It's important to diagnose and treat hidradenitis suppurativa as soon as possible. This can help prevent scarring and spreading of the condition. It may help lessen the physical and emotional pain caused by the condition, too.
To diagnose hidradenitis suppurativa, doctors typically look for:
- Lumps under the skin
- Lumps in skin folds or areas of the body where skin rubs together, such as the armpits, under the breasts or between the buttocks
- Lumps that have lasted six months or more
Unfortunately, hidradenitis suppurativa is often misdiagnosed as boils — a different type of painful lump under the skin. Some people with hidradenitis suppurativa wait years before their condition is correctly diagnosed.
There is no cure for hidradenitis suppurativa, but once diagnosed, several treatment options exist. Treatment goals include:
- Preventing new lesions
- Treating nodules quickly to prevent the formation of tunnels that connect multiple nodules under the skin
- Eliminating current nodules and reducing scarring
- Managing pain
Your doctor will recommend treatments based on how severe your condition is, your lifestyle and other factors. Treatments might include:
- Topical and oral medications, including antibiotics and drugs derived from vitamin A (retinoids)
- Minor outpatient surgery to drain the nodules and help prevent new lumps from forming in the same area
- Extensive surgery for complicated cases
Emerging treatments for hidradenitis suppurativa also include biologic medications such as adalimumab (Humira) and infliximab (Remicade), laser therapy and advanced surgical techniques.
Depending on your lifestyle, your doctor might also recommend changes to supplement your treatment, such as:
- Protecting your skin. Avoid skin friction as much as possible. Wear loose fitting clothes. And avoid abrasive cleansers, loofahs and bath brushes. Consider using an antiseptic wash — such as 4 percent strength chlorhexidine (CHG Scrub, Hibiclens, others) — one or more times a week when you shower. It may help prevent some infections caused by the condition.
- Giving up smoking. Smoking can worsen symptoms and flares.
- Losing weight. If you're obese, weight loss can reduce the hormonal activity that influences hidradenitis suppurativa. Weight loss also reduces your risk of type 2 diabetes. Some research suggests your risk of type 2 diabetes may be higher if you have hidradenitis suppurativa. It can also lessen skin friction and chafing, which can worsen symptoms.
- Changing your diet. Limited evidence suggests that eliminating dairy and highly processed or sugary foods from your diet might reduce the number of new lesions that develop and lessen signs and symptoms of hidradenitis suppurativa. Talk to your doctor before making any drastic changes to your diet.
Jan. 08, 2019
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- Lindhardt Saunte DM, et al. Hidradenitis suppurativa — Advances in diagnosis and treatment. JAMA. 2017;318:2019.
- Ingram JR. Hidradenitis suppurativa: Treatment. https://www.uptodate.com/contents/search. Accessed Dec. 9, 2018.
- Bui TL, et al. Hidradenitis suppurativa and diabetes mellitus: A systematic review and meta-analysis. Journal of the American Academy of Dermatology. 2018;78:395.
- Danby FW. Diet in the prevention of hidradenitis suppurativa (acne inversa). Journal of the American Academy of Dermatology. 2015;73:S52.