Hidradenitis suppurative is defined as an aching, long-standing skin condition that results to abscesses and skin scarring.
The precise cause of the condition is unknown, but it is likely to form near hair follicles where there are sweat glands, typically near the buttocks, groin, armpits and breasts. Women are prone to develop the condition than men.
What are the signs?
The indications of hidradenitis suppurative vary from minor to severe. It results to a combination of reddened, boil-like bumps, cysts, blackheads, scarring and skin channels that drain pus.
The condition arises with a firm pea lesion which forms in one area. This either disappears and drains pus after hours or days.
Fresh lumps often form in the adjacent areas. If not controlled with drugs, bigger bumps might develop and spread. The condition can be quite painful and the lumps form in the following areas:
- Groin and genitals
- Beneath the breasts
- Buttocks and around the anus
The abscesses might also spread to the nape, inner thigh and waistband. In some cases, some of the lumps can become infected, resulting to a secondary infection that requires antibiotics.
Management of hidradenitis suppurativa
As a life-long, recurrent condition, hidradenitis suppurative requires continuous care and often hard to manage.
It is vital to recognize and diagnose the condition in its initial phases and prevent it from worsening. The treatment is tailored for each case. During the initial phases, it is managed with medications. For severe or persistent cases, it requires surgical intervention.
If the lumps are painful, inflamed and draining pus, antibiotics are prescribed for 1-2 weeks.
If a bacterial infection is not present, low-dose antibiotics might be given a suppressive treatment. This prolonged course of antibiotics usually last at least for 3 months with the aim of reducing the lumps that might form.
Topical antibiotics is used every day on the affected regions. The oral antibiotics that might be given include tetracycline, erythromycin, lymecycline and doxycycline.
An antiseptic wash such as chlorhexidine can be applied daily on the affected areas. This is often prescribed with other treatment options.
Retinoids such as acitretin and isotretinoin are vitamin A based medications. These are not highly effective but can help in some cases.
Women with hidradenitis suppurativa who experience flare-ups before their period can benefit from using a combined contraceptive pill.
In severe cases of hidradenitis suppurativa, the treatments are aimed on suppressing the immune system. On the other hand, there are certain risks linked if the immune system is suppressed. In such cases, this form of treatment is only prescribed if other treatment options fail to work.
In rare cases, a corticosteroid is given such as prednisolone to lessen the significantly inflamed skin. The drug can be taken in tablet form or as an injection direction into the affected skin.
Surgery might be an option in case the condition could not be managed with medications.