Not all skin lesions are the same. Expert skin specialists explain how to rule out (or maybe rule in) hidradenitis suppurativa.
Any form of bump on your skin might be concerning—and at times perplexing, because numerous skin disorders can generate elevated lesions. Some are red and swollen. Others may have skin tones, scaliness, or itching. They might have a head or a smooth surface. Do you suspect that your bumps and lumps are the result of hidradenitis suppurativa (HS)? This skin illness is characterized by painful, pus-filled boils that can explode and develop under-the-skin tunnels. Bring any bumps to your doctor’s notice, but in the interim, our specialists can help you determine whether or not yours is HS-related.
What Are HS Bumps and Lumps?
Before we get into what isn’t HS, let’s speak about what is. “For the most part, an HS bump is a skin-colored nodule in a hairy area, such as the armpits or groin,” explains Dr Adil Moulanchikkal, Lead Ayurveda Specialist at EliteAyurveda Clinics. Lesions typically begin as a hard lump that resolves in one to two weeks, or they may get larger and fill with pus as they form an abscess. Abscesses may then come to a head and spontaneously rupture, leaking blood or pus and necessitating drainage. They can leave a scar in some circumstances.
Is there symmetry involved?
According to Dr. Adil, symmetry is common with HS. “More often than not, patients have involvement on both sides of the body,” he explains. Recurrences are also possible with HS, he says. “It’s a chronic disease, so it comes and goes.” Many women, for example, will experience a flare around their menstrual cycle. In the later stages of HS, where sinus tracts (pus-filled tunnels under the skin) emerge, you’ll notice “openings in the skin with a roof-like scar between openings,” according to Dr. Adil.
Is it possible that you have Folliculitis?
“Folliculitis is a [pustule] involving a hair follicle,” says Dr. Adil. In comparison to smaller and more widespread pustules throughout the body, HS causes bigger nodules and abscesses in skin folds. Both eventually harm hair follicles, though HS seldom affects the body beyond skin folds. Folliculitis is frequently associated with a mild infection that disappears with medication, whereas HS is unlikely to be associated with infection and may persist after antibiotic treatment.
What If You Have an Epidermoid Cyst?
This little bulge beneath the skin rarely causes pain, unlike an HS lesion, until it ruptures, which is extremely common. Another important distinction between an epidermoid cyst and an HS bump? “HS bumps typically lack a punctum or a pore, whereas epidermoid cysts frequently do,” says Dr. Adil. These skin cysts most usually develop on the face and neck, but they can also appear on the genitals, where HS bumps are very common.
Maybe it’s Cutaneous Crohn’s Disease?
According to Dr. Adil, Crohn’s disease, an inflammatory bowel ailment, can produce lesions around the anus that resemble ulcers and abscesses. In cutaneous Crohn’s disease, also known as metastatic Crohn’s disease (a bowel condition that forms plaque-like patches on the arms, legs, and trunk), purplish-red, ulcer-like lesions can appear in high-friction areas like as the genitals, which are also a true HS hot zone. “It’s rare, but it can happen—and it certainly looks like HS,” Dr. Adil explains.
Lipomas are never painful, right?
According to Dr. Adil, these fatty tissue growths that generate lumps under the skin can resemble HS bumps. Lipomas, on the other hand, may feel soft and rubbery and grow slowly, as opposed to HS bumps, which grow swiftly. Furthermore, HS lesions can be quite painful and require antibiotics or steroids to heal, whereas lipomas are normally benign and require no therapy at all. “They’re not as tender as HS bumps, and they don’t go away,” Dr. Adil explains. “If you have a lipoma, you’ve probably had it for a while.”
Is it cystic acne?
Some people still refer to HS as acne inversa. Acne and HS bumps are both caused by inflammation and potentially bacteria that dwell in hair follicles. Furthermore, in the early stages, HS lumps can mimic blackheads, and cystic acne can sometimes resemble larger HS pimples. Both illnesses can create inflammatory lesions, but HS lumps tend to recur in the same location and can rupture and drain into the skin, resulting in pus-filled tunnels that leave scars. Finally, the agony of HS is significantly worse than that of acne. It can even be crippling at times.
What Is the Distinction Between a Regular and an HS Boil?
According to experts, “boil” is a non-medical phrase for a skin abscess that can be associated with an infection or HS. Hair follicles are involved in both HS and boils. Furuncles are abscesses that form around hair follicles and are often caused by infection (with staph being the most common culprit), though an in-grown hair can also generate a non-infectious furuncle. It can be difficult to distinguish an HS abscess from an infected abscess only on a visual examination of a single lesion. Only when the lesion occurs in typical skin folds repeatedly over time, rather than disappearing with a short course of antibiotics, will it be obvious that HS is to blame.
Is it possible that swollen lymph nodes are the culprit?
“Often, patients will say they have a bump under their armpit, and it turns out to be a swollen lymph node,” Dr. Adil explains. Lymph nodes, unlike HS, are not red and pus-filled, although they can be painful to the touch. “They’re often rubbery and can move around,” he says. To make matters worse, HS can develop enlarged lymph nodes, however evidence indicates that this is more likely in late-stage HS. If any of the above symptoms sound familiar, consult your dermatologist to find out what’s wrong. Whatever the diagnosis, the correct one can put you on the road to greater health.
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According to Ayurveda, hidradenitis suppurativa is a cause of Kapha and Pitta dosha. When the digestive fire (Agni), or Pitta, is out of balance, the Kapha Dosha becomes vitiated, which slows down metabolism. Due to the disruption of fat molecules, they start to build up in muscles and impede bodily passageways, causing painful, swollen sores in the groin, buttocks, thighs, and armpits.
In Ayurveda, hidradenitis suppurativa Treatment is to restore the body’s natural equilibrium by detoxifying it with potent herbal therapies.
The treatment for Hidradenitis Suppurativa at Elite Ayurveda comprises balancing the Kapha and Pitta doshas, as well as providing harmony to the metabolism. The treatment comprises body detoxification, internal drugs to balance doshas, and external applications to heal scars.
The treatment involves combinations of herbs created based on individual Prakruti and Vikruti analysis. Visit our website to know more
Connect with us to get our patient testimonials and also to speak with our patients directly about their experience in getting their disease treated by us and by Ayurveda as a whole.
Medically reviewed by Dr Adil Moulanchikkal, Lead Ayurveda Specialist at EliteAyurveda Clinics. With over 15 years of experience in treating Neurological, Skin & Autoimmune Diseases.
