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What Is Hidradenitis Suppurativa And How To Treat It

Updated 12/06/22

When it comes to the war against itch, it seems that the same cast of usual suspects gets most of the attention. Eczema and psoriasis, I'm looking at you. Even shingles and athlete's foot have their moments in the spotlight. But there's one lesser-known skin condition that's just as itchy, inflamed, and painful as any of these: hidradenitis suppurativa (HS).

Even if you've never heard of HS before, you're probably familiar with at least some of its symptoms. That's because HS manifests as large, deep-seated pimples that can occur in areas where skin rubs together.

In this article, we're going to dive deep into the symptoms and causes of hidradenitis suppurative, and most importantly, how to treat it and prevent it.


What Is Hidradenitis Suppurativa?

Hidradenitis suppurativa (HS) is a long-term condition that causes painful lumps to form under the skin. The lumps are usually small, filled with pus and can bleed or become infected. They often occur in areas where the skin rubs together, such as the armpits, groin, and buttocks.

On a microscopic level, HS results in hyperplasia of follicular epithelium. In layman's terms, this means that the small pores in your skin become blocked, trapping oil, sweat and bacteria underneath the surface of the skin.

A microscopic view of Hidradenitis suppurativa ( HS ).

As the condition progresses, the lumps can become larger and more painful. They may also form tunnels under the skin (known as sinus tracts), which can drain pus or blood. In severe cases, HS can lead to the formation of scar tissue and sinus tracts that connect different parts of the body.

Infographic showing the stages of Hidradenitis suppurativa.

These lumps are clearly more than just your run-of-the-mill pimples or blemishes. They're often quite large and can take weeks or even months to go away completely. And, unlike regular acne, HS pimples tend to occur in groups of two or three.

What's more, these pimples are often accompanied by scarring, making HS a physically and emotionally painful condition, causing everyday activities to be difficult.

HS: The Symptoms

he main symptom of hidradenitis suppurativa is deep, painful lumps that develop under the skin. These lumps are usually filled with pus and can bleed and itch.

Blemishes on the skin caused by Hidradenitis suppurativa.

HS tends to appear in areas where the skin rubs together, such as the underarms, under the breasts and in the genital area. Though it is most commonly found in these areas with sweat glands and hair follicles, the condition can occur anywhere on the body; such as the inner thighs, chest, or back.

An infographic showing the areas of the body that are susceptible to Hidradenitis suppurativa.

In addition to deep-seated pimples, hidradenitis suppurativa can also cause fever, fatigue, headache and nausea.

Treatment of Hidradenitis Suppurativa

There is no one cure for hidradenitis suppurativa; however, medical treatment options are available that can help improve quality of life for those suffering from this affliction.

Treatments for hidradenitis suppurativa typically include antibiotics, anti-inflammatory medications, immunosuppressive drugs, and surgery. Some people may also require radiation therapy or cryotherapy (freezing treatment).

For many sufferers of HS, the most urgent goal is to find a respite from the incessant itching. And while there is no one-size-fits-all solution, there are a few options that can provide some much-needed relief.

One of the most effective ways to get immediate relief from the painful itching is to use a powerful anti itch cream like Dermeleve®. Not only does Dermeleve® start working immediately, but a single application can last over five hours.

Tubes of Dermeleve on a counter.

What's more, unlike common OTC anti-itch medications, Dermeleve doesn't contain any topical steroids. This means that Dermeleve doesn't have the dangerous side effects of long term corticosteroid use or the risk of topical steroid withdrawal syndrome. This allows Dermeleve to be used as frequently as desired, for as long as you want. And when you're dealing with HS, that's exactly the kind of relief you need.

Another treatment option for hidradenitis suppurativa is topical retinoids. Topical retinoids are medications that are applied to the skin to treat the underlying inflammation and infection.

Other treatments include antibiotics and antifungals, which help to fight off the bacteria or fungus that is responsible for causing the disease.

Most people with hidradenitis suppurativa experience mild symptoms that can be managed with medication. However, in some cases, the disease can become severe and lead to a wide variety of complications, including recurrent abscesses, scarring, and infertility. In some cases, surgery may be needed to remove the lesions.

