Hidradenitis suppurativa is a non-contagious skin condition, also known as reverse acne. This condition affects areas of the body where there is contact with the skin and where sweat or sebaceous glands are present. Common areas are the armpits, breasts, buttocks, anal area, and groin. It affects between 1% and 4% of the world’s population and is more common in women.


Hidradenitis suppurativa is characterized by persistent abscesses, cysts (epidermoid, sebum and pilonides) and infections. The disease is chronic and often alternates between periods of remission and relapse. During the flare, the inflammation tends to be severe and the patient may develop a fever and be very tired. The pain can be unbearable and the person’s movement will be very limited. Abscesses often drain the pus and leave open sores that may not heal. Finally, abscesses can be connected by tunnels under the skin, making treatment of the disease more difficult.


The immediate cause of HS is blockage of the apocrine glands because dead skin cells get trapped in the gland, too much oil is produced, or bacteria builds up. This causes the plug to swell with the formation of pus. What makes this simple blockage a complete case of hidradenitis suppurativa is still under discussion. However, the possible theories are the autoimmune response, hormonal disorders, and genetic disorders. Excessive sweating and obesity are also known to increase your risk of developing the disease. Wearing tight clothing, excessive shaving, use of lithium medications, and hot and humid climates have also been identified as triggers.


Clinically, it is described that hidradenitis suppurativa occurs in three stages. Stage 1 is characterized by the presence of one or more scarless abscesses that can be misdiagnosed as acne. Stage 2 is characterized by recurrent abscesses, lesions, and sinus formation. At this point, the inflammation will limit the person’s range of motion. Stage 3 is characterized by severe inflammation which leads to swelling up to the waist of the baseball. Scars are common, as are common infections.


Treatment with hidradenitis suppurativa depends on the clinical picture and the extent of the disease. Antibiotics may be prescribed to treat infections and for anti-inflammatory effects. Corticosteroids, NSAIDs, and other anti-inflammatory drugs are also common. Surgery may be necessary in some cases. In Europe, electron beam radiation therapy is sometimes used.

Unfortunately, medical treatments for hidradenitis suppurativa are of very limited effectiveness and can cause side effects. Lifestyle changes, dietary interventions, and natural extracts are often more effective in controlling disease and putting it into remission, and in fact, complete recovery is possible without medical intervention. Lifestyle changes include the use of hydrotherapy, balneotherapy and area icing. Dietary intervention includes the introduction of an anti-inflammatory diet, the use of supplements of specific vitamins and minerals, and achieving a healthy body weight.

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