Reasons for Not Treating Hidradenitis Suppurativa (HS) That Go Beyond Your Skin
Table of Contents
Abstract
Hidradenitis suppurativa (HS) is often thought of as a skin condition due to its visible manifestations, such as boils and pustules. However, HS affects more than just the skin, impacting various other parts of the body. Treating HS correctly is crucial for preventing the condition from deteriorating and leading to more severe health issues. This article explores the reasons why proper treatment is essential and how HS can impact other systems in the body, alongside Ayurvedic approaches to managing this chronic condition.
reasons for not treating hidradenitis suppurativa
Introduction
Hidradenitis Suppurativa (HS) may start as what appears to be a skin issue—boils, pustules, and abscesses primarily located in the armpits, groin, buttocks, and inner thighs. However, HS is far more than a skin condition. It is an autoimmune disease that can lead to severe, systemic complications if left untreated. The immune system attacks healthy cells, leading to chronic inflammation not only of the skin but also within other systems of the body (Alikhan et al., 2019).
This systemic nature of HS is often overlooked, which is why treatment that goes beyond the visible symptoms is crucial. Ignoring or mismanaging HS can lead to a cascade of comorbidities, from cardiovascular diseases to mental health issues, and drastically impact the overall quality of life (Jfri et al., 2021). Understanding this full-body impact is the first step in managing HS effectively.
Causes of Hidradenitis Suppurativa (HS)
While the exact cause of HS remains elusive in modern medicine, it is widely believed to be the result of genetic predisposition combined with environmental and lifestyle factors that trigger the immune system (Sabirli et al., 2020). In Ayurveda, HS is seen as a disorder rooted in the imbalance of Pitta and Kapha doshas (Patwardhan et al., 2015). Pitta, representing fire and transformation, governs digestion and metabolism, while Kapha, associated with earth and water, provides structure and stability in the body.
When these doshas become imbalanced—often due to improper digestion, lifestyle factors, and stress—Ama (toxins) accumulate in the body, obstructing its channels (srotas) and resulting in the painful abscesses and inflammation characteristic of HS (Fimmel & Zouboulis, 2020). This build-up of Ama disturbs the body’s Agni (digestive fire), leading to a cascade of immune dysfunctions that are reflected not just in the skin but throughout the body.
Understanding these root causes is vital because HS is not a superficial condition; it is a systemic disease. In Ayurveda, treatment focuses on correcting these doshic imbalances and removing the accumulated toxins to restore balance and health.
The Importance of Treatment
HS is a chronic autoimmune condition with no known cure. The disease begins when the immune system mistakenly attacks the body’s own cells, triggering inflammation and the formation of painful, pus-filled nodules and abscesses. Over time, if not treated properly, HS progresses from mild to severe stages, bringing with it a host of comorbidities that can severely affect a person’s health and quality of life (Alikhan et al., 2019).
It’s essential to understand the broader impact HS can have beyond the skin. The comorbidities associated with HS fall into several categories:
Cardiovascular and Related Illnesses: Chronic inflammation in HS patients significantly increases the risk of Type 2 diabetes, hypertension, high cholesterol, metabolic syndrome, and obesity. Studies have shown that individuals with HS are at a much higher risk of developing cardiovascular diseases compared to the general population. Without effective management, the inflammatory processes in HS can extend into the vascular system, leading to long-term cardiovascular damage (Sabirli et al., 2020).
Inflammatory Disorders: HS is frequently associated with other inflammatory diseases such as Crohn’s disease, rheumatoid arthritis, and asthma. These co-occurring conditions suggest a systemic immune dysregulation that goes far beyond the skin, affecting multiple organ systems. The shared inflammatory pathways between HS and these disorders highlight the importance of comprehensive treatment (Jfri et al., 2021).
Hormonal Disorders: Hormonal imbalances are also commonly linked to HS, particularly in women. Conditions such as Polycystic Ovarian Syndrome (PCOS) and thyroid disorders are frequently seen in patients with HS. These hormonal disorders exacerbate the inflammatory process in HS, leading to worsening symptoms and more severe flare-ups (Fimmel & Zouboulis, 2020).
Skin Diseases: HS patients often suffer from other skin-related conditions like psoriasis, acne, pilonidal cysts, and pyoderma gangrenosum. For example, studies show that HS patients are 35 times more likely to develop pilonidal cysts than the general population (Benhadou et al., 2019). These additional skin conditions can complicate the diagnosis and treatment of HS, making it even more challenging to manage effectively.
Psychological Conditions: The emotional and psychological toll of living with HS can be significant. Depression, anxiety, social isolation, and poor sexual health are common among HS patients. The chronic pain, discomfort, and visible nature of the disease often lead to low self-esteem and a diminished quality of life. Without proper psychological support and management, these mental health conditions can worsen over time (Matusiak et al., 2010).
The systemic nature of HS makes it imperative to adopt a holistic approach to treatment—one that goes beyond merely addressing the skin lesions and focuses on the whole person. Ayurveda, with its emphasis on balancing the doshas and addressing the root causes of disease, is uniquely positioned to offer this comprehensive care.