If you are experiencing significant symptoms or if your condition is progressing rapidly and requires urgent treatment, please speak with your dermatologist about what options are available to you.

What Causes Hidradenitis Suppurativa?

While the exact cause of HS is unknown, it's thought that a combination of factors, both genetic and environmental, may play a role in its development.

Some possible triggers for HS include:

Tight clothing or underwear:

Woman in yoga pants stretching.

Tight clothes can rub against the skin, causing inflammation and increased production of sweat and sebum.

Dry skin:

Closeup of dry skin

Dry skin can become inflamed when it doesn't receive the hydration it needs. This can lead to trapped bacteria, which sets off an inflammatory response.

Chemical irritants:

A variety of chemicals and cleaners.

Chemicals found in cosmetics, detergents, and other products can also trigger HS symptoms.


A lit cigarette held in a hand.

Smoking can play a part in HS cases, as it causes chronic inflammation throughout the body, including in the skin.

How to Manage Hidradenitis Suppurativa

Managing hidradenitis suppurativa involves taking care of both the physical and emotional aspects of the condition. If you are struggling with the symptoms of hidradenitis suppurativa, there are a few things you can do to help improve your quality of life.

Keep Yourself Clean and Dry

A woman drying off after a shower.

Cleaning removes excess skin oils and bacteria, which can help reduce inflammation and pain. Dryness helps minimize the amount of swelling that occurs due to the accumulation of fluid in the affected area.

Maintain a Proper Diet

A healthy meal of pasta and tomatoes. Eating healthy is a great way to help treat  hidradenitis suppurativa.

A proper diet is important for overall health and well-being, but it is also important when dealing with skin conditions like hidradenitis suppurativa. Consuming foods that are high in antioxidants (such as fruits and vegetables) can help fight off infection and improve overall symptom relief.

Improve Your Overall Health and Well Being

A cigarette being broken in half.

Avoiding alcohol, tobacco products, caffeine, and stressors such as work or school-related aggravations may also be beneficial for sufferers of hidradenitis suppurativa. What many people fail to realize is that the choices we make on a day-to-day basis can have a profound effect on our physical and mental health.

Your Skin Isn't the Only Organ That Needs Support with HS

A therapist and patient talking during a session. Talking to a professional about hidradenitis suppurativa is an important step towards treating the affliction.

We sometimes forget that our skin isn't the only organ affected from a dermatological condition. Our brain and mental health are also very much intertwined with the health of our skin.

Consider speaking with a therapist or counselor about the way your condition is affecting you emotionally. Oftentimes, just talking about the challenges we're facing can help us to feel better and more in control.

Medications For The Symptoms of Hidradenitis Suppurativa

There are a variety of medications that can be used to treat HS, and each offers its own set of benefits and side effects. Some of the most common medications used to treat HS include antibiotics, Accutane (isotretinoin), corticosteroids, and minocycline. Each of these medications has its own set of benefits and side effects, so it’s important to talk with your doctor about which one is right for you.

Some potential side effects associated with all types of medication used to treat HS include dry skin, acne scars, hair loss, increased oil production in the skin, and difficulty getting pregnant. It’s also important to note that some people may experience serious side effects from any type of medication prescribed for HS – so it’s best to speak with your doctor about your individual situation before starting treatment.

Hidradenitis Suppurativa Surgery

Surgical removal of the affected tissue may be one option for people who have not responded to other treatments; however, this procedure has its own risks and benefits and should be discussed with a doctor beforehand.

Ablative treatment using lasers, heat or radiation may also be an option; however, it too has potential risks and should only be attempted if other treatments haven't worked well enough.


Wrap Up

Living with hidradenitis suppurativa can be difficult, but there are treatments available that can help lessen the symptoms and improve quality of life. If you think you may have HS, it's important to see a doctor so they can diagnose and treat the condition. While there is no cure for hidradenitis suppurativa, the sooner it's treated, the better.

If you're struggling with hidradenitis suppurativa, don't suffer in silence. Talk to your doctor about your symptoms and treatment options.

And in the meantime, find fast relief from the itching with Dermeleve.

Be sure to check out our H.S. video, below!


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