The condition hidradenitis suppurativa may also be referred to as acne inversa or apocrine cysts. However, regardless of which name is used, hidradenitis suppurativa symptoms and treatments are the same. It is a long term, chronic condition that affects the apocrine sweat glands, leading to their inflammation and the production of large amounts of pus, which will sometimes leak out onto the skin.
There are three stages to the disease, each increasing in severity. Not all patients will progress to stage 3 hidradenitis suppurativa symptoms, which are most severe.
Stage 1 hidradenitis suppurativa is the mildest form of the condition. It begins when the apocrine sweat glands become blocked, leading to the build up of sweat in the narrow tubes that lead to the skin. This stage has a small number of abscesses underneath the skin, usually in the groin and armpit areas, due to the high number of hair follicles. These follicles can also become blocked, and because these regions of the body are warm and moist, the conditions are ideal for bacteria to flourish.
The bacteria will then act on the pus, breaking down some of the substances it contains and releasing the foul stench that is commonly associated with hidradenitis suppurativa. It is a common misconception that the smell is linked to a poor level of hygiene – this is not the case, and washing every day will not be able to eliminate this symptom.
Stage 2 hidradenitis suppurativa is more severe, with recurrent abscesses that heal and then develop again in the same places. These will be more extensive than in stage 1, and some sinus tracts will be starting to form between the abscesses. Sinus tracts are pus-filled channels underneath the skin that link the abscesses and cysts. These tracts may sometimes open up and leak pus onto the surface of the skin.
Stage 3 is the most severe form of this condition. At this point, the abscesses will be large and extremely widespread across the worst-affected areas. They may also be starting to spread to other parts of the body, so you may find them developing on the buttocks, inner thighs, and parts of the chest and back. These large cysts are also likely to be exceedingly painful, and they will probably be linked by a network of sinus tracts that leak large amounts of pus. Some stage 3 hidradenitis suppurativa patients find that the leaking of pus is almost continuous. Severe scarring will also be present, once some of the abscesses have healed.
Treatment of this condition primarily involves the management of the symptoms, and this must be done on a continuous basis. In order to minimise the extent and size of the abscesses, a combination of anti-inflammatories and antibacterial substances will be needed. You can choose to use either natural remedies or prescribed treatments, though it may be best to try several different options and see which is the most effective for you.
Not everybody responds in the same way to the treatments, and it would be best to avoid antibiotics as much as possible, in order to reduce the chances of antibiotic resistance developing. This means that during a severe flare up, you will still respond to the medications.
Maintaining a healthy diet can also help to control your symptoms on a long term basis. If you smoke or are overweight, then it would be beneficial to address these issues as soon as possible, as these both make the hidradenitis suppurativa symptoms much more severe. Losing some of the excess weight and giving up smoking are two extremely effective ways to reduce your discomfort.