Certain areas of the body have skin folds that rub against each other. These areas may also have plenty of hair follicles, sweat glands and oil glands in the skin. Examples of these are the armpits, groin, the anal area, between the buttocks, inner thighs, and under the breasts. Some people develop pimple-like bumps in these areas, which appear red, while others develop larger bumps that look like boils filled with pus. These pimples or boils are characteristic of hidradenitis suppurativa, a chronic skin condition that affects the hair follicles and sweat glands in the affected areas.
What is Hidradenitis suppurativa?
Obstruction of the hair follicles, inflammation, and infection of the sweat glands in areas of the body where skin rubs against another skin surface, causes breakouts on the skin that look like pimples or boils. This chronic, progressive skin disease leads to the formation of pus-filled bumps that become hard and painful. They are commonly found in the armpits, groin, buttocks, inner thighs, and under the breasts. Sometimes, the inflamed skin lesions form tracts and become interconnected. Sweat and bacteria in these areas cause infection and inflammation.
Without proper treatment, the symptoms can worsen and may include pain, rupture of abscesses, leaking of foul-smelling fluids, serious infection, and thickened scars. Lymphatic drainage may be obstructed, causing swelling of the arm, leg or genitals. Limitation in movement, foul odor and social isolation may occur.
Young adults, particularly women, are more likely to be affected. A family history of the condition may play a role in developing the disease.
For mild cases, one can apply hot compresses over the affected area to relieve inflammation. The skin must be kept clean by gently washing with antibacterial soap. An over-the-counter antibiotic cream or ointment may be applied on the bumps. It is important to avoid irritation of the skin by wearing loose clothing and avoiding tight clothes. It is also advisable to keep the skin cool and to avoid shaving when inflammation is present.
People who are prone to develop hidradenitis suppurativa must lose excess weight, since obesity increases the likelihood of having skin folds that promote friction, sweating and bacterial growth.
For severe infection, long-term use of oral antibiotics can help treat and prevent worsening of symptoms. Steroid injections may be administered directly into the affected skin to reduce inflammation. TNF-alpha inhibitors such as adalimumab (Humira) and infliximab (Remicade) are medications that seem to be effective in the treatment of this condition. However, they can also increase the risk of heart failure, infection, and certain types of cancer.
Deep, persistent bumps that do not improve with conservative treatment may need surgical drainage for short-term relief. Interconnected lesions may be removed and covered with a skin graft. However, these procedures are not curative and do not prevent recurrence of the disease in other areas of skin.
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