Hidradenitis Suppurativa (HS), also known as Acne Inversa, is a chronic skin condition that is more common in women who have PCOS. HS that occurs in areas of the body with the most sweat glands. Acne inversa tends to develop after puberty and begins with mild symptoms often mistaken as regular acne. However, milder cases often take a turn for the worse, as the condition can progress without proper treatment.
Symptoms of Hidradenitis Suppurativa
The most common symptom to watch out for is sudden, painful skin breakouts that occur in areas of your body where you sweat the most. The breakouts will look like red, acne-like bumps and will most likely be painful. Other symptoms can also include:
- Deep nodules or cysts: These bumps can sometimes leak out a foul-smelling fluid.
- Blackheads: Clusters of blackheads may appear in sweaty areas like armpits, buttocks, and the scalp.
- Tunnels: Scarring that looks like tunnels connecting lumps may become apparent over time. These tend to heal slowly or not at all.
Hidradenitis Suppurativa and PCOS
Researchers have examined the records of 22,990 women in the United States and found that women who have Polycystic Ovarian Syndrome (PCOS) have a higher chance of contracting acne inversa. Because of this, it is recommended that females who have HS or PCOS get tested for one or the other. Additionally, excess testosterone and other androgens in women with PCOS has been associated with those diagnosed with HS. Therefore, strategies tackling lowering androgens for women with PCOS may also be effective in managing HS.
Hidradenitis Suppurativa Treatment Options
For mild cases, you can use warm compresses to bring down swelling. Your primary care physician may recommend over-the-counter medicine to help manage pain and swelling, such as aspirin and ibuprofen.
To treat more serious cases of HS you may want to see a dermatologist. Dermatologists can prescribe antibiotics like clindamycin combined with rifampin, taken continually for 2 to 3 months, which may help alleviate the breakouts or clear them up completely.
A physician could also inject corticosteroids directly into the bumps to decrease any inflammation. Medications that affect your immune system could also be used, such as the only FDA approved HS drug Adalimumab. Other options include hormone therapy and oral retinoids to manage the condition.
Although rare, severe cases of this condition will sometimes require surgery to be performed. Doctors may choose to incise the affected areas to provide short-term relief or use a method known as “unroofing,” which involves cutting away skin and flesh to provide a semi-permanent solution.
Improving Hidradenitis Suppurativa with Diet and Lifestyle
HS is associated with high androgens. Women living with PCOS and HS can improve their hormonal balance by following a PCOS friendly diet and following an exercise program that incorporates strength training, cardio and stress recovery.
Avoiding HS triggers like excessive sweating, smoking, and stress can go a long way towards managing the condition as well.
Improvements in healthcare and extensive research are invaluable in combatting HS, but for now, maintenance and self-care is the best option. Living with acne inversa may be difficult, but it doesn’t have to be too debilitating — HS’s effects are bearable for most with the right medical advice and the proper lifestyle.