenitis suppurativa develops when hair follicles become blocked, but it is not known why these blockages happen. It is thought it may be connected to hormones, genetics, cigarette smoking or excess weight.

Being unclean or having an infection does not cause hidradenitis suppurativa. It also cannot be spread to other people.

Hidradenitis suppurativa usually starts around puberty. It is more common in women than men.

Hidradenitis suppurativa can be painful. Symptoms can range from mild to severe.

Hidradenitis suppurativa causes a mixture of boil-like lumps, blackheads and cysts. It also causes scarring and channels in the skin that leak pus. DermNet has pictures that show what the condition looks like.

Pictures of hidradenitis suppurativa — DermNet (external link)

There is no definitive test to help diagnose hidradenitis suppurativa.

Your healthcare provider will examine the affected areas of skin. They will diagnose hidradenitis suppurativa by:

• the appearance of the skin
• where the lumps are
• whether they keep recurring.

There are things you can do to reduce your risk of flare ups of hidradenitis suppurativa. These include:

• lose weight if you are an unhealthy weight
• stop smoking if you smoke
• wear loose-fitting clothes
• be careful when shaving — apply shaving cream or gel when wet shaving or consider laser hair removal instead.

Antiseptic cleansers

If you have an area of skin that has broken open, use an antiseptic skin cleanser for 5 days.

You can use:

• benzoyl peroxide 5% wash
• chlorhexidine
• octenisan.

Benzoyl peroxide 5% wash is available at supermarkets. Chlorhexidine and Octenisan are available at pharmacies.

To use the wash:

1. Wet your skin in the shower then turn the shower off.
2. Apply the wash product with your hand or a clean wash cloth.
3. Wait 5 minutes.
4. Rinse your skin off under the shower.

Get support

Having hidradenitis suppurativa can have a significant impact on your quality of life. You may need support in looking after your mental health and wellbeing. Talk to your healthcare provider about this.

You may like to join an online support group.

Hidradenitis Suppurativa Australia and New Zealand Facebook group (external link)

Hidradenitis suppurativa is a lifelong, recurring condition that can be difficult to manage. But there are treatments that may improve or stop your symptoms.

You may be given antibiotics either as a product you put on your skin or as tablets to take by mouth. A course of antibiotics may last from 1 to 2 weeks or up to 3 months.

There are medications that may reduce flare-ups. These include metformin, spironolactone and the combined oral contraceptive pill.

Metformin — My medicines (external link)

Spironolactone — My medicines (external link)

Combined contraceptive — My medicines (external link)

If you have a severe condition, a skin specialist (dermatologist) may suggest other medications such as immunosuppressive medications (biologics).

Surgery is sometime needed to drain a collection of fluid. Rarely, an area of skin with severe disease may be cut out. Unfortunately, this does not cure the underlying hidradenitis suppurativa and it may still recur in another area.