Hidradenitis suppurativa is inflammation of the apocrine sweat glands, resulting in painful accumulations of pus under the skin.
Hidradenitis suppurativa develops in some people after puberty because the apocrine sweat glands (the specialized sweat glands under the arms, in the genital area, around the anus, and under the breasts) are chronically blocked. Doctors do not know why the blockage occurs, but it is not related to the use of deodorants or powders or to underarm shaving. The blockage causes the glands to swell and rupture, frequently leading to infection by various bacteria. The abscesses (pus-filled pockets) that result are painful and foul smelling and tend to recur. After several recurrences, the skin in the area becomes thick and scarred.
Hidradenitis suppurativa resembles common skin abscesses. A doctor makes the diagnosis based on the location of the abscesses and on the fact that they recur often.
For people with mild cases, a doctor injects corticosteroids into the area and prescribes antibiotics, such as tetracycline or erythromycin, to be taken by mouth. Clindamycin applied topically is also effective. In some cases, a doctor cuts open the abscesses to drain the pus. For severe cases, isotretinoin, an anti-inflammatory drug, may be given by mouth. Laser treatment has also been used. In severe cases, cutting out the involved area followed by skin grafting may be necessary.
Last full review/revision October 2007 by A. Damian Dhar, MD, JD