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Hidradenitis Suppurativa

Medically reviewed by Last updated on Aug 31, 2022.

What is hidradenitis suppurativa?

Hidradenitis suppurativa (HS) is a chronic (long-term) skin disease that causes your sweat glands or hair follicles to get clogged and inflamed. HS causes red bumps that look like pimples or small boils to develop on your skin. The cause of HS is unknown. It may run in families. Being overweight and smoking worsens signs and symptoms of HS.

What are the signs and symptoms of HS?

HS usually occurs in areas around skin folds or where sweat glands or hair follicles are. This includes the armpits, groin, genital or anal area, and under breasts in women. Your signs and symptoms may come and go. They may also get worse over time. You may have any of the following:

  • Mild or early signs of HS: One or more tender, red bumps that look like pimples or boils
  • Worsening signs and symptoms of HS:
    • Painful, hard bumps that get larger, break open, and drain pus that smells bad
    • Bumps that form deep under your skin and connect to each other and form a tunnel
    • Deep, thick scars caused by bumps that heal and reappear over time in the same area

How is HS diagnosed?

Your healthcare provider will ask about your symptoms and examine your skin. The provider will diagnose HS based on your signs and symptoms.

How is HS treated?

The goal of treatment is to control symptoms, prevent the development of new bumps, and limit scarring. You may need any of the following:

  • Antibiotics are used to treat or prevent a bacterial infection. Antibiotics may be used long-term. Antibiotics may be given as a cream or pill.
  • NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.
  • Acetaminophen decreases pain and fever. It is available without a doctor's order. Ask how much to take and how often to take it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.
  • Other medicines may be used to treat HS. These may include hormones, acne medicines, steroids, biologic therapy, and medicines that slow your immune system.
  • Incision and drainage is a procedure to drain pus from an HS wound and clean it out so it can heal.
  • Surgery may be needed if medicines do not work. Surgery may be done to remove areas of skin affected by HS.

Treatment options

The following list of medications are in some way related to or used in the treatment of this condition.

How can I manage symptoms and decrease flare-ups?

  • Apply warm, moist compresses. This may help to decrease pain. Keep the compress on your skin for 10 minutes. Sitz baths may be recommended if your genital or anal area is affected by HS. To do a sitz bath, fill a bathtub with 4 to 6 inches of warm water. You may also use a sitz bath pan that fits inside a toilet bowl. Sit in the sitz bath for 15 minutes. Do this 3 times a day, and after each bowel movement. The warm water can help decrease pain and swelling. 
  • Wash your skin gently. Use cleansers recommended by your healthcare provider. Antibacterial soap may be helpful.
  • Lose weight if you are overweight. Weight loss may help to improve signs and symptoms of HS.
  • Do not smoke. Smoking can make it more difficult to treat HS and worsen symptoms. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.
  • Do not wear tight clothing. Tight clothing rubs against your skin and causes irritation that can worsen HS.
  • Do not shave or use deodorant in areas of skin affected by HS. Ask your healthcare provider about safe deodorant or hair removal options.
  • Keep your skin cool. Overheating and sweating can cause an HS flare-up.
  • Ask your healthcare provider if you should make any changes to the foods you eat. Your healthcare provider may recommend that you avoid dairy foods. A dairy-free diet may help decrease your symptoms. Dairy foods include milk, cheese, yogurt, and ice cream.
  • Tell your healthcare provider if HS is causing you to feel depressed. Your healthcare provider may recommend counseling to help you cope with HS.

When should I contact my healthcare provider?

  • Your symptoms get worse, even with treatment.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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