Hidradenitis Suppurativa

Hidradenitis Suppurativa (HS) is a skin condition that results in expanding tender lumps in the folds of the skin generally in the armpits and groin area.  Painful skin lesions, nodules and boils can appear in these inflamed areas, and usually occur in areas of the body where certain sweat glands (known as apocrine sweat glands) are located. Other sites include areas under the breasts, on the buttocks and inner thighs, where the skin rubs together. Lumps that are close together can bond together under the skin.

It is estimated that over 1 million Canadians are currently living with HS, however, the exact number is not known since HS is often misdiagnosed and many who are living with HS don’t seek out a dermatologist for help.

Fast Facts

• Around 3.8% of Canadians have HS
• It is not contagious
• It can be hereditary
• It usually starts around puberty but it can start in childhood
• Stress management, loose clothing, losing excess weight and smoking cessation can relieve symptoms.

Causes

The exact cause of HS is not known. Multiple genetic and environmental factors appear to play a role.  The onset around puberty suggests that hormones contribute to disease process probably through plugging of hair follicles where the apocrine sweat glands are located.  HS is not an infection, rather it is a chronic skin condition. It is important to note that HS is not contagious and is not caused by poor hygiene.

HS commonly occurs in teens, young adults in their early 20s, but can occur at any age.  Women are more likely to develop HS than men.  Research has shown that HS may run in families, as 1/3 of HS patients have a family member who is also living with the condition.  Other factors that can play a role in developing HS are smoking and being overweight.

HS can be associated with other conditions such as arthritis, severe acne, depression, metabolic syndrome, anemia and inflammatory bowel disease. 

In 2017, The Canadian Skin Patient Alliance (CSPA) conducted a literature search and survey of patients with HS (formally diagnosed or self-diagnosed) to answer critical questions regarding gaps in patient care, and deficiencies in provincial healthcare systems. The focus of this research was to describe the patient experience from diagnosis and beyond, including a path to diagnosis, symptom control, experience with treatments, healthcare utilization, patient needs, and impact on the quality of life.

You can read this report here:  Scarred for Life:  A National Report of the Patient Experience Living with Hidradenitis Suppurativa