Overview Hidradenitis suppurativa (HS), also known as acne inversa, is a chronic and often debilitating skin disease that affects hair follicles and sweat glands in areas of the body with skin folds, such as the armpits, groin, and buttocks. HS typically begins as painful, inflamed, and recurrent nodules or abscesses that may progress to draining sinuses or scarring. The exact cause of HS is unknown, but it is thought to be a combination of genetic, environmental, and immune system factors. Risk factors for HS include obesity, smoking, hormonal imbalances, and a family history of the disease. HS is often misdiagnosed or undiagnosed for years, leading to significant delays in appropriate treatment. Treatment options for HS vary depending on the severity and location of the disease, but may include topical or systemic medications, surgical interventions, and lifestyle modifications. Living with HS can be challenging and may significantly impact a person's quality of life, including their ability to work, exercise, and engage in social activities. It is important for individuals with HS to work closely with their healthcare provider to manage symptoms and receive appropriate care. Symptoms The symptoms of Hidradenitis Suppurativa can vary widely from person to person, and can range from mild to severe. Some common symptoms include: - Painful, inflamed, and recurrent nodules or abscesses in the skin folds, such as the armpits, groin, and buttocks. - Drainage of pus or other fluids from the affected areas. - Formation of tunnels or tracts under the skin, connecting the affected areas. - Scarring and thickened skin. - Itching and burning in the affected areas. - Limited mobility or flexibility due to pain and swelling. - Bad odor or foul-smelling discharge from the affected areas. - Depression and anxiety due to the chronic and disfiguring nature of the disease. It is important to note that not all individuals with HS experience all of these symptoms, and some may only have mild symptoms that come and go over time. It is important to seek medical attention if you experience any of these symptoms or suspect that you may have HS. Early diagnosis and treatment can help manage symptoms and prevent further complications. When to see a doctor If you experience any symptoms of Hidradenitis Suppurativa, it is important to see a doctor or dermatologist for an evaluation and diagnosis. In particular, you should seek medical attention if you experience: - Painful, recurring lumps or bumps in areas with skin folds, such as the armpits, groin, or buttocks. - Pus or other fluids draining from these areas. - Skin changes, such as thickened, scarred, or discolored skin. - Development of tunnels or tracts under the skin. - Limited mobility or flexibility due to swelling and pain. - Psychological symptoms, such as depression or anxiety, related to the condition. - Symptoms that interfere with your daily activities, such as work or exercise. Early diagnosis and treatment of HS can help manage symptoms and prevent further complications. Your doctor may recommend lifestyle changes, topical or oral medications, or surgical intervention depending on the severity of your condition. If you suspect you have HS or are experiencing any of the symptoms mentioned above, make an appointment with your doctor or dermatologist as soon as possible. Causes The exact cause of Hidradenitis Suppurativa is not fully understood, but it is believed to be a combination of genetic, environmental, and immune system factors. Here are some possible causes: - Genetics: There is evidence to suggest that HS may be inherited, with about one-third of people with HS having a family history of the condition. - Hormones: Hormonal changes, such as those that occur during puberty, menstrual cycles, or pregnancy, may trigger the development of HS. - Immune system dysfunction: HS is thought to be an autoimmune condition, meaning that the immune system attacks healthy tissue in the skin. - Bacterial infection: Some studies suggest that certain types of bacteria may contribute to the development and progression of HS. - Lifestyle factors: Smoking, obesity, and stress may increase the risk of developing HS or worsening symptoms. - Friction or pressure: The constant friction or pressure from tight clothing or repeated shaving of the affected areas may contribute to the development of HS. It's important to note that while these factors may increase the risk of developing HS, they do not necessarily cause the condition in all individuals. Further research is needed to fully understand the underlying causes of HS. Risk factors Several risk factors have been identified for Hidradenitis Suppurativa, including: - Gender: HS is more common in women than in men. - Age: HS usually develops after puberty and affects people in their teens and twenties, although it can occur at any age. - Genetics: As mentioned earlier, about one-third of people with HS have a family history of the condition, suggesting a genetic component. - Hormonal changes: Hormonal changes, such as those that occur during puberty, menstrual cycles, or pregnancy, may trigger the development of HS. - Obesity: Obesity has been linked to an increased risk of developing HS, possibly due to increased friction and sweating in skin folds. - Smoking: Smoking has been shown to increase the risk and severity of HS, possibly due to its effect on the immune system. - Stress: Chronic stress may contribute to the development or worsening of HS. - Certain medical conditions: People with other inflammatory conditions, such as Crohn's disease or psoriasis, may be at increased risk of developing HS. - Shaving or other hair removal methods: Shaving or other hair removal methods can cause skin irritation and lead to the development of HS in some people. It's important to note that having one or more of these risk factors does not necessarily mean that a person will develop HS, and some people with HS may not have any of these risk factors. However, understanding these risk factors can help individuals identify potential triggers and work with their healthcare provider to manage their symptoms. Complications Hidradenitis Suppurativa can lead to a number of complications, some of which can be serious. Here are some potential complications: - Scarring and disfigurement: HS can cause scarring and thickening of the skin in the affected areas, which can be permanent and disfiguring. - Abscesses and infections: Recurrent abscesses and infections can occur in the affected areas, which can be painful and require medical treatment. - Fistulas and sinuses: Over time, HS can cause the formation of abnormal connections between the affected areas, called fistulas and sinuses, which can be difficult to treat. - Limited mobility: Severe HS can cause limited mobility and make it difficult to perform daily activities, such as walking or exercising. - Depression and anxiety: The chronic and disfiguring nature of HS can lead to depression and anxiety, which can further impact a person's quality of life. - Cancer: Studies have suggested that long-term inflammation associated with HS may increase the risk of certain types of cancer, although more research is needed to confirm this link. It's important to seek medical attention if you experience any complications associated with HS. Early diagnosis and treatment can help manage symptoms and prevent further complications.

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