What is hidradenitis suppurativa (Verneuil's disease, or HS)?

Hidradenitis suppurativa was first documented in 1854. This chronic skin disease is characterised by painful nodules and abscesses which can degenerate into pus discharge, sinus tracts and hypertrophic scarring. These nodules and abscesses are generally located near major skin folds (groin, armpit, chest…), were the apocrine sweat glands can be found.

This disease affects around 1% of the population, predominantly women (3 women for 1 man), and usually appears after puberty. There are 3 stages of the disease, also know as the Hurley staging system. The 3 stages characterise the different types of HS: Stage 1: Solitary or multiple isolated abscess formation without scarring or sinus tracts

Stage 2: Recurrent abscesses, single or multiple widely separated lesions, with sinus tract formation

Stage 3: Diffuse or broad involvement across a regional area with multiple interconnected sinus tracts and abscesses

What are the symptoms of hidradenitis suppurativa?

The cause of this disease remains unknown, but two events can participate in the apparition of these nodules: an inflammation of the sweat glands, and a hyperkeratosis of the hair follicles.

Sometimes, an infection appears on top of the inflammation process. Indeed, the plugged sweat gland of hair follicle facilitate the proliferation of germs, the dilation of the follicle and the diffusion of the infection to the deep hypodermis.

The disease evolves by outbreaks of inflammation. It can be triggered by several factors:

Hormones : women often have outbreaks during their menstrual periods. Their severity decreases after menopause

Smoking : 70% of patients are smokers

Excess weight : the proportion of overweight persons is over-represented in patients suffering from HS. Indeed, excess weight exacerbates the disease through mechanical irritation around skin folds, which triggers outbreaks. It can also be the sign of a metabolic anomaly

Stress and tiredness : these factors trigger the disease

Lastly, 20 to 30% of patients suffer from a genetic factor, with sometimes a severe autosomal dominant form of the disease.

How can hidradenitis suppurativa be treated?

Topical

Using topical antibiotics such as fusidic acid or clindamycin can have good results on the treatment of nodules.

Systemic

This treatment consists of an antibiotherapy to manage the outbreaks, with short or long-term treatments which can help prevent the flares and reduce their frequency and intensity.

The preferred molecules are usually tetracycline, macrolides (erythromycine, azithromycine, …), beta-lactamines (amoxicilline and clavulanic acid), clindamycin, rifampicin, fusidic acid or fluoroquinolones. Zinc gluconate has shown good results on less severe forms of the disease.

Studies are registered to evaluate the efficiency of TNF inhibitors on HS.

Surgery

Surgery is the only efficient solution for severe forms of HS or resistant to medical treatment.

These acts can more or less serious, depending on the extent of the lesions : they range from a removal under local anaesthesia to a wide surgical excision for the stage 3 severe forms.

These surgeries can request a skin graft, and it may be needed to operate a zone several times to remove all lesions, sinus tracts or sweat glands triggering the outbreaks.

How can skin with hidradenitis suppurativa be relieved?

A critical part of the surgery process is the postoperative tissue healing. Using a pure and efficient hydrating product can improve the tissue healing and help regain a healthy and supple skin.

The Skintifique Moisturizing Balm may be the best product on the market for this.

It hydrates and soothes very efficiently, and the results on people having tested this product are excellent. 

he active ingredients used in this gel create an extremely strong and lasting long term hydrating and soothing effect. Also, this product is composed of a limited number of ingredients, all selected carefully so as to minimize the risk of unwanted reactions.

Also, it contains no paraben, silicone, mineral oil, perfume, EDTA, corticosteroids or cortisone.