acne inversa | hidradenitis suppurativa | hidradenitis suppurativa treatment | hidradenitis suppurativa surgeryWhat is Hidradenitis Suppurativa or Acne Inversa?

Hidradenitis suppurativa, commonly referred to as acne inversa, is a severe inflammatory skin condition manifesting through blackheads and painful red bumps filled with pus that may persist for weeks or even months. This inflammatory skin condition is certainly amongst the most distressing and severe, which many sufferers find difficult to cope with both physically and psychologically. Although there is no known Hidradenitis suppurativa treatment, statistics show that there are certain acne treatment methods and specific Hidradenitis suppurativa surgery methods, which have an extremely low success rate as they do not address the causative factors.

Despite its name, this ailment is not really a type of acne, but a chronic disorder of a certain type of sweat gland called apocrine, characterized by similar symptoms to acne. The term ‘inversa’ is used to link the pathogenesis of this illness to acne, suggesting the localizations of the pustules and skin lesions – inverse to acne vulgaris. In other words, abscesses affect the armpits, groin and inner thighs as well as the anal area, these being the main locations of the apocrine glands. But other areas of the body, where skin tends to rub together or where hair follicles are found, can also be affected.

Why does Acne Inversa occur?

Hidradenitis suppurativa appears when the openings of the hair follicles and sebaceous glands become blocked with dead skin cells, fluid or oil released by the apocrine glands and bacteria existing on the skin’s surface. All these mixed substances become trapped under the skin and start pushing into the surrounding tissues. This leads, in the first stages of the diseases, to blackheads and small bumps called abscesses, which then develop into hard, puss-filled lumps and large draining lesions that can reach the size of golf balls.

The general symptoms and signs of this skin condition are small black spots appearing in pairs, tender bumps which usually enlarge and break after a while, draining pus, painful lumps which develop under the skin, get inflamed and persist for years and the leaking sores that trigger the formation of tunnels under the affected areas of the skin.

These skin lesions are extremely painful and often leave scars or open wounds that can only be reduced through specific Hidradenitis suppurativa surgery methods. Although it’s not known what exactly triggers the appearance of HS or what causes the flare-ups, it is thought that hormonal changes, stress, humidity, heat, excess weight and smoking play a role in this process. However, given the uncertainty about the causes of this skin condition, Hidradenitis suppurativa treatment alternatives are often unspecific and therefore can prove to be ineffective in the long run.

Hidradenitis Suppurativa Treatment Methods


Acne inversa treatment schemes often rely on the same remedies and methods used in managing other common types of acne, such as topical or oral acne medications and surgical removal of the skin lesions. Still, the recommended acne treatment methods are strongly linked with the severity of the manifestations, as mild cases of Hidradenitis suppurativa are generally managed through self-care measures such as warm compresses or regular washings using antibacterial soaps.

Antibiotics are prescribed for both short and long term treatments, as they help the body fight against infections, preventing the symptoms from getting worse and reducing the risks of future outbreaks. Non-steroidal anti-inflammatory drugs (NSAIDs) are also recommended for alleviating the pain and reducing the swelling of the affected skin areas, while corticosteroids are used for reducing the inflammation in the early stages. Birth control pills and oral retinoid medications, taken to stop the oil production in the sebaceous glands, may also be prescribed.

In severe cases with persistent symptoms, deep lesions and disabling pain Hidradenitis suppurativa surgery is the only realistic option for eliminating the abscesses and reducing the discomfort. The typical procedure consists of three stages: the first stage involves the lump’s incision and drainage of the accumulated pus. The second stage refers to the surgical removal of the lesions together with the tracts and tunnels formed under the skin. Unfortunately, none of these two steps prevents new lumps from occurring in other areas of the body so in some patients the third stage is the only solution for getting long-term relief from the symptoms.

This last surgical Hidradenitis suppurativa treatment alternative involves the complete removal of all the skin areas affected by abscesses and sores, followed by direct closure of the wounds with skin grafts. In order to do this, smaller or larger skins flaps are removed from one area of the body (usually a less visible one) and attached to another region. The procedure and the recovery period are very painful and lots of patients require additional plastic surgery interventions to get rid of all the scars left by acne inversa.

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