Rare Presentations of Hidradenitis Suppurativa (HS) and Their Ayurvedic Treatment Approaches
Table of Contents
Hidradenitis Suppurativa (HS) is most commonly recognized by painful nodules, abscesses, and sinus tracts in regions such as the armpits, groin, and under the breasts. However, some patients exhibit atypical, rare presentations that are often misdiagnosed or poorly managed, especially when they deviate from classical anatomical patterns.
In Ayurveda, HS aligns with Shotha (inflammation), Dushta Vrana (non-healing wounds), and Kleda-Pitta-Vata vitiation in Mamsa, Rakta, and Meda Dhatus. Rare forms signal deeper dhatu-level imbalances, chronic Ama (toxins), and often a disturbed hormonal-immune matrix.
🔍 Rare and Atypical Presentations of HS
1. Scalp HS
- Nodules or abscesses in the scalp region, often confused with folliculitis or cystic acne.
- May lead to patchy hair loss, trichodynia (pain in hair), and secondary infection.
2. Facial HS
- Painful cysts or sinus tracts on the cheeks, jawline, or behind ears.
- Often misdiagnosed as cystic acne or acne conglobata.
3. Periumbilical or Waistline HS
- Lesions around the navel or waist crease, especially in obese individuals or those with insulin resistance.
- Chronic irritation from belts or clothing may aggravate the site.
4. Breast Inframammary HS (without classic axillary involvement)
- Tunnels and nodules under or between breasts, often in postpartum or PCOS-affected women.
- May be mistaken for mastitis or fungal infections.
5. Generalized Follicular HS (HS-like Folliculitis)
- Diffuse, painful follicular papules across the back, thighs, arms, and buttocks.
- More common in men; may mimic follicular occlusion syndromes.
6. Perianal-Vulvar or Penile HS
- Extremely painful and psychologically distressing.
- Can co-occur with fistulas, fissures, or chronic abscesses.
- Often mistaken for sexually transmitted infections or Crohn’s disease complications.
7. Ophthalmic HS
- Rare orbital or eyelid nodules resembling chalazion or recurrent styes.
- Suggests immune dysregulation with Rakta-Pitta vitiation.
🌿 Ayurvedic Pathogenesis (Samprapti) of Rare HS Types
These rare presentations signify a deep-seated imbalance in:
- Rakta, Mamsa, and Meda Dhatus
- Kleda and Kapha accumulation with Pitta-Vata vitiation
- Srotorodha (channel blockages), especially in sweat and sebaceous glands
- Ama deposition in atypical srotas due to poor Agni
- Often, hormonal triggers (Shukra and Majja Dhatu involvement) and Ojakshaya (immune depletion)
🌿 Ayurvedic Treatment Approach for Rare HS Presentations
🔸 1. Ama Pachana & Agni Deepana
- Essential to start with digestion of toxins
- Prevents further accumulation and breaks the chronic inflammatory cycle
🔸 2. Shodhana (Detox Therapies)
Depending on the site and chronicity:
- Virechana: Pitta and Rakta detoxification for facial or scalp HS
- Basti: For lower body lesions, perianal involvement, and hormone correction
- Raktamokshana: Localized bloodletting for persistent swelling or pain
🔸 3. Srotoshodhana (Channel Clearing)
- Herbs and formulations to open clogged hair follicles and sweat glands
- Enhances circulation, lymph drainage, and immune clearance in skin tissues
🔸 4. Rakta-Prasadana (Blood Cleansing)
- Rejuvenation of Rakta Dhatu to correct the immune inflammation loop
- Essential in scalp, facial, and generalized HS presentations
🔸 5. Taila & Lepa (External Therapies)
- Custom medicated oils to reduce swelling, pain, and suppuration
- Gentle, non-steroidal local applications for delicate areas (face, genital)
🔸 6. Hormonal and Immune Modulation
- Rare HS forms often overlap with hormonal issues (PCOS, thyroid, insulin resistance)
- Ayurvedic endocrine-balancing therapies support deeper immune correction
- Rasayanas targeted at Majja and Shukra Dhatus are central to long-term remission
🌿 Personalized Herbal Formulations for Rare HS Types
At EliteAyurveda, we prepare personalized medicines based on:
- Site of lesion and chronicity
- Associated hormonal conditions
- Digestive and metabolic status
- Immune sensitivity and stress levels
These formulations are aimed to:
- Clear internal blockages (Srotas)
- Prevent further abscess formation
- Calm the immune overdrive
- Rebuild skin strength and Ojas
Note: We do not list specific herbs to avoid misuse or self-medication.
🧘 Lifestyle and Dietary Support
- Avoid heavy, oily, fermented, and processed foods
- Use warm water for bathing and drinking
- Strict skin hygiene without harsh chemicals
- Manage stress and emotional suppression (which aggravate Pitta and Vata)
- Gentle yoga and pranayama to reduce inflammation and improve hormone flow
🧠 Mind-Body Support
Rare HS types, especially on visible or intimate areas, can lead to:
- Shame, withdrawal, or relationship issues
- Suppressed anger, anxiety, and body image distress
Ayurveda recommends:
- Nasya and Shirodhara for psychosomatic balance
- Manas Rasayanas (mind rejuvenating herbs)
- Meditation and counselling to rebuild body confidence and mental calm
📞 Begin a Root-Cause Treatment for Your HS
At EliteAyurveda, Dr. Adil Moulanchikkal and our team offer:
- Complete evaluation of rare or misdiagnosed HS types
- Customized detox and rejuvenation plan
- Long-term immune and hormonal balance without dependency on biologics or steroids
🔹 Website: www.eliteayurveda.com
🔹 Phone: +91 88847 22246
🔹 Consultations: Online & In-Clinic Available
Don’t ignore rare HS types — they are a call for deeper healing, not just symptom suppression. Heal from within with Ayurveda.
