Severe Hidradenitis Suppurativa

Severe Hidradenitis Suppurativa

Hidradenitis suppurativa (HS), otherwise known as ‘acne inversa’, is a chronic skin condition that mainly affects the armpits, groin, and buttocks, as well as other body areas. It causes tracts of lumps and boils to form under the skin, which can be extremely painful and lead to serious infections. While it’s relatively rare, it can be very debilitating for those people who have it.

Severe hidradenitis suppurativa is a particularly serious form of the condition. It is estimated to affect around 1-4% of the population and can have a big impact on quality of life for those affected by it. The symptoms of severe hidradenitis suppurativa can range from mild discomfort to severe pain and infection, which can even lead to hospitalization. In some cases, the condition can become disabling and may require surgery.

Symptoms of Severe Hidradenitis Suppurativa

The common symptoms of severe hidradenitis suppurativa include:

  • Tunnel-like tracts or sinus tract under the skin
  • Painful, inflamed lumps, or abscesses, typically near hair follicles of the armpits, groin and—for women—the breasts
  • Boils that ooze pus or blood
  • Foul smell
  • Scarring

The abscesses associated with severe hidradenitis suppurativa can sometimes become very large, making them difficult to manage. In some cases, they can burst and spread the infection to other parts of the body.

Treatments for Severe Hidradenitis Suppurativa

The goal of treatment of severe hidradenitis suppurativa is to reduce the inflammation and pain, decrease the number of lumps, and prevent or reduce infection. Treatment typically includes a combination of different therapies, such as:

  • Topical creams and ointments
  • Antibiotics (oral or topical)
  • Pain relievers
  • Hormonal therapy
  • Immuno-modulating drugs
  • Radiation therapy
  • Cryosurgery (freezing)
  • Mesotherapy (injections to increase healing)
  • Surgical excision of the lumps

In cases of severe hidradenitis suppurativa, surgery may be necessary to remove the affected tissue. Surgery can be a very effective way to get rid of the lumps and abscesses, reduce the risk of infection and help to improve quality of life. In cases of extensive scarring, skin grafts may be necessary.


Hidradenitis suppurativa is a chronic and often debilitating skin condition that affects 1-4% of the population. Severe cases can have a significant impact on a patient’s quality of life, causing pain and infection and even leading to hospitalization. However, there are a range of treatments available that can help to reduce symptoms, control infection and improve quality of life.