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What Is Hidradenitis Suppurativa (Acne Inversa)?

Hidradenitis Suppurativa (HS), sometimes called Acne Inversa, is a chronic inflammatory skin disease that causes painful, deep lumps, abscesses, and tunnels beneath the skin. It occurs primarily in areas where skin rubs together, such as the armpits, groin, under the breasts, and on the buttocks. HS is caused by the blockage and inflammation of hair follicles, not by poor hygiene. It is often a cyclical disease, with painful flare-ups and periods of relative calm.

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What Is Hidradenitis Suppurativa (Acne Inversa)?

Hidradenitis Suppurativa (HS), sometimes called Acne Inversa, is a chronic inflammatory skin disease that causes painful, deep lumps, abscesses, and tunnels beneath the skin. It occurs primarily in areas where skin rubs together, such as the armpits, groin, under the breasts, and on the buttocks. HS is caused by the blockage and inflammation of hair follicles, not by poor hygiene. It is often a cyclical disease, with painful flare-ups and periods of relative calm.

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Primary Symptoms and Progression

HS is marked by specific, often repeated lesions:

  1. Painful Nodules: Deep, hard, pea-sized lumps that look like pimples but are much more painful and stick around longer.
  2. Abscesses: These nodules can burst, leaking foul-smelling fluid.
  3. Tunnels (Sinus Tracts): Channels that form under the skin, connecting multiple lumps and leading to extensive scarring.
  4. Scarring: The repeated cycle of rupture and healing causes thick, rope-like scars that can sometimes limit movement.

Diagnosis and Treatment Options

A doctor diagnoses HS by examining the skin and ruling out other conditions. There is no single cure, so treatment aims to reduce inflammation and prevent new outbreaks:

  1. Topical and Oral Medications: Antibiotics or retinoids to manage flare-ups.
  2. Biologic Drugs: Stronger medications that target the underlying inflammation in the immune system.
  3. Minor Surgery: Incision and drainage of painful abscesses, or in severe cases, wide excision to remove deep, scarred skin and sinus tracts.

Long-Term Management

HS is chronic, meaning it can't be cured, but it can be managed effectively. The focus is on controlling flare-ups, reducing pain, and preventing new tunnels and scarring. This involves a long-term plan often combining medication such as biologics, weight management, quitting smoking, and gentle skincare. Staying consistent with the treatment plan is central to improving quality of life and lowering the frequency of outbreaks.

Summary of Care

HS is a chronic inflammatory skin disease that causes painful lumps and tunnels, primarily in areas with skin folds. Management requires a long-term approach combining hygiene, lifestyle changes (weight loss, quitting smoking), and prescription medication, often including biologics, to control the underlying inflammation.

Frequently Asked Questions About Hidradenitis Suppurativa (Acne Inversa)

Is Hidradenitis Suppurativa contagious?

No. HS is a chronic, non-contagious inflammatory disease of the hair follicles. It is not caused by a virus or bacteria that can be passed to another person.

Is HS the same as severe acne?

No. While both involve skin lesions, HS involves deep, inflammatory nodules in specific, skin-fold areas (like the armpit or groin) and forms tunnels under the skin, which is not typical of acne.

What specialist treats Hidradenitis Suppurativa?

The condition is primarily treated by a dermatologist. For severe cases, they may partner with a rheumatologist (for systemic inflammation) or a surgeon.