Hidradenitis suppurativa is a chronic and stubborn disease centred on inflammation of the large specialised sweat glands (apocrine glands) that are found mainly in the armpits and groins. These areas show a distinctive mixture of boil-like lumps, areas leaking pus, and scarring.
What causes hidradenitis suppurativa?
It is still not clear why the apocrine sweat glands are affected like this in some people, but mechanical blockage plays a part. As the secretions cannot escape, the tubes containing them may swell up and burst, or become infected.
Contributory factors include the following:
Hormones are involved in the control of apocrine sweat glands and certainly play a part in the disease. Hidradenitis suppurativa affects women more often than men. It does not start before puberty or after the menopause. It may get better during pregnancy, but is often worse before menstrual periods. Some patients do well with hormone treatments (see below).
Bacteria play a part too, but a variety of germs, and not just one special type, is found in the spots. It is not clear whether they cause the disease, or just flourish within it.
There may be a link with acne.
Is hidradenitis suppurativa hereditary?
Hidradenitis suppurativa sometimes runs in families, and some patients or family members may also have had bad acne, or a chronic abscess at the base of the spine (a pilonidal sinus).
What are the symptoms of hidradenitis suppurativa?
Hidradenitis suppurativa can be itchy, but is usually painful, and the lumps hurt if they are pressed.
What does hidradenitis suppurativa look like?
The severity of hidradenitis suppurativa varies from person to person. The main areas to be affected are the armpits, and the skin around the genitals – in the pubic area and in the groins. The skin around the back passage, on the upper buttocks and thighs, and below the breasts, can give trouble too.
In these areas, the skin shows a variable mixture of blackheads, red lumps looking like boils, pus spots, cysts, and areas that constantly leak pus (sinuses). The abscesses can even burrow into nearby structures. As time goes by, more and more scarring appears.
How will hidradenitis suppurativa be diagnosed?
The diagnosis is made clinically, taking into account the areas that are affected, and the look of the spots. Your doctor may take swabs from the area to see which type of germ is present.
Can hidradenitis suppurativa be cured?
No, it usually persists for many years, but may disappear eventually. Treatment usually helps even though it cannot switch the hidradenitis off once and for all.
How can hidradenitis suppurativa be treated?
There are many ways in which your doctor can help you with your hidradenitis suppurativa. In general terms, early hidradenitis suppurativa is usually treated medically, whereas hidradenitis suppurativa that has been going for a long time may need surgery:
If hidradenitis suppurativa suddenly becomes worse:
This may be due to an infection with ordinary germs of the types that infect cuts and grazes; so antibiotics such as flucloxacillin may be used as a short course.
Frequent episodes of this type, with proven bacterial infection, usually mean that you have a sinus or abscess (see treatments below).
Antibiotics by mouth, taken are long-term, help to suppress attacks. The ones that are used are the same ones used for acne – such as oxytetracycline. They are sometimes put on as topical applications.
Other anti-acne drugs such as isotretinoin (vitamin A derived tablets) may help too, but have important side effects and are available only from dermatology departments.
For women whose hidradenitis suppurativa flares before each period, tablets known as antiandrogens can be useful. The usual one is cyproterone acetate, 50 mg taken on days 5-15 of the menstrual cycle in conjunction with an oral contraceptive called Dianette. It cannot be used for anyone with a tendency to have high blood pressure or to form blood clots.
If the disease is severe, stronger drugs including oral corticosteroids may be used but all carry the risk causing of side effects.
Treatment of scarred sinuses and abscesses:
Persistent discharge or infection in the same site usually means that the medical treatments listed above will not work, and surgical operations – either to remove small areas of repeated inflammation, or wider procedures to take away all the diseased glands – are needed in some cases. In general, hidradenitis of the armpits does better with surgery than hidradenitis in other sites.
What can I do?
If you are too heavy, you will need to lose weight.
As with many other diseases in skin folds, friction makes hidradenitis suppurativa worse, and should be avoided.
You should wash with antiseptic soaps or bath additives.
Do a 3 day APPLE Fast, i.e. eat ONLY apples (6 a day min max 10 a day).. I made apple sauce smoothies, drink 1 full tablespoon of olive oil on days 1 & 2... on day 3 of the apple fast, drink a full cup of olive oil.
Do an enema with 4 cups of coffee.. add 1 tsp of baking soda and another tsp of sea salt, repeat these enemas for 3 days in the am.
Every day put a small pinch of baking soda into a glass of water and drink it. This alkalizes the system.
According to this Healer Shaman/ naturopath, My system, liver & kidneys were toxic so by following this protocol you are allowing your body to detox. She said that I should repeat the fast and enemas every 6 mos.. and YES I do this 2x per year. It's the only thing that has helped me. I hope it will help you. I send each of you much love and wishes for abundant and radiant health. :)
This is so great!! I've been receiving boils known as "Cyst" to doctors since I've was a child I an now 20 years old. Let me start by saying this . . . Be careful of the body soap you wash up with and the Laundry soap you wash you clothes with. It's plays a big part of what your body could and may be allergic to!! I know for a fact. I use antibacterial soap WITHOUT dye and fragrance and ladies trust me when I say this IT WORKS. I've had 3 surgeries within the past 5yrs I mainly receive my boils in the middle of my two breast . . . Very painful and irritating. Crazy thing about mines is I only get them around the time that my period comes. I only take hot showers twice a day and a hot bath once a week it really helps especially if you sweat a lot. Also it has to do with the foods that you eat!! Try plain yogurt and a homemade smoothy it doesn't only help with the vagina but any other infections that your body may have for those who has boils on their lady parts. Try soaking in a hot bath. " NO FRAGRANCE SOAP just WATER. I am not a doctor bit I'm just giving information on how I treat myself.