A patient came into the clinic today and said she had a couple lumps in her left armpit (axilla) that have been very painful and draining some clear liquid. She told me that she had one before in her right arm pit and she had it treated by taking antibiotics and a doctor also performed an incision and drainage.
Hidrandenitis suppurativa (HS) is a condition in which there is red, swollen painful bumps in places where the skin rubs together. The nodules can make it difficult to move because they are so painful. They can also smell foul and drain pus or blood. These bumps may go away on their own, but often stay for weeks to months and often come back.
Causes: This is not caused by being unclean – it’s not an infectious disease. Often the area may become irritated by shaving in that area or a certain deodorant or antiperspirant. You cannot spread this to anyone else as it’s not contagious. It is generally a genetic condition that is more common in first-degree relatives that have the condition.
The bumps or nodules are usually located in the:
1) Armpits (axilla)
2) In the groin
3) Under the breasts (in women)
4) On the inner thighs
5) Buttocks
6) Around or near the anus
Often the skin hardens and scars around the painful nodules and some can form tunnels under the skin.
Treatment: Possible treatment options include:
1) Antibiotic liquids or gels that you put on the affected areas – these actually work to reduce inflammation rather than treat infection
2) Antibiotic pills – to reduce inflammation
3) Injections of steroid medications into the areas to bring down the inflammation
4) Some women take hormone treatments to improve their condition
5) Surgery
Things you can do to reduce your symptoms:
1) If you are overweight, lose weight because this condition is more common or severe in people who are overweight
2) Try to avoid activities that cause your skin to rub against itself
3) Do not wear tight-fitting clothes
4) For people with recurrent infections, the use of an antibiotic lotion such as clindamycin 1% applied to the area twice a day can help prevent recurrence.
5) Show and wash the tender areas everyday gently. Do not scrub with a washcloth, brush or loofah
6) Avoid smoking
7) Use antiperspirants rather than deodorants
8) Avoid exposure to hot, humid environments as much as possible
This document is for informational purposes only, and should not be considered medical advice for any individual patient. If you have questions please contact your medical provider.
I hope that you have found this information useful. Wishing you the best of health,
Scott Rennie, DO
Doctor Rennie's Blog 