Hidradenitis suppurativa treatments, diagnoses, and causes

This painful condition affects the skin, but the pain aspect along with the ongoing inflammation certainly impacts every aspect of life. Hidradenitis suppurativa is chronic, there is no cure for it, but thanks to a multi-faceted approach, the symptoms can be managed.

What is Hidradenitis suppurativa?

Hidradenitis suppurativa is a chronic condition that affects both men and women, although it is more prevalent among women. Hidradenitis suppurativa treatment is varied from patient to patient. It presents as hard lumps or nodules on the skin that look like pimples (at the start). It occurs in regions where there are sweat glands and hair follicles, like the groin, armpits, buttocks, or under the breasts. The lumps can be painful and may leak puss. The condition can be frustrating to live with, people often assume they are simply prone to boils or abscesses, never realising it is a chronic condition that needs to be managed.

What causes Hidradenitis suppurativa?

There’s no concrete cause and no single Hidradenitis suppurativa treatment has been established. It is thought that Hidradenitis suppurativa is caused by a defect in hair follicles and exacerbated by hormones (women may experience aggravated symptoms at different times during their monthly cycle). 

The research suggests:

1. A blockage occurs around a hair follicle.
2. This blockage gets inflamed and pressure builds, forcing the leak to move sideways under the skin rather than up and out.
3. This results in tunnels under the skin.
4. An added immune response brings on further inflammation.
5. The cycle then restarts, giving Hidradenitis suppurativa its chronic tendency.

Comorbid conditions

A comorbid condition is a term given to two conditions that coexist at the same time in one body, often they are both inflammatory or chronic conditions. There is some suggestion that conditions like Crohn’s disease, anaemia, spondyloarthropathy, and ulcerative colitis are often accompanied by Hidradenitis suppurativa. This simply suggests that those suffering from the above conditions may be at a higher risk for developing Hidradenitis suppurativa. 

Smoking has been documented as a major factor in the severity and frequency in which the condition occurs – meaning it exacerbates the symptoms and complicates Hidradenitis suppurativa treatment. That said, the condition also affects non-smokers. Smoking doesn’t necessarily cause Hidradenitis suppurativa.

The symptoms of Hidradenitis suppurativa

Hidradenitis suppurativa often starts out looking like pimples. When the condition progresses, the nodules may enlarge and start looking more like boils. The lumps are painful and often oozy. The affected areas: apocrine gland-bearing regions, presenting inflamed skin with lesions, nodules, scarring, and abscesses. Hidradenitis suppurativa treatment looks at these symptoms and address each one as effectively as possible.

Hidradenitis suppurativa symptoms look similar to a number of other conditions:

• Acne and pimples
• Cysts 
• Boils
• Blackheads
• Folliculitis (swollen pimple with a hair in the centre)

How is Hidradenitis suppurativa diagnosed?

Hidradenitis suppurativa is typically diagnosed by examining the affected area. Based on the physical signs of the condition and with a thorough patient history, Dr Khoza can make a diagnosis in the consulting room. If the wounds are oozing, swabs can be taken of the puss and sent to a lab to confirm the diagnosis. 

Hidradenitis suppurativa Treatment

There is no cure, but there are numerous for Hidradenitis suppurativa treatment options. It is a chronic condition, which means we treat the symptoms as and when they appear. Starting an early treatment protocol will make it easier to manage the condition. It is imperative to allow the wounds to heal quickly. There are several treatment options available, some of which may not be suitable for you.

• Topical and oral drugs: Antibiotics and/or retinoids (vitamin A derivatives)

Inflammation-reducing drugs like steroid injections into the nodule and oral steroids.

• Hormones: Hormone therapy is not suitable for pregnant women, but some research indicates that the combined contraceptive pill is effective at reducing the severity of the symptoms. Hormones can be an effective Hidradenitis suppurativa treatment protocol. 

• Immunosuppressants: These show great promise as an Hidradenitis suppurativa treatment. “They work by neutralizing an immune system protein known as tumour necrosis factor (TNF)”. There are possible side effects, this treatment should be discussed with Dr Khoza before you start on it.

Hidradenitis suppurativa treatment: Pain medication

Pain is a major aspect of this condition. It can be debilitating, affecting the patient’s quality of life, even leading to depression if the symptoms are not adequately managed. There’s no pain medication specifically used to treat this condition because there’s very little information available on the underlying mechanics. 

Typically, topical analgesics, non-steroidal anti-inflammatory drugs, paracetamol, opioids, gabapentin, pregabalin, duloxetine and venlafaxine are used to manage the pain aspects in the Hidradenitis suppurativa treatment regimen.

Dermatology tips for dealing with Hidradenitis Suppurativa

• Lifestyle modification: Try to lose weight, this will help lessen the severity of Hidradenitis suppurativa.
• Reduce or stop smoking.
• Stop shaving in affected areas.
• Keep area affected clean and cool.
• Wear loose fitted clothing.

Hidradenitis suppurativa is a chronic condition associated with poor quality of life. Early diagnosis, treatment and management is necessary to prevent complications and permanent scarring.

If you find you are prone to boils and painful acne, contact Dr. Khoza. It may be Hidradenitis suppurativa. If it isn’t we can still help you by finding the best way to manage the symptoms: 031 5812543