Treating Hidradenitis Suppurativa (HS) in Ayurveda
Ayurvedic treatment for HS is based on balancing the disturbed Pitta and Kapha doshas, which are responsible for the disease’s progression. According to Ayurvedic principles, when Pitta becomes aggravated, it causes excessive heat and inflammation in the body, while excess Kapha contributes to the accumulation of moisture and blockages in bodily channels (Patwardhan et al., 2015).
The Ayurvedic approach to treating HS is multifaceted, focusing on detoxifying the body, reducing inflammation, and restoring the body’s natural balance. Unlike conventional treatments that focus primarily on symptom suppression, Ayurveda works to eliminate the underlying causes of the condition and promote long-term healing.
Ayurvedic Detoxification for HS
A key component of Ayurvedic treatment is detoxification, aimed at removing toxins (Ama) from the body that contribute to the development and progression of HS. Panchakarma, a time-tested Ayurvedic detox therapy, is often employed to cleanse the body’s channels and rejuvenate its systems. This treatment includes procedures like Virechana (therapeutic purgation) to clear excess Pitta, and Vamana (therapeutic emesis) to eliminate excess Kapha from the system (Patwardhan et al., 2015).
Detoxification is not just a surface-level treatment but a deep cleansing process that purifies the entire body, including the blood, lymphatic system, and digestive organs. This holistic approach ensures that the body’s channels remain open and unobstructed, preventing the formation of new lesions and abscesses.
Internal Herbal Medications
Internal herbal treatments are central to balancing the doshas and restoring health. Ayurvedic practitioners prescribe a customized regimen of herbs tailored to each patient’s unique constitution (Prakruti) and the nature of their imbalance (Vikruti). Herbs such as Turmeric (Curcuma longa) and Neem (Azadirachta indica) are commonly used for their anti-inflammatory, antibacterial, and immune-modulating properties (Goel et al., 2010).
These herbs help to pacify aggravated Pitta, reduce inflammation, and prevent infections that often accompany HS flare-ups. Unlike conventional medications that may suppress symptoms temporarily, Ayurvedic herbs work to support the body’s natural healing mechanisms, promoting long-term balance and reducing the risk of future flare-ups.
Ayurvedic External Therapies
External therapies complement internal treatments in Ayurveda. Herbal pastes and medicated oils are applied to affected areas to soothe inflammation, promote wound healing, and reduce scarring. Pastes made from Manjistha (Rubia cordifolia) and Sandalwood are frequently used to heal the skin and prevent the formation of new abscesses (Patwardhan et al., 2015).
Abhyanga (therapeutic oil massage) using medicated oils such as Kumkumadi oil is also a critical part of external treatment. This massage therapy helps improve circulation, detoxify the skin, and reduce inflammation. By nourishing the skin and deeper tissues, these treatments address the disease at both the surface and systemic levels (Patwardhan et al., 2015).
Conventional Treatment Methods
While conventional treatments such as antibiotics, immunosuppressants, and biologics can provide temporary relief, they often come with long-term risks. These medications suppress the immune system, increasing the risk of infections and other complications. Furthermore, long-term dependence on these drugs can result in diminishing effectiveness and adverse side effects (Alikhan et al., 2019).
In contrast, Ayurveda’s approach focuses on restoring the body’s natural balance, reducing dependency on medications, and promoting sustained healing from within. The goal is to empower the body to heal itself, leading to long-term remission rather than temporary relief (Patwardhan et al., 2015).
Achieving Long-Term Remission
The ultimate goal of Ayurvedic treatment is to achieve long-term remission, not just symptom control. Ayurveda’s approach to HS involves three key phases:
Addressing the Root Cause: Ayurvedic practitioners focus on identifying and treating the root cause of HS by addressing the imbalances in Pitta and Kapha doshas (Patwardhan et al., 2015).
Stabilizing the Body’s Immune Response: Ayurvedic treatments aim to stabilize the immune system, reducing chronic inflammation and preventing new abscesses from forming (Patwardhan et al., 2015).
Maintaining Lifestyle Changes: Ayurveda emphasizes the importance of long-term lifestyle changes, including dietary modifications, stress management, and regular detoxification practices to prevent future flare-ups and maintain remission (Patwardhan et al., 2015).
This holistic approach ensures that patients experience not just a reduction in symptoms but a complete restoration of balance, promoting long-term health and wellness.
Conclusion
Hidradenitis Suppurativa is a complex autoimmune condition that affects far more than the skin. Left untreated, it can lead to severe systemic complications, including cardiovascular, hormonal, and psychological issues. Ayurveda offers a holistic, individualized approach to treating HS, focusing on detoxification, balancing the doshas, and promoting long-term healing. By addressing the root causes of the disease and providing personalized care, Ayurveda helps patients achieve long-term remission and a significantly improved quality of life.
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Medically Reviewed by Dr. Adil Moulanchikkal, Lead Ayurveda Specialist at Elite Ayurveda Clinics, with over 15 years of experience in treating neurological, skin, and autoimmune diseases.
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