Hidradenitis Supportiva 101
Hidradenitis Supportiva (HS), also known as Acne Inversa, is a chronic inflammatory skin condition involving the hair follicles and sweat glands. These follicles and glands become clogged, which starts the inflammation process causing boil-like accesses to form underneath the skin. Overtime, these abscesses connect and form skin tunnels, called sinus tracts. They drain outside the body through a hole in the skin, which eventually leads to scarring.
HS is a chronic follicular disease that can affect anywhere in the body. Most common areas are where skin rubs against itself, including the armpits, groin, underneath the breasts, and buttocks. HS starts to show around the mid-teenage years. Breakouts reoccur in the same spots or develop new ones.
HS is underreported and under diagnosed due to patient shame and embarrassment. If affects 1 in 100 Americans and women more than men. The root cause of HS is still unclear, but thought to be due to an autoimmunity or genetic link. Smoking cigarettes, living in a humid climate, wearing tight clothing, and living a sedentary lifestyle are risk factors for HS.
HS D/T/M
HS is diagnosed by taking a comprehensive patient history and performing a physical exam. A hallmark sign of HS in painful lesions appearing and reappearing. These lesions eventually become so infected that they rupture and leak out purulent fluid and pus through a hole outside of the skin.
There is currently no cure for HS. Management includes primary care and dermatology care. Oral antibiotic treatment, such as doxycycline and amoxicillin-clavulanate, and topical clindamycin ointment are recommended for daily maintenance. Oral anti-inflammatories and corticosteroids can be used for painful lesions. In severe cases of HS, incision and drainage of abscesses, laser treatment and deroofing of sinus tracts may be warranted. Immunotherapy, such as, adalimunab may be used. The prognosis of HS depends of the severity of each individual case.
Managing HS can be very difficult, painful, and burden-like for individuals. There are simple everyday practices that can be performed to help manage HS. Wearing lose fitting clothing, maintaining a healthy weight, not shaving affected areas, and cleaning areas with antibacterial soap should be performed daily. Regular exercise and movement should be performed everyday to boost lymphatic drainage. Eating an anti-inflammatory diet and drinking 2-3 liters of water per day is crucial for optimal nutrient intake and hydration.
Essential supplements for HS include a daily probiotic, multivitamin, and zinc supplement.
HS + Mental Health
HS can be a very debilitating skin disease- extremely painful lumps, lots of pus leaking out, redness and scarring on the skin occurring and reoccurring in uncomfortable areas throughout the body. This can tremendously impact body image, self-esteem, sex life, mental health, and the ability to attend work and perform everyday activities. It is important to seek a mental health professional if you experience any mood changes, feelings of hopelessness, financial stress, or your daily activities of daily living are impacted by HS. Seek community and know you are not alone. Surround yourself with people who believe in you and support you. If you know anyone with HS, simply be there for them. Support them through whatever they are experiencing- a mild outbreak or a severe one.
Final thoughts
HS is a common under diagnosed chronic skin condition that is very painful and currently has no cure. It is important to be aware of HS to be able to help and support these individuals, and to hopefully find a cure in the near future.
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