What is it?

Hidradenitis suppurativa (HS) is a chronic inflammatory condition that leads to development of comedones, abscesses, and scarring primarily in the axilla and groin. The cause is unknown, but it is increased in frequency in patients with inflammatory bowel disease, obesity, and other conditions characterized by occlusion of the hair follicles.  The disease has a significant negative impact on mental wellbeing.

What does it look like?

HS presents with abscesses in the axilla and groin area. These are often quite painful and might drain pus. Comedones and sinus tracts as well as scars are visible in the affected areas.

How is it treated?

HS is a chronic condition and is difficult to treat. Weight loss and smoking cessation are recommended when relevant. For early disease, simple measures such as use of antibacterial washes and unscented antiperspirant, wearing loose fitting clothing, decreasing friction, and pain control may be sufficient. In more extensive disease, systemic therapies including antibiotics, retinoids, anti-inflammatories (methotrexate/cyclosporin) or biologics (esp adalimumab) are necessary. Individual lesions can be treated with intralesional triamcinolone or drainage. Some patients find that laser hair removal is beneficial. Surgical removal of affected skin is sometimes required.