Hidradenitis Suppurativa (HS) Skin Condition Pictures

Understanding Hidradenitis Suppurativa (HS) Through Pictures

Hidradenitis suppurativa (HS) is a long-term skin condition that causes painful bumps and abscesses to form in folds or creases of the body, like the armpits, groin, between the buttocks, and under the breasts. These lesions tend to recur, often leaving extensive scarring and skin damage.

HS remains poorly recognized and undiagnosed in many cases. Images showing what HS skin lesions look like in different body areas and stages can help patients identify when to seek medical care for this challenging chronic disease.

Early Stage HS Skin Lesions

During initial phases, HS first appears as:

Red Bumps and Pimple-Like Lesions

Small, tender red bumps emerge that resemble pimples, boils, or even insect bites. They typically form in areas of skin folds and friction like the armpits, below breasts, inner thighs, genital area, and buttocks cleft.

Painful Nodules Under the Skin

These can feel like hard or rubbery lumps ranging from pea-sized to several centimeters wide sitting under the skin layers. Nodules cause discomfort and restrict movement in adjacent joints and tissues.

Leaking Pus and Fluid

As lesions grow, many ooze small amounts of blood-tinged fluid or pus due to localized infection and inflammation. Some itch intensely while others feel hot and tender.

These early small lesions often resolve temporarily after leaking only to recur in the same or nearby areas as HS progresses.

Moderate Stage Hidradenitis Suppurativa Skin Damage

With time, untreated HS skin lesions increase in size, frequency, and severity with more extensive infections, swelling, tunnels, and scars forming.

Interconnected Abscesses and Tunnels

Ruptured lesions can create sizable, hollowed out pockets under the skin up to several inches deep filled with pus and debris. New lesions often connect with old wounds.

Expanding Areas of Inflammation and Swelling

Large, warm, reddened zones of skin become raised and swollen surrounding active abscess formation. This inflamed tissue can spread widely and feel extremely painful.

Draining Sinus Tracts

Draining channels or tunnels may form from deeper lesions traveling to the skin surface causing copious leakage of fluids rich in bacteria, white blood cells, and cell debris.

Advanced Stage HS Skin Damage and Scarring

After years living with uncontrolled HS inflammation, the affected skin areas undergo profound architectural damage and disfiguring scars.

Widespread Scar Tissue

Repeated HS lesion formation, infections, and healing attempts eventually replace normal soft skin tissues with extensive bands of tough, ropy fibrosis and scar tissue.

Skin Contour Deformities

Proliferating scar collagen distorts and disfigures skin shape in affected body zones. The armpits or groin creases flatten abnormally while rigid skin restrictive bands can impair limb mobility.

Fistulas and Skin Fragility

Large, irregular epidermal fistulas lined with distorted scar tissue may persistently leak fluid. Surrounding fragile skin prone to new wounds that won't heal tears or cracks open easily.

What Triggers HS Flare Cycles

Doctors don't know exactly what prompts hidradenitis suppurativa flare ups but suspect the following factors play a role:

• Hormones - HS often emerges after puberty, with symptoms worsening before periods
• Genetics - 30% of people with HS have an affected family member
• Obesity and metabolic syndrome
• Smoking
• Heat, sweat retention, and skin friction
• Skin microbiome alterations
• Immune system abnormalities

HS is not caused by poor hygiene. Flare cycles seem triggered when predisposed sites endure minor skin friction, shaving, sweat retention, or introduction of bacteria like common skin germs into vulnerable pores and glands.

Getting an Accurate HS Diagnosis

Unfortunately hidradenitis suppurativa gets frequently misdiagnosed as routine boil or cystic acne outbreaks for years before patients learn what’s truly causing their chronic lesions. Getting correctly diagnosed involves:

Clinical Evaluation of Lesion Patterns

An experienced dermatologist identifies signature HS signs like location in body folds, recurrent abscess and tunnel formation with scarring that differ from sporadic pimples or boils.

Assessing Phase and Severity

Doctors grade the extent of current skin damage and count active lesions to classify HS as mild, moderate or severe using validated measures like the Hurley staging system.

Ruling Out Look-alike Conditions

Doctors must exclude similar presenting skin disorders like pilonidal cysts, acne vulgaris, granuloma, or skin infections causing recurrent abscesses and drainage.

Once a clear HS diagnosis is made, additional testing like bloodwork, cultures or skin biopsies may further evaluate known HS complications or treatment considerations.

Hidradenitis Suppurativa Treatment Options

HS has no definitive cure, but various treatments aim to prevent new lesions, resolve current ones, curb infections, reduce scarring severity, and manage pain or drainage.

Early Supportive Wound Care

Keeping lesions clean, exudate-free and uninfected while promoting healing includes antibiotic soaks or compresses, bandages, gentle debridement, and non-irritating topical antibacterials.

Prescription Anti-Inflammatory Medications

Powerful injections, oral or topical anti-inflammatory drugs like biologics, retinoids, or cytokine inhibitors may be prescribed to calm HS inflammation and suppress the immune defects driving flare ups.

Antibiotics for Infection Prevention

Oral antibiotic courses lasting from weeks to over a year along with topical antibiotics reduce HS-related infections and may have anti-inflammatory effects. Antiseptic body washes also help.

Surgery to Remove Severe Lesions and Scar Tissue

Various surgical techniques can eliminate troublesome HS lesions, draining tunnels, dysfunctional glands and extensive scar tissue. Recurrence risk remains but surgery provides substantial symptomatic relief for many HS patients.

Coping With HS Pain and Drainage

Even with medical therapies, living with hidradenitis suppurativa often means enduring considerable day-to-day discomforts like:

Significant Pain

HS lesions frequently cause throbbing, stinging pain disrupting sleep, concentration, exercise and work. Pain medication tailored to each case brings relief.

Perpetual Exudate Management

Continual wound drainage necessitates wearing gauze, absorbent pads and loose, breathable clothing to remain productive and socially engaged.

Struggles With Mobility and Flexibility

Skin damage under arms, around thighs or between buttocks hinders comfortable movement critical for most jobs, travel, fitness and recreation.

Counseling and support groups help many gain perspective and learn hands-on coping strategies from those living happily with HS.

The Outlook for People With Hidradenitis Suppurativa

With newer medical therapies and surgical options, the long term outlook for HS patients continues improving. Combining persistent skin care, lifestyle adjustments and stress-relief practices empowers many to manage symptoms and enjoy full, active lives despite battling this puzzling skin disease.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.