Treatment of hidradenitis suppurativa

Hidradenitis suppurativa is a skin disease that is unknown to a lot of people, yet it does affect many. In the course of the disease, discharge-producing bumps appear on the armpit, groin area, the inner surface of the thigh, between the two sides of the buttocks, or in the case of women, even under the breasts.


How does hidradenitis suppurativa develop?

The immune system creates an inflammation against the apocrine sweat glands in the areas mentioned above. Therefore, it is not a contagious disease, but an autoimmune inflammatory process. Unfortunately, we do not yet have an exact explanation of why the disease develops, and we do not yet know the reasons of the recrudescences, either.
Several predisposing and aggravating factors are involved in the development of the disease, such as smoking, excess weight, heredity, too tight clothing, and overlapping areas rubbing against each other.


What are the symptoms of hidradenitis suppurativa?

The skin symptoms develop on the aforementioned overlapping areas, but they can be of varied severity. In the early stages, comedos develop, around which inflammation might occur. If the inflammation escalates, several inflamed, painful, stretching bumps appear, which can later turn into ulcer, burst or produce discharge. In the most severe stage of the disease, passageways under the skin, fistulas develop.  At this stage, the inflammation also causes scarring. It is important to know that the symptoms do not escalate in the case of every patient. For many of them, only a few inflamed bumps cause discomfort, while in other cases, severe symptoms that substantially hinder quality of life develop over the years.


How can hidradenitis suppurativa be diagnosed?

Since the disease is difficult to identify in the early stages, and the bumps that appear might seem harmless, many people do not go to the doctor in time. In order to avoid more serious complaints, visit a dermatologist if you notice pimple-like inflamed bumps on various areas or recurrently (2-3 times a year) in your armpit, groin area, or under your breasts.
Diagnosing hidradenitis suppurativa is done via physical examination by a dermatologist.  It can also happen that the disease comes together with inflammatory bowel diseases (Chron disease) or autoimmune joint inflammation, therefore the patient is always thoroughly questioned in addition to the physical examination.


How can the disease be treated?

According to the severity of the disease, treatment is possible using local or oral medications which require a prescription. Apart from the medicinal treatment, the best treatment option to date is the removal of the bumps, which is possible through surgical excision, deroofing with electrocauter, or CO2 laser.
Another part of the treatment is canceling out the predisposing factors mentioned before, if it is possible.

Do not let the disease hinder you in your everyday life! If you experience the skin symptoms mentioned above, book an appointment with our dermatologist specialist, Dr. László Képíró, to begin the treatment!
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László Képíró MD
László Képíró MD