Hidradenitis suppurative (HS) is an inflammatory skin disease characterized by the formation of pimple-like bumps beneath the skin. These nodules are most commonly found in areas with apocrine sweat glands, such as the armpits and groin. They may also appear in areas where skin rubs against skin, such as the buttocks, waist, inner thighs, anus, and under the breasts.

The cause of HS is unknown, but experts believe it is caused by an overactive immune response. Proteins and other skin substances can clog your hair follicles. This blockage can sometimes trap bacteria inside the follicle. If the clog or the rupture of the blocked follicle causes an inflammatory response, a nodule can form.

Hidradenitis Suppurativa & Ayurveda

Hidradenitis suppurativa is classified as a Kapha-Pitta imbalance in Ayurveda. The vitiated digestive fire-Agni (Pitta) leads to impaired metabolism and vitiation of the Kapha Dosha. The damaged fat molecules accumulate in the muscle mass, resulting in swollen, painful lesions in the armpit, groin, anal, and breast regions. According to Ayurveda, diseases are caused by channel incompetence or blockage. In HS, the impaired fat molecules are deposited in the body’s fatty locations and block the body’s channels. When we look at the pathology of HS, we can see that the disease occurs due to hair follicle obstruction, infection of apocrine sweat glands, and secondary infections, which can be correlated to the Ayurvedic channel block theory.

Bacteria and bodily oils in the armpit and groin, according to Allopathic medical concepts, cause the infection. Another reason is improper hair shaving. However, Ayurveda believes that this is due to internal issues, which is why some people are affected.

Microbiological studies of the skin disease hidradenitis suppurativa revealed bacteria that cause skin and soft tissue infections (HS). According to a study published in Emerging Infectious Diseases, Staphylococcus lugdunensis dominated nearly 60% of cultures. Immunity is weak in people with impaired digestive fire, allowing bacteria to grow in the body. So the real factor is the internal impaired metabolism, and others, such as bacteria, are the triggering factors.

Is Hidradenitis Suppurativa classified as an autoimmune disease?

It is still unknown what causes hidradenitis suppurativa (HS). While abscesses can become infected, they are not caused by bacteria and are not contagious. It is thought to be caused by an abnormal immune response in the body. To put it another way, HS is an autoimmune disease.

This statement demonstrates the clarity of the Ayurvedic concept, and according to pathologic explanations and Ayurvedic treatment concepts, | have a lot of experience in managing HS with Ayurveda.

HS is not contagious, proving once again the concept of Ayurveda. Because the bacteria that cause infection and inflammation are not working properly. As a result, some other internal factors and environmental factors that favor the growth of the triggering factor are the true cause of HS. As a result, we must address the issue with a systematic root cause diagnosis and treatment.

Causes of Hidradenitis Suppurativa

• The following causes are explained by Ayurveda.
• Those who consume incompatible foods on a regular basis
• Liquids, heavy substances, and hazardous substances
• Suppress natural urges, especially vomiting
• Exposed to intense heat as a result of excessive eating
• Using cold, hot, and lightning measures
• Diet contrary to the prescribed order
• Immediately applying cold water after being exposed to sunlight o
• Eating when the previous meal has not been digested
• Consumption of prohibited items while undergoing panchakarma procedures

However, modern science explains that the cause of the development of this condition is unknown. This could be in your genes. It is generally thought to begin with a hair follicle infection caused by sweat gland obstruction. Males are less affected than females. Normal factors that may contribute to the development of this condition include:

• You do not wash frequently.
• Make liberal use of deodorant or talc powders.
• As a result of excessive underarm shaving.
• Tobacco Use
• Obesity 

Stages of Hidradenitis Suppurativa

• Hurley stage 1: A single bump with no sinus tract.
• Hurley stage 2 consists of one or two bumps with little tunneling.
• Hurley stage 3: Numerous bumps with numerous sinus tracts and scars that almost cover the entire body.

Symptoms of Hidradenitis Suppurativa

It begins bilaterally and affects both sides of the body at the same time. The patient will notice a small pea-sized lump that will gradually firm up and fill with pus. The situation becomes more painful, and inflammation is visible. Sinus tracts are narrow channels that develop beneath the skin and ooze pus when they break open. The most commonly affected areas are those with skin-to-skin contact.

दाह कण्डु रुजा राग परीतं लोम पिच्जरम्

उदुम्बरम् फ़ल आभासं कुष्ठं औदुम्बरं विदुः (च चि ८/१५)

The symptoms of audumbara kustha are explained in Ayurveda.

Typical symptoms include a burning sensation, itching, pain, and redness. It is associated with brown skin hairs and resembles ripened udumbara fruit.

Heat, redness, discharge, suppuration, fleshy odour, and moisture are also symptoms of kustha with a pitta dosha predominance.

Risk Elements of Hidradenitis Suppurativa

• People who have reached puberty
• In rare cases, menopausal women have been linked to Crohn’s disease.
• People who have a family history of such diseases.
• Inadequate hygiene

Treatment for Hidradenitis Suppurativa

Antibiotics are commonly used in modern treatment (internally and externally). Clindamycin and rifampicin are given in severe cases. Antiseptics and retinoids are used. If HS flares up before menstruation, contraception can also be given. Prednisolone, a steroid, is also prescribed.

In Ayurveda, if kushta has a pitta predominance, as in audumbara kustha, acharya charaka mentioned:

पित्तोतरेषु मोक्षो रक्तस्य विरेचनं च आग्रे (च चि ८ / ३९)

Purgation followed by bloodletting is recommended for the treatment of audumbara. Also,

मरुतकफकुष्ठघनंक्मोक्त पित्तकुष्ठनाम कार्यं

कफ पित्त रक्त हरणं तिक्त कषये प्रशमन च (च चि ८/ ५८)

Pittaja kushta should be treated with the same measures as vatakaphaja kustha, namely elimination of kapha pitta and impure blood, and

pacification with bitter and astringent drugs. Ghee processed with bitters can be used both internally and externally.

Conclusion

Hidradenitis-like illnesses are painful and hard to treat if the patient gets further complications owing to ignorance or bad prescriptions.

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