What is Hidradenitis Suppurativa
Hidradenitis Suppurativa (pronounced hidra-den-itis supp-ura-tiva) is a chronic and stubborn disease centred on inflammation of the large specialised sweat glands (apocrine glands) that are found mainly in the armpits and groin.
What are the symptoms?
Boil-like lumps, blackheads and leaking pus. The boils are extremely painful if pressed. The boils leave scars which do not disappear.
What are the stages of Hidradenitis Suppurativa?
Stage 1: The formation of single or multiple areas of inflammation and pus (abscesses), without sinus tracts (tunnels under the skin) and scar formation (cicatrisation).
Stage 2: Single or multiple abscesses recur, possibly at widely separated areas of the body. Sinus tracts form and there is scarring.
Stage 3: Multiple abscesses develop across an entire area of the body. Sinus tracts may connect otherwise separate abscesses.
Can I catch it?
No, you can’t catch HS.
Does anything make it worse?
Being overweight, smoking, scented toiletries are all linked to making it worse.
Will it go away on its own?
Some people have HS for many years before it just goes, other people have HS get worse as the years go on.
What are the common names for HS?
Hidradenitis Suppurativa is the most common medical term, but it is also called:
Pyodermia Sinifica Fistulans
Is there a cure?
Unfortunately there is no cure. There are many treatments out there but nothing guaranteed to work. Speak to your doctor for advice.
What treatments are available?
Generally it is recommended that you don’t smoke, wear loose fitting clothes, wash with antibacterial cleansers
Long courses of antibiotics such as Tetracycline (500mg twice daily), Erythromycin (500mg twice daily), Doxycycline (100mg twice daily), Minocycline (100mg twice daily) or Clindamycin (300mg twice daily) together with Rifampicin (300mg twice daily) for at least 3 months.
For women tablets known as antiandrogens can be useful. The usual one is cyproterone acetate (50mg-100mg) taken on days 5-15 of the menstrual cycle, or spironolactone (50mg- 250mg) in conjunction with an oral contraceptive called Dianette
Dapsone 25-200 mg/day
Corticosteroid tablets or injections to reduce inflammation such as triamcinolone, prednisolone, prednisone
Adalimumab (Humira) The only FDA and EU approved treatment. 160 mg on day 1 (given as 4 injections in 1 day or as 2 injections each day for 2 consecutive days), 80 mg on day 15 (given as 2 injections in 1 day), and a single 40‑mg injection every week from week 4 onwards.
Anti-acne drugs such as isotretinoin or acitretin (vitamin A derived tablets) 0.5-1.2 mg/kg/day for 4-12 months
Skin grafts to take away all the diseased glands
Hydrogen Peroxide 3%
Antiseptic washes such as 4% chlorhexidine wash