Hidradenitis Suppurativa, Sweat Gland Abscess

Hidradenitis suppurativa is a long lasting (chronic), uncommon disease of the sweat glands. With this, boil-like lumps and scarring develop in the groin, some times under the arms (axillae), and under the breasts. It may also uncommonly occur behind the ears, in the crease of the buttocks, and around the genitals.

CAUSES

The cause is from a blocking of the sweat glands. They then become infected. It may cause drainage and odor. It is not contagious. So it cannot be given to someone else. It most often shows up in puberty (about 10 to 12 years of age). But it may happen much later. It is similar to acne which is a disease of the sweat glands. This condition is slightly more common in African-Americans and women.

SYMPTOMS

  • Hidradenitis usually starts as one or more red, tender, swellings in the groin or under the arms (axilla).

  • Over a period of hours to days the lesions get larger. They often open to the skin surface, draining clear to yellow-colored fluid.

  • The infected area heals with scarring.

DIAGNOSIS

Your caregiver makes this diagnosis by looking at you. Sometimes cultures (growing germs on plates in the lab) may be taken. This is to see what germ (bacterium) is causing the infection.

TREATMENT

  • Topical germ killing medicine applied to the skin (antibiotics) are the treatment of choice. Antibiotics taken by mouth (systemic) are sometimes needed when the condition is getting worse or is severe.

  • Avoid tight-fitting clothing which traps moisture in.

  • Dirt does not cause hidradenitis and it is not caused by poor hygiene.

  • Involved areas should be cleaned daily using an antibacterial soap. Some patients find that the liquid form of Lever 2000®, applied to the involved areas as a lotion after bathing, can help reduce the odor related to this condition.

  • Sometimes surgery is needed to drain infected areas or remove scarred tissue. Removal of large amounts of tissue is used only in severe cases.

  • Birth control pills may be helpful.

  • Oral retinoids (vitamin A derivatives) for 6 to 12 months which are effective for acne may also help this condition.

  • Weight loss will improve but not cure hidradenitis. It is made worse by being overweight. But the condition is not caused by being overweight.

  • This condition is more common in people who have had acne.

  • It may become worse under stress.

There is no medical cure for hidradenitis. It can be controlled, but not cured. The condition usually continues for years with periods of getting worse and getting better (remission).