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Hidradenitis Suppurativa Information Page

This page has been developed by the Tissue Viability Team at NHS UHNM to raise awareness of Hidradenitis Suppurativa (HS).

What is Hidradenitis Suppurativa (HS)?

Hidradenitis Suppurativa is a chronic, inflammatory skin disease that causes recurrent and painful nodules, boils, abscesses and lesions of the skin. It is estimated to affect at least 200,000 people in the United Kingdom.

Early warning signs of HS include:

  • Clusters of blackheads, especially if you notice small pits or tiny tunnels in your skin with a blackhead in each one.
  • Single or multiple lumps that look like boils, often found in the armpits, groin, buttocks, and thighs. These lumps can appear anywhere on the body. They may burst and drain pus before healing, leaving scars.

More serious signs of HS include:

  • Multiple lumps that become swollen, burst, and drain continuously.
  • Tunnels under the skin, called sinus tracts. You may be able to feel these, or sometimes they aren’t noticeable. Pressing on affected areas can cause pus to drain from other parts of the skin.
  • Large, painful lumps, which can grow to the size of golf balls, lemons, or even grapefruits. This can be very painful and may require urgent medical care.
  • Scarring that’s rope-like or knotted, caused by the tunnels and inflammation. These scars can limit movement and be very painful.

How is HS diagnosed?

It’s important to seek medical advice as soon as you notice signs of HS. There’s no blood test for HS, so your physician will examine the lesions and ask about your symptoms. You will likely be referred to dermatology or the tissue viability team.

The Dessau Criteria can be used to confirm the diagnosis. Your doctor will check:

  • If you have typical HS lesions (nodules, sinus tracts, scarring)
  • How often the lesions occur (more than twice in the last 6 months)
  • Which areas are affected (commonly the armpits, buttocks, groin, thighs, genitals, and sometimes breasts, chest, back, neck, or behind the ears)
  • Your family history – Signs of inflammation, redness, pain, and ease of movement

The doctor will confirm the diagnosis, assess the severity, and discuss treatment options.

Treatment options

HS treatments aren’t one-size-fits-all, and that’s a good thing. It means that you can work with your health care provider to find the right HS treatment (or combination of treatments) for you that reduces symptoms. Some options are:

  • Medicines (topical or systemic)
  • Surgical procedures
  • Complementary and alternative medicine
  • Advanced wound care including dressing retention systems

Support

  • Talk with close friends, family or healthcare professional.
  • Join online communities. Search: hidradenitis suppurative support group on Facebook.
  • Prioritise your well-being and self-care
  • Eat nutritious food
  • Try to get regular exercise especially to support your mental health

Websites:

https://www.hs-foundation.org/

https://www.nhs.uk/conditions/hidradenitis-suppurativa/

https://www.bad.org.uk/pils/hidradenitis-suppurativa/

https://patient.info/skin-conditions/hidradenitis-suppurativa-leaflet

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