Hidradenitis Suppurativa (HS)

Hidradenitis suppurativa, known as acne inversa, is like acne on steroids. It attacks places on your skin prone to chafing. If left untreated, you may develop scars. Don’t let it get that bad. At the first sign of symptoms, call Manhattan Dermatology Specialists on the Upper East Side or in Union Square. Dr. Susan Bard addresses your symptoms and treats the condition to keep HS away.

What Is Hidradenitis Suppurativa?

Hidradenitis suppurativa (HS), also known as acne inversa, is a chronic skin condition. HS usually begins after puberty and tends to follow a long-term, recurring pattern. It causes painful bumps, abscesses and tunnels to form under your skin, usually in areas where your skin rubs together, such as your:

• Underarms
• Groin
• Inner thighs
• Buttocks
• Under-breast areas

Acne inversa starts when your hair follicles become inflamed, leading to the formation of tender nodules. These nodules may create pustules, which can rupture and leave scars. As the condition progresses, you notice tunnel-like tracts beneath your skin. While hidradenitis suppurativa affects both men and women, women tend to experience it more often.

For effective HS treatment, find the best dermatologists in Manhattan at Manhattan Dermatology Specialists. With two offices — one on the Upper East Side and one in Union Square — they make it easy to get an accurate diagnosis and effective treatment for hidradenitis suppurativa.

What Causes Hidradenitis Suppurative?

Hormonal, genetic and environmental factors contribute to HS. If you have hidradenitis suppurativa, it’s not because of poor personal hygiene or anything you did or didn’t do. Acne inversa is a chronic condition that’s triggered or exacerbated by your body’s internal imbalances and immune responses. It’s influenced by factors that include:

• Hormonal shifts. Puberty may trigger HS, due to hormonal changes.
• Family history. If you have a close relative with HS, that increases your risks.
• Your immune system may overreact, blocking hair follicles and causing flare-ups.
• Obesity and friction. Extra weight means more sweat and skin rubbing, which triggers HS.
• The use of tobacco leads to increased inflammation and slower healing.
• Sweat and bacteria. Though not root causes, these factors irritate blocked follicles to trigger symptoms.

Becoming aware of the triggers helps you manage your HS. You may find that it’s difficult to wear certain clothing or perform some physical activities due to the pain of flare-ups. If you catch changes in your skin early, especially during hormonal shifts or lifestyle changes, you can learn to control your symptoms.

What Symptoms Can I Expect?

You may notice painful, tender bumps under your skin. These lumps often turn into pus-filled abscesses that drain fluid that sometimes has an unpleasant odor. They look like pimples or ingrown hairs at first, but over time, they grow deeper and more painful. Other symptoms include:

• Recurrent breakouts and red spots in the same locations
• Thickened skin or scarring over time
• Tunnel-like tracts under the skin
• An itching or a burning sensation
• Blackheads in small, pitted spots, usually in pairs

At Manhattan Dermatology Specialists, Dr. Susan Bard provides expert, personalized care to manage your symptoms. This board-certified dermatologist starts by reviewing your medical history. Then she asks about the timing, location and frequency of your symptoms. No lab tests are usually needed. If there’s any drainage, your NYC dermatologist may take a sample for lab testing.

What Are the Treatment Options for Hidradenitis Suppurativa?

Managing hidradenitis suppurativa often requires a tailored approach, based on the severity of your symptoms. Dermatologists often combine medication, lifestyle changes and medical procedures to manage your symptoms. Hidradenitis suppurativa options may include:

• Topical and oral antibiotics that control infection and inflammation
• Steroid injections to reduce swelling in painful areas
• Hormonal therapy to manage flare-ups linked to hormone changes
• Retinoids that deal with acne-like symptoms
• Botox injections to control excessive sweating
• Biologics targeting your immune system, in moderate-to-severe cases
• Pain relief options, based on the severity

Sometimes, surgery is necessary, especially when tunnels, lumps or abscesses develop. The right surgical procedure depends on how widespread and severe your condition is. Acne inversa treatments may include:

• Unroofing, which exposes the tunnels in your skin for long-term relief
• Punch debridement, which targets and removes a single lesion
• Laser therapy, which uses a medical-grade laser to eliminate lesions
• Surgical removal, which involves excising the affected skin
• Incision and drainage, which offers short-term pain relief only

What Lifestyle Changes Help Manage Hidradenitis Suppurativa Symptoms?

Adopting certain lifestyle changes may reduce your discomfort, lower flare-up frequency and improve your quality of life. Maintaining a healthy body weight is beneficial because excess weight increases skin friction and sweating. Losing even a small amount of weight reduces inflammation and eases pressure on skin folds. Other lifestyle changes include:

• Wearing soft clothing
• Quitting smoking
• Managing your stress levels
• Keeping your skin clean and dry
• Eating an anti-inflammatory diet
• Avoiding harsh hair removal methods
• Staying physically active
• Monitoring your triggers

If you’re struggling with hidradenitis suppurativa, you deserve a dermatologist who delivers effective results. Dr. Bard at Manhattan Dermatology Specialists provides expert care for chronic skin conditions like acne inversa. She develops an individualized treatment plan that addresses your symptoms and supports long-term healing. Whether you’re in the Upper East Side or near Union Square, contact Manhattan Dermatology Specialists to start feeling better in your skin.