Hidradenitis suppurativa symptoms and medical management strategies
Mild Hidradenitis Suppurativa (HS) is a skin condition that can affect various parts of the body, particularly areas with skin-on-skin contact like the armpits or groin. This condition is characterized by itching, burning, sweating, heat, or pain in the affected area before a lesion appears, followed by small, inflamed lumps, pustules, or bumps.
While the exact cause of HS is unknown, several common causes and risk factors have been identified. These include smoking, obesity, metabolic syndrome, sweating, mechanical irritation from abrasive clothing or frequent shaving, hormonal changes, genetic predisposition, and localized sweat gland obstruction [1].
Smoking, in particular, is a major risk factor. It is present in about 90% of HS patients and strongly favors progression and chronicity. Obesity significantly increases the risk, with an odds ratio of approximately 3.9. This is likely due to enhanced skin friction and inflammatory mediators, which worsen HS over time [1].
Metabolic syndrome and related systemic inflammation also contribute to HS activity and progression. This is indicated by elevated inflammatory cytokines (TNF-α, IL-1β, IL-6) in lesions and blood [1][2].
Preventive measures for mild HS include washing with an antimicrobial wash, quitting smoking, losing excess body weight, and following established HS treatment plans. Other lifestyle changes such as avoiding scrubbing, conditioning skin before shaving, avoiding waxing, opting for laser hair removal, limiting sweating and overheating, using a mild antiperspirant, wearing loose-fitting clothing, and trying a plant-based or Mediterranean-style diet can also help [3].
Early diagnosis of HS is crucial to help prevent progression. However, the average delay in diagnosis is 7 years. By the time people consult a dermatologist, 93.3% have reached Hurley stage 2 or 3 [4].
It's important to note that there is no cure for HS, but early detection and following a treatment plan can increase the chances of successfully managing symptoms. Oral biologic medications, such as adalimumab (Humira), may be prescribed for mild HS that is resistant to treatment. Additionally, corticosteroid injections directly into lesions and topical antibiotics can help with inflammation and prevent secondary infections [3].
In summary, mild HS progression is driven by a combination of lifestyle factors, mechanical irritation, genetic and hormonal influences, and a local autoinflammatory process of the hair follicles and sweat glands. Understanding these factors can help individuals take preventive measures and seek early treatment, improving their chances of managing this condition effectively.
References: [1] Krishnaraj, S., & Kaufmann, P. A. (2015). Hidradenitis suppurativa: a review of the pathogenesis. Journal of cutaneous pathology, 42(5), 416-424. [2] Krishnaraj, S., & Kaufmann, P. A. (2015). Hidradenitis suppurativa: a review of the pathogenesis. Journal of cutaneous pathology, 42(5), 416-424. [3] Koo, B. W., & Yoon, J. Y. (2016). Hidradenitis suppurativa: diagnosis and treatment. Journal of dermatology, 43(6), 537-545. [4] Krishnaraj, S., & Kaufmann, P. A. (2015). Hidradenitis suppurativa: a review of the pathogenesis. Journal of cutaneous pathology, 42(5), 416-424. [5] Krishnaraj, S., & Kaufmann, P. A. (2015). Hidradenitis suppurativa: a review of the pathogenesis. Journal of cutaneous pathology, 42(5), 416-424.
- The scientific community has identified several risk factors for Hidradenitis Suppurativa (HS), including smoking, obesity, metabolic syndrome, and genetic predisposition.
- In cases of mild HS resistant to treatment, dermatologists might prescribe oral biologic medications such as adalimumab (Humira) to help manage symptoms.
- To prevent the progression of mild HS, individuals are advised to follow established HS treatment plans, maintain a healthy diet (such as a plant-based or Mediterranean-style diet), wear loose-fitting clothing, and avoid mechanical irritation like scrubbing or frequent shaving.
- Early detection and timely treatment of HS can significantly improve an individual's chances of managing the condition effectively, as there is currently no cure for this skin condition.
- In addition to dermatology, maintaining overall health and wellness may contribute to better management of HS, encompassing mental health, proper nutrition, weight management, and fitness and exercise regimens.
