Hidradenitis Suppurativa aka Acne Inversa

Typically, Hidradenitis Suppurativa is caused when the hair follicle is blocked due to unknown reasons. Experts say it could be due to smoking, genetics, hormones, etc. 

A few symptoms of Hidradenitis Suppurativa are as follows: 

• Blackheads, usually in pairs
• Pea-sized lumps that stay the same for weeks or months 
• Leaky sores that break open to release pus and odour
• Tunnels under the skin connecting the lumps 
• People who smoke and suffer from excessive weight are more likely to experience severe symptoms. 
• People in their teens and 20s are more prone to acne inversa. It can also be inherited.
• Individuals with severe acne, diabetes, arthritis, inflammatory bowel syndrome, and metabolic syndrome may also see more symptoms of this condition. 

In some cases, the symptoms are mild and stay the same.

Hidradenitis Suppurativa can go on for many years and may not be fully treated. Treatments focus more on reducing pain and minimizing the symptoms to provide relief. The treatment will depend on where the lumps have appeared and the severity of your case. Some of the treatment methods are:

• Warm Compress

Place a warm compress on the affected area for ten minutes every day or twice a day. This works when the symptoms are mild. 

• NSAIDs

Nonsteroidal anti-inflammatory drugs are OTC (over-the-counter) medicines to reduce pain and swelling. These are aspirin, ibuprofen, etc. However, don’t take more pills than necessary. 

• Oral Retinoids

Oral retinoid medicines like aci-tre-tin (So-ri-at-ane) or iso-tre-tin-oin (Acc-uta-ne) are prescribed when acne inversa is severe. This is prescribed when the condition cannot be managed through topical creams and compresses. 

• Antibiotics

Antibiotics like do-xy-cy-cl-ine or min-ocy-cli-ne are prescribed for several months to fight the infections in severe cases. The doctor will adjust the course based on your condition. 

• Corticosteroids

Corticosteroids are injected directly into the lumps every three months. If the condition persists, the doctor will use oral steroids for faster relief. 

• Hormone Therapy

Some women can find relief from Hidradenitis Suppurativa if they use birth control pills. However, this can lead to other side effects and is not always the first treatment choice. 

• Topical Resorcinol

Topical resorcinol is a type of chemical peel applied to the affected areas to reduce inflammation and lumps. 

• Biologics

Biologics are drugs that work on the immune system. Ad-ali-mu-mab is an FDA-approved (Food and Drug Administration) medicine to treat acne inversa. It is injected into the veins through the IV system. Biologics can have side effects when used in the long term and are prescribed only in rare cases. 

• Surgery 

The last option to treat Hidradenitis Suppurativa is to perform surgery to remove them. This is recommended for highly severe conditions with deep lumps in the skin. The surgery can be of different types. 

A simple surgery involves cutting open the bumps to release the pus and provide short-term relief. A grafting surgery is when skin from other body parts is transferred to the affected area after removing the lumps. Deroofing is a third type of surgery where the bumps are converted into scars so that they won’t hurt. This method is suitable if the lumps reappear often. 

• Laser Surgery 

This is the latest option to treat Hidradenitis Suppurativa by destroying the hair follicles in the affected area. You will need multiple sessions to burn the hair follicles completely and prevent the bumps from recurring.