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Hidradenitis Suppurativa - Pictures, Symptoms, Treatment, Causes, Surgery

Updated on November 30, 2013

Hidradenitis Suppurativa Pictures

Hidradenitis Suppurativa

Hidradenitis suppurativa is a chronic ailment that affects the apocrine glands (sweat glands found on certain parts of the body such as the armpits and genital area). This has always been described by the affected as an annoying and discomforting disease because of the areas it affects. The mechanism of the condition is to start plugging the apocrine glands, imagine what it does to the person’s armpits, nipples and genital areas. It is sometimes compared to the common acne as it can also affect the said areas of the body.

According to reports, hidradenitis suppurativa is a common condition in women and to the African-American descent. In women, they develop hidradenitis suppurativa under the breasts. People who are overweight experience a more discomforting sensation as this condition progresses. As others may point out, this condition is not caused by poor hygiene practices instead it can worsen when one is at stress. Hidradenitis suppurativa is commonly observed in patients who have passed the puberty age. This condition can be disabling but is known to be rarely fatal. Hidradenitis suppurativa becomes lethal when a person affected is immunocompromised or with an underlying extensive ailment.

This condition can be readily diagnosed through a clear medical assessment of the patient’s history and by inspection. Examining the skin of the patient with supporting blood chemistries can help rule out other conditions and suggest hidradenitis suppurativa. Culture of a skin sample may also be necessary to readily rule out other possible conditions.


As discussed above, hidradenitis suppurativa is a condition that affects the apocrine glands. The condition usually occurs around the hair follicles of the armpits, genital area and nipples. Multiple areas of the body can be affected at once but usually affects a local area. Here are the signs and symptoms of hidradenitis suppurativa:

  • The sweat glands contain blackheads.
  • Red and painful bumps often break out. They may seem to be enlarged and can contain draining pus. Unpleasant odor may be emitted from the drainage. This can then trigger itching and burning sensation on the area.
  • The pain may persist for years and shall result for the lumps to become inflamed.
  • There is possible scarring for the lesions may heal in a slow manner.

There are 3 stages of Hidradenitis suppurativa:

  1. Single or multiple abscesses develop without scar formation
  2. Recurrence of abscesses with scar formation.
  3. Diffuse involvement or multiple interconnected abscesses are observed.

The condition can result to complications and may persist because it has come to a point of severity. These are the following possible complications from hidradenitis suppurativa:

  • Sore formation may be uncontrollable and can persist.
  • Skin changes which are severe can develop. This can leave thick, raised scars from the lumps that may have developed initially.
  • The affected may have a difficult time for initiating actions or movements because of the pain.
  • Continuous swelling of the area due to bacterial invasion can be identified as cellulitis. The patient may experience swelling of the area and feel tenderness. This can even spread to one’s lymph nodes and bloodstream affecting the body’s defenses.


The condition is considered idiopathic, from an unknown cause. But according to studies, genetic predisposition plays a good role for the outbreak of this skin problem. About 38% of the cases reported have a close relative with hidradenitis suppurativa. Families of the Sephardic Jewish, Italian, Greek, Middle Eastern and Northern African descent are said to be mostly affected of this condition. Precipitating factors for this condition are excessive sweating and obesity. Stress and smoking is also related to the development of this condition. Hormonal problem such as increased androgen production can trigger for acne formation thus predispose a person to develop hidradenitis suppurativa. Bacterial infection can also trigger this condition.

Other conditions are also said to be associated with this skin problem and these are:

  • Crohn’s disease
  • Irritable bowel syndrome
  • Down syndrome
  • Arthritis
  • Grave’s disease
  • Sjogren syndrome
  • Herpes simplex.

Those who are at risk for this condition are women, people who are past puberty and those who have a familial history of hidradenitis suppurativa.


One should avoid the occurrence of this condition by doing the following steps and guidelines:

  • Avoid wearing tight, synthetic clothing
  • Avoid places that are hot or have humid climates
  • Limit the use of deodorant
  • Live a stress-free life
  • Maintain a healthy lifestyle by exercising regularly and getting enough sleep. Lose weight if one is overweight or obese.

There is no known cure for this condition. The treatment for this condition is mostly symptomatic, meaning the presenting symptoms are being managed to avoid the worsening of the patient’s state. Self care at home can be done when the state is not that entirely severe. Simple regular washing of the areas affected with antibacterial soap and application of warm compress can help soothe the discomfort. But this would really require medications and other treatment courses:

  • Topical antibacterial agents are prescribed. This should be rubbed on the area as per doctor’s advice.
  • Oral antibiotics are also recommended.
  • Oral retinoid medications can avoid plugging of hair follicles.
  • Analgesics are given for pain and NSAIDs to reduce the swelling.
  • Corticosteroids can also reduce the inflammation and swelling of the areas affected.
  • Birth control pills are provided to those with hormonal problems. Anti-androgen therapy is also introduced to patients.
  • Vitamin supplementation is necessary to patients for skin wellness.
  • Radiation therapy is also found successful for hidradenitis. This is a rare treatment option for this skin problem but is very much effective.
  • Zinc supplementations help reduce the inflammation and prevent new outbreaks.


Surgery is needed and recommended when the patient’s case has become severe. These are the surgical interventions for hidradenitis suppurativa:

  • Incision and drainage is the removal of the pus or draining substance from the affected area. This involves a single and small incision then the manual draining from the lesion. This is usually done to patients who are at the first stage of the ailment.
  • Another form of surgical manipulation of the area is the cutting of the skin and flesh that cover tracts. This can increase the healing of the lesions and can minimize the scarring. This is also performed to patients who suffer from stage 2 of the disease process.
  • Surgical removal is recommended in serious cases. This would involve the removal of all the involved skin then closing it with skin flaps or from skin graft.

These surgical interventions do not ensure avoidance of recurrence of the disease. This shall not assure the patient but can only treat the present problem.


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