If you have painful red bumps in the tender areas of your body where skin meets skin — think armpits and inner thighs — you may have a skin condition called hidradenitis suppurativa (HS). Many people live with HS for years before they get a diagnosis, according to the American Academy of Dermatology Association.
“The overall prevalence of HS, based on a recent meta-analysis published in the Journal of the American Medical Association, is 0.4% of the general population; however, I believe the numbers are higher,” says Monica Christmas, MD, Director of the Center for Women’s Integrated Health at the University of Chicago Medicine. “In my practice, I often see patients who’ve suffered with HS for years, but no one ever told them what it was. They are surprised to learn it’s an actual medical condition and there are treatments available to improve symptoms.”
HS is a chronic inflammatory skin disease, which means it can persist and sometimes even flare up. Its distinctive red bumps form around hair follicles and, in addition to armpits and thighs, can commonly form in the groin and on the buttocks and breasts, according to information from UChicago Medicine.
The bumps can be painful and deeply embedded, even enlarging and draining pus. Complications of HS include scarring and disfigurement, restricted range of motion in areas where they exist, and a narrowing or opening of the anus or urethra caused by inflammation.
HS is more common in women and can even run in families. And, it can have an impact on life and make daily activities more difficult, especially if scarring occurs.
“The impact of HS is mentally and physically debilitating,” Dr. Christmas explains. “The lesions are extremely painful, and the drainage is often associated with a foul odor. The associated pain and itching disrupt sleep and daily function often leading to absence from work. The condition is isolating and is extremely embarrassing for most leading to depression and sexual dysfunction.”
Getting to know hidradenitis suppurativa
It’s important to know that HS is not a sexually transmitted disease, nor is it caused by unclean skin. It’s also not contagious. HS is not life-threatening unless it causes a serious infection, says the American Academy of Dermatology Association.
Without treatment, however, HS can worsen. Dermatologists specialize in diagnosing and treating skin conditions and physicians at the Center for Women’s Integrated Health at UChicago Medicine can help identify triggers and offer treatment options.
Triggers can cause flare-ups of HS, and, while not every woman’s condition has the same triggers, hormonal changes can often cause HS to worsen. This can include worse symptoms during your period, during pregnancy and during the postpartum stage.
Some people may have dietary triggers, or have worse symptoms when they sweat or are exposed to heat. Tight clothing also can make this worse. Use of tobacco can increase the risk of symptoms, as can weight gain.
Risk factors and treatments
The cause of HS is not known, but there are some common underlying risk factors, including arthritis, diabetes, inflammatory bowel disease, obesity, metabolic syndrome and polycystic ovarian syndrome, according to the experts at UChicago Medicine.
In addition, African American and biracial women in their 30s in the U.S. have an increased risk of developing HS.
There’s no cure for HS, but there are effective treatments, including medications and procedures, that can treat existing bumps and prevent new ones. It’s important to work with a dermatologist who can determine your own individual triggers and create a treatment plan that works for you.
“It is important to see a dermatologist early to help prevent scarring and recurrence,” says Dr. Christmas.
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