Thursday 30 May 2019

Everything You Need To Know About Hidradenitis Suppurativa

I've briefly mentioned on the blog before about living with two chronic skin diseases - Psoriasis and Hidradenitis Suppurativa (also known as HS for short), the latter being a disease I have only just learnt how to pronounce properly, and one I still can't spell without the internet's help. I've had psoriasis since I was a teenager and developed HS when I was a young adult, however I was only officially diagnosed with HS around two years ago.

Whilst lots of people may know, or at least heard of psoriasis, Hidradenitis Suppurativa isn't very well known at all, and that's amongst the medical community too. It was only a few weeks ago I thought I was going to be admitted to hospital for another emergency operation, instead I went to my local walk-in clinic and explained to the doctors there what I had - as they, like many other medical professionals, including dermatologist are unaware of the condition. 

So, What Is Hidradenitis Suppurativa?
The British Skin Foundation describes Hidradenitis Suppurativa, or HS, as “a long term, recurrent and painful disease”. The disease causes inflammation of the skin, specifically areas that encompass apocrine sweat glands. Typically, these glands are located in the armpits, breast and groin. HS occurs when there is blockage obstructing the follicles in these areas, which can cause pus-filled lumps, abscesses and scarring; the direct cause is, however, unknown. The condition is only estimated to affect around 1% of the population.

HS is common in some areas more than others, but common places for flares to happen are the armpits, groin, buttocks and breast areas. However, no place is safe when living with HS, I have seen fellow sufferers develop HS on their face, neck, legs, stomach and even their genital areas, often the latter leaving them with misdiagnosis of STI's. 

What Causes Hidradenitis Suppurativa?
Research is yet to find the exact cause of the disease. There are many theories as to how it develops, but sadly none are proven to be definitive. The following are thought to be factors that may contribute.

Hormones may be involved in the control of apocrine sweat glands and might play a part in the disease. In women, HS can be worse before menstrual periods. Some patients may benefit from hormone treatments, which are detailed in the causes below:

• Obesity or weight issues
• Smoking
• Genetic disorders
• Repeatedly wearing tight, non-breathable clothing
• Hormone-affecting drugs, most noted are birth control or contraceptives
• Blocked sweat glands and excessive perspiration
• Trapped bacteria in a blocked gland
• Excess of sex hormones, an increase particularly in androgenic hormones or dysfunction of these hormones

As you can see from the image above, shaving my flaring armpit is almost impossible due to the risk of further infection, injury or just because of the sheer amount of pain and swelling, making what should be a relatively easy task, seeming impossible. 

How To Manage HS With Lifestyle Changes
Eating a healthy diet is not only a great lifestyle choice, but it can also help to prevent flare-ups. Certain foods are believed to cause bouts with HS, with the below thought to have an impact:

• Dairy• Sugary foods• Yeast• If you are Gluten intolerant, avoiding eating gluten can also prevent flare-ups

Foods rich in Fibre and Omega-3 are also thought to be great for easing HS symptoms. It is also advisable to not irritate the skin around affected areas, for example by shaving or wearing itchy clothing. Some individuals report that acupuncture and taking steps to reduce stress have resulted in fewer flare-ups, however this is more of an individualistic approach than a widely-known tactic.

Treating HS
Treatment very much depends on the affected individual. You should speak to your GP or Dermatologist if you begin exhibiting any of the aforementioned symptoms.

Painkillers that have anti-inflammatory properties like Ibuprofen and other NSAID’s (non-steroidal anti-inflammatory drugs) can help to reduce pain and swelling. If the affected area has become infected antibiotics may be prescribed to reduce infection. Some doctors may also prescribe long-term antibiotics such as Tetracycline and lymecycline. These are often prescribed to ward off acne, yet they serve a similar purpose in trying to prevent further flare-ups.

Surgical treatment may be required to relieve the pus. If there are persistent attacks in a specific area, surgery may be considered to remove repeatedly affected areas. I had an emergency operation for one of my HS flares as the abscess was just getting bigger and bigger with no sign of it draining, no matter what I tried. It got to the point where I couldn't even leave my arm in its natural resting place because of the pain and pressure it was putting on my armpit. I was having to constantly hold my whole arm away from my body. 

Antibacterial products, like moisturisers and scrubs, can be prescribed to reduce further inflammation and irritation.

Some skincare professionals may offer new special treatments that they feel can work in your particular case. Speak to a skincare professional to see what treatments they offer and whether they will benefit your HS.

Until next time,
Jada x

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