Hidradenitis suppurativa is a rare, long-term skin disorder characterize by small, painful lumps under the skin. Usually found where the skin rubs together, such as the armpits, the groin, between the buttocks and under the breasts.The lumps may break open and discharge with offensive smell.


Hidradenitis suppurativa tends to start after puberty. It is important to detect this early, manage the symptoms, keep new lumps from forming and prevent complications, such as scarring, fistulas and or discomforts that come along with it.


Hidradenitis suppurativa usually starts between puberty and age 40.Excess weight, stress, hormonal changes, heat or humidity can worsen symptoms. In women, the disease severity may lessen after menopause.

The cause is unknown but Factors that may play a role include:

• Hormones
• Metabolic syndrome
• Genetics
• Irregular immune system response
• Smoking and excess weight.

The symptoms include:

• Blackheads. Small deep areas of skin containing blackspots — often appearing in pairs are common features.

• Red, painful bumps. These bumps often swell, break open and drain pus. The drainage may have an odor. Itching and burning may accompany the bumps. They usually appear in areas where skin rubs against skin.

• Painful, pea-sized lumps. These hard lumps, which develop under the skin, may persist for years, enlarge and become swollen.

• Tunnels; Also called fistulas Over time, tracts connecting the lumps may form under the skin. These wounds heal very slowly, if at all, and can leak pus.


* Age:-
Hidradenitis suppurativa most commonly occurs in women between the ages of 20 and 29.

* sex:-
Women are more likely to develop hidradenitis suppurativa than men.

*Family history:-  it can be inherited

*Having certain other conditions:-
Hidradenitis suppurativa can be associated with several other conditions, including arthritis, severe acne, obesity, inflammatory bowel disease, Crohn’s disease, metabolic syndrome and diabetes.

*Smoking:- tobacco smoking has been linked to hidradenitis suppurativa.

You can see a doctor when it:

• Is painful
• Doesn’t improve in a few weeks
• Returns within weeks of treatment
• Appears in several locations
• Recurs often


Mild hidradenitis suppurativa may be treated with only self-care measures. But self-care is also an important complement to any medical treatment you may be getting. The following suggestions may help relieve discomfort and speed healing of sores:

•Follow a daily skin-care routine. Gently wash your body with a non soap cleanser such as Cetaphil. Use only your hands, not washcloths, or other items that might irritate the skin. If odor is a concern, try an antibacterial body wash. Then apply an over-the-counter antibiotic cream. It might also help to apply extra absorbent powder or zinc oxide. Using antiperspirants that do not contain alcohol may help keep the skin. Stop using any product that irritates your skin.

•Manage your pain. Gently applying a wet, warm washcloth which can help reduce swelling and ease pain. Keep it on for about 10 minutes. Ask your doctor to recommend the most appropriate pain reliever. And talk with your doctor about how to properly dress and care for your wounds at home.

•Avoid tight clothes and irritating products. Wear loose, lightweight clothes to reduce friction. Use detergents and other products that are free of perfumes, dyes and enzymes. Whatever you use should be mild on skin.

•Avoid injuring the skin. For example, don’t squeeze the pimples and sores. And stop shaving affected skin.

•Keep a healthy weight and stay active. Over weight can make symptoms worse.

•Consider altering your diet. Avoid dairy products, processed sugar and flour, beer and other foods containing brewer’s yeast or wheat.

•Avoid all tobacco products. If you smoke, try to quit. Smoking and other tobacco use may play a role in making hidradenitis suppurativa worse. Tobacco smoke weakens the immune system.


Your doctor might prescribe one or more of the following types of medications:

•Topical and oral drugs. These include antibiotics and drugs derived from vitamin A (retinoid).

•Other drugs that reduce swelling. Injecting steroid medications directly into the tender nodule can reduce inflammation. Oral steroids, such as prednisone, can also help. But long-term use of prednisone has many side effects, including bone thinning (osteoporosis).

•Hormones. Hormonal therapy also is not suitable for pregnant women due to the risk of side effects.

•Drugs that suppress the immune system. The drugs infliximab (Remicade) and adalimumab (Humira) can be effective in the treatment of hidradenitis suppurativa. Possible side effects include an increased risk of infection, heart failure and certain types of cancers.

•Pain medication. Your doctor may prescribe a stronger type.


Surgery and other procedures
Hidradenitis suppurativa may be treated with various surgical approaches. The method used depends on the extent and location of the wounds, among other factors.

•Incision and drainage. Surgical drainage may be an option when the disease involves a single small area. This treatment generally provides short-term pain relief, but the sores tend to reoccur.

•Punch debridement. This procedure is also called mini-unroofing and may be used to remove a single swollen nodule.

•Uncovering the tunnels. Known as unroofing, your doctor cuts away the skin and flesh that cover any interconnected tunnels. This solution usually doesn’t have to be repeated.

•Tissue-sparing excision with electrosurgery. The goal is to remove diseased tissue and preserve healthy tissue in complicated cases.

•Surgical removal. Surgical treatment of recurrent or severe symptoms involves removal of all involved skin.


It might reoccur
Scarring of the affected area
Septicemia etc.