Hidradenitis suppurativa: Signs and symptoms
If you have this skin disease, you may notice breakouts on your skin that look like pimples or boils. Your skin may clear for a while, but you notice new breakouts develop in the same area.
Unlike everyday pimples, hidradenitis suppurativa (HS) forms in areas where skin touches skin. HS is most common in these areas:
Underarms (one or both)
Groin (genitals, around the anus, and surrounding area)
Women’s breasts (underneath and sometimes on the breasts)
Although rare, a few studies have found HS near an ear or around the bellybutton. There have also been a few cases of HS appearing on the face, neck, or back.
Women tend to get breakouts on their genitals and upper thighs. Men are more likely to have HS on their genitals and around the anus.
Some people develop breakouts in the exact same spot each time. For others the breakouts appear in the same area, but never seem to be in the exact same spot.
In its earliest stage, hidradenitis suppurativa often looks like boils or pimples (left), but with time thick scars can form (right).
Early signs and symptoms
When people first get hidradenitis suppurativa (HS), they often see:
One (or several) breakouts that look like pimples or boils
Breakouts may stay on the skin; sometimes, they clear and reappear
Later signs and symptoms
Without treatment, HS can worsen. If this disease progresses, the person may develop:
Painful, deep breakouts that heal and reappear
Breakouts that rupture and leak a foul-smelling fluid
Scars that form as breakouts repeatedly heal and reappear
Scars that become thicker with time
Skin that begins to look spongy as tunnel-like tracts form deep in the skin
Skin cancer (rare)
Signs and symptoms can change
The signs and symptoms of HS can change quickly. One week, a person may have a foul-smelling fluid leaking from breakouts. The next week, the breakouts have cleared and scars are the only sign of HS.
Some people always have breakouts on their skin.
Skin cancer risk
HS develops on skin that tends to get little or no direct sunlight. Yet, a few people have developed squamous cell carcinoma, a common type of skin cancer, where they had HS breakouts and scarring for years. Most cases developed in men who had long-standing HS on their genitals or around their anus.
Treatment helps prevent long-standing HS.
Quality of life affected
Without treatment, HS can continue its cycle of breakouts and healing. As the breakouts clear, scars form. Continual healing and scarring can cause hollow passages called fistulas to develop inside the body. Fistulas can be painful and require surgery to repair.
People who have a foul-smelling liquid draining from the breakouts can feel embarrassed. They may feel too embarrassed to see a doctor. Dermatologists understand this. You should not feel embarrassed to see a dermatologist about this problem.
Images used with permission of the Journal of the American Academy of Dermatology. (J Am Acad Dermatol 2009;60:539-61.)
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