Hidradenitis Suppurativa is a chronic, recurrent inflammatory condition with painful skin nodules. It is characterized by persistent or recurrent boil-like nodules and abscesses that culminate in a purulent discharge, sinuses, and scarring. Although the exact cause is not yet understood, contributing factors include:

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• Friction from clothing and body folds​

• Unusual immune response to normal body bacteria (commensals)

• Occlusion of hair follicles (similar to acne)

• Release of pro inflammatory molecules from the immune system

• Secondary bacterial infections

• Certain medications

• Common areas include the armpits (axilla), groin, under the breasts, and abdominal folds

• Much more common in women then men – about 1% of the population are affected

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TREATMENT OPTIONS

• General measures:

  • Weight loss, low glycemic diet, low dairy diet

  • Smoking cessation

  • Loose fit clothing

  • Antiperspirants to keep skin folds dry, sometimes Botox can help with this

  • Dilute bleach baths if prone to infections

  • Antiseptic washes

  • Dressings and wound care 

  • Pain control with acetaminophen or ibuprofen as needed 

 

• Topical/Oral Antibiotics​

• Hormone based treatments such as the birth control pill, Spironolactone or Metformin​

• Intralesional Steroid Injections​

• Supplements

• Immune System Suppressants​

• Acne Medication​

• Biologics​​

• Surgical & Laser management, such as abscess drainage, deroofing, laser ablation, excision, ​and laser hair removal