What is Hidradenitis Suppuritiva?
Often abbreviated as HS, hidradenitis suppuritiva is a painful, chronic inflammatory condition affecting some sweat glands and hair follicles. The hair follicles can become blocked by normal cell shedding. Bacteria then multiply in the closed space, causing infection. This can progress from a pimple to a boil and even an abscess.
What Causes Hidradenitis Suppuritiva?
Your body has 2 types of sweat glands: eccrine and apocrine:
Eccrine glands secrete a watery fluid and empty directly onto the surface of your skin. They are present over most of your body.
Apocrine glands secrete an oily substance that has an odor. They empty deep into hair follicles and are concentrated in the armpit, breast, buttock and groin region.
When hair follicles or pores get clogged with cells, the bacteria on our skin gets trapped inside. We continue to produce sweat, but it has no way to escape and infection occurs.
When this happens on the surface of the skin, it can create a pimple that is relatively easy to treat due to its location. However, when it happens in a hair follicle and the sweat is the oily type produced by apocrine glands, the infection is deep, and hard to reach with medications, and bacteria flourish in the oily, protein-rich fluid. The apocrine gland continues to produce sweat, the bacteria continue to grow and the infection grows larger and more painful.
In the early phases (stage 1, or mild HS) lesions may:
Become large and painful
Last for months
Leak foul-smelling pus
As the condition progresses (stage 2, moderate):
Abscesses increase in number
Can become connected by tunnels deep beneath the skin’s surface, called tracts
Scars worsen on the surface and go deeper into the tissue
Finally (stage 3, severe):
Large areas of the body are covered by painful, oozing abscesses
Scarring can be severe above and below the skin’s surface
Widespread tunneling occurs, connecting multiple abscesses beneath the skin
Is there a Cure for Hidradenitis Suppuritiva?
There is no cure for hidradenitis suppuritiva. Treatment is aimed at management. Several things known to help are:
If you smoke, stop. Nicotine is thought to worsen HS
Maintain a healthy weight. Abscesses occur in areas where skin rubs against skin, so being overweight tends to worsen outbreaks
Irritated hair follicles often turn into boils for patients with HS, so be careful shaving and waxing. Many people have found Laser Hair Removal to be very effective in controlling hidradenitis suppuritiva
How do you Treat Hidradenitis Suppuritiva?
Topical and oral antibiotics
Retinoids (to assist skin cell turnover)
Cleansing skin with acne washes
Steroids and anti-inflammatory medications
Biologics-medications that alter the immune system and disrupt the disease cycle. Adalimumab (Humira), or tumor necrosis factor, is the 1st FDA-approved biologic for the treatment of moderate to severe HS. Others are being studied
Surgical: in severe stages, abscesses often require drainage or even removal of the follicles, glands, and tracts (tunnels) that continue to flare up
Laser Hair Removal is one of the most successful ways of treating hidradenitis suppuritiva. Because LHR destroys the hair follicles, the abscesses don’t have a place to form
What's new in Hidradenitis Suppuritiva Treatment and Hidradenitis Suppuritiva Scar Removal?
PicoSure™ Laser Treatments: at Skin Deep Laser MD, we discovered that when we treating the scars from hidradenitis suppuritiva, patients would get almost immediate relief from their active hs lesions!
We see the same effect on cystic acne. With both HS and cystic acne, the boils are deep below the surface of the skin. The bacteria in the lesions is anaerobic, meaning it doesn’t need oxygen to thrive. This, in addition to the depth and contained nature of the boils makes them very hard to treat as it is extremely difficult to get antibiotics into the infected tissue
We have found that the PicoSure™ Laser, while it doesn't have FDA approval yet for the treatment of acne, cystic acne or hidradenitis suppuritiva, is very effective at killing the anaerobic bacteria that is so hard to treat with other methods. PicoSure™ works so well that patients usually see marked improvement in the size, inflammation and pain from their lesions and abscesses by the next morning!
Is There a Way to Treat Hidradenitis Suppuritiva Scars?
Yes! At Skin Deep Laser MD we have multiple lasers that we use to treat different types of scarring. We have found that the gentle PicoSure™ Laser is the most effective at treating the both the hyperpigmentation (dark color) and scar tissue that often forms after hidradenitis suppuritiva boils heal.
Even more importantly, not only does the PicoSure™ remove the scars, it also kills the bacteria deep in the active abscesses, giving patients relief from their pain and inflammation almost immediately. Abscesses begin to heal and shrink within hours of treatment.
At Skin Deep Laser MD, serving Fort Worth, Weatherford, Benbrook, Burleson, Mansfield, Granbury, Arlington, Dallas, Texas and more, Dr. Riehm offers a range of skin care, scar treatments, age reversal and skin rejuvenation options, tattoo removal, body sculpting, chemical peels, facials and more.
To learn more about each treatment and what it targets specifically, arrange for a consultation with Dr. Riehm and her team. They will examine your skin type and explain each treatment to help you decide which ones are right for you. You can schedule an appointment by calling 817-263-7546 or book online.