What is Hidradenitis Suppurativa?
Hidradenitis Suppurativa is a non-contagious skin disease that is also known as Acne Inversa. This condition affects areas of the body where there is skin to skin contact and where sweat or oil glands are present; common areas are the underarms, breasts, buttocks, anal region, and groin. It affects between 1 to 4% of the world’s population, and is more likely to occur in females.
Hidradenitis Suppurativa (HS)is characterized by persistent abscesses, cysts (epidermoid, sebaceous, and pilonidal) and infections. The condition is chronic and often goes through alternating periods of remission and flare-ups. During flare-ups, the inflammation tends to be severe and patients may develop fever and be very fatigued. The pain can be unbearable and the person’s movements will be very limited. The abscesses often drain pus and leave open wounds that may not heal. Eventually, abscesses may become interconnected through tunnels under skin and this makes the condition harder to treat.
The immediate cause of Hidradenitis Suppurativa is clogging of the apocrine glands, due to dead skin cells become trapped in the gland, over production of oil, or bacterial accumulation. This will cause the plug to swell with pus formation. What causes this simple blockage to progress into a full blow Hidradenitis Suppurativa case is still debated, however, possible theories include an auto-immune reaction, hormone imbalances and genetic disorders. It is also known that excessive sweating and being overweight will increase the risk of developing the condition. Furthermore, wearing tight clothing, excessive shaving, using lithium medications and hot humid climates have been identified as triggering factors.
Clinically, Hidradenitis Suppurativa is described to occur in three stages. Stage 1 is characterized by the presence of a single or multiple abscesses without scarring that may be misdiagnosed as acne. Stage 2 is characterized by recurrent abscesses, lesions and sinus tract formation. At this stage inflammation will limit the person’s range of movement. Stage 3 is characterized by severe inflammation leading to swellings up to the size of baseballs. Scarring is prevalent, as are frequent infections.
Hidradenitis Suppurativa treatment will depend on the clinical presentation and extent of the condition. Antibiotics may be prescribed to treat any infections and for anti-inflammatory effect. Corticosteroids, NSAIDs and other anti-inflammatory drugs are also widely used. For some cases, surgery may be needed. In Europe, Electron Beam Radiotherapy is also sometimes used.
Unfortunately, medical treatments for Hidradenitis Suppurativa are of very limited effectiveness and may cause side effects. Lifestyle changes, dietary intervention and natural extracts are often more effective at controlling the condition and sending it into remission, and indeed a complete cure is possible without any medical intervention. Lifestyle changes include the use of hydrotherapy, balneotherapy and icing of the area. Dietary intervention includes the adoption of an anti-inflammatory diet, use of specific vitamin and mineral supplements, and the achievement of a healthy bodyweight.
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