If your hair follicles get blocked in areas where you also have many oil and sweat glands, you may first notice them as pimple-like bumps on your skin. They may be in places where you normally don’t have breakouts. Over time they can become painful or maybe get infected and turn into scars.
The condition is also called hidradenitis suppurativa (HS) or acne inversa. It happens when the shafts where hair grows out of your skin, called follicles, get blocked.
There’s no cure for the condition, but treatments can make flares happen less often. A healthy lifestyle can help a lot, too.
What Causes Blocked Hair Follicles?
ROOPAL BHATT: With hidradenitis,
we now consider it to be
a disease of the hair follicles.
So just like any other disease
process, an ounce of prevention
is always worth a pound of cure.
So HS typically appears on body
folds.
Underarms are probably
the number one area.
They can also occur on groin
folds as well, sometimes
the upper inner thighs,
between the buttocks area,
underneath the breasts
in women as well,
sometimes in the back
of the neck.
Severe cases, you can get it
on the genital area.
The fact is that there are
a few things that can mimic HS.
Many times patients do confuse
their symptoms
for another disease.
And it is almost
like a bad acne, something
called a blackhead
or a comedone.
One thing that can mimic
early hidradenitis is something
called boils.
Because hidradenitis affects
the younger population,
they may not, of course,
have the medical awareness
to know that hey,
this can represent something
more than just a cyst or a boil
or something that's going to go
away.
There is definitely
a psychosocial element
of hidradenitis as well.
They feel embarrassed.
Or they just feel that maybe
they'll be judged, because they
will assume that other people
think that this is either
a contagious disorder
or something that they caused
because of poor hygiene.
And of course, that's not
the case at all.
Most people can't necessarily
self-diagnose.
But I think people now are
becoming a lot more cognizant
of their bodies and their skin,
and they're able to go
to the physician to get
that diagnosis.
Whenever the skin is telling
you, hey, look at me,
this is not normal,
we do recommend for patients
to seek their dermatologist
or their primary care physician
to kind of get that process
started being treated.
Doctors don’t know for sure. Many think hormones might play a role, since the condition usually hits after puberty and breakouts can flare for women around the time they have their periods. The problem is three times more common for women than for men.
It may also happen because of your immune system. Most people get clogged hair follicles from time to time, but if you have HS, your body may be overreacting to those blockages.
Continued
Your genes may make a difference, too. One-third of people who have the condition are related to someone else who has it.
Doctors know what doesn’t cause the condition:
- It doesn’t happen because you don’t wash yourself well enough.
- You can’t catch the disease from someone else.
Other things can trigger breakouts:
- Smoking
- Being overweight
- For women, getting your period
- Hormone changes
- Heat
- Sweating
What Are the Symptoms?
At first, blocked hair follicles usually look like breakouts of pimples or boils. They usually form in places where your skin rubs together, like your armpits or groin.
If you’re a woman, you’re more likely to have them on your genitals, upper thighs, or under your breasts. For a man, they happen more on your genitals and around your anus. The bumps may come and go or just stay the same. You might get them in the same spot every time, or they might move around your body.
Continued
If your condition gets worse, you may have:
- Deep breakouts that hurt
- Bumps that burst, and maybe leak fluid that smells bad
- Scars after your breakouts heal. They may get thicker over time.
- Skin that looks spongy because of deep lines called tracts
- Infections
- In rare cases, skin cancer
Your symptoms might change quickly, so blocked hair follicles can look different at different times. One week you might have bumps leaking fluid, and the next, the area may be cleared up.
Once you start to notice these breakouts, see your doctor as soon as you can to start tackling the problem. You can get treatments that can help clear your skin and maybe prevent more breakouts and complications.