Hidradenitis suppurativa (HS), also known as acne inversa, is an inflammatory condition characterized by boil-like abscesses in folds of skin that tend to rub together, such as the armpits, breasts, groin, and buttocks. HS can release foul-smelling fluid when they open, and often leave behind severe scars that can restrict movement making it difficult to treat. The lesions are extremely unsightly and painful and highly prevalent in Black people, who are more than twice as like to develop HS as white people.
The condition has a strong genetic component, so there may be genetic variants in Black Americans that lead to a higher prevalence, says Anthony Fernandez, MD, PhD, a dermatologist at Cleveland Clinic in Ohio.
Despite this Blacks don't receive necessary HS care and are often underrepresented in clinical trials, according to Everyday Health.
Treating HS in Black people
If you have HS, you are likely to be up against difficult challenges, both physically and emotionally. However, the good news is that with proper education, a dermatologist experienced in treating Black patients, and medical and self-care treatments, you can successfully manage your condition.
Treatment strategies for HS are generally the same for Black as they are for other races because research has mostly been done on white people. However, further research may provide targeted therapies for Black patients.
In the meantime, you can manage your HS with a combination of medical treatments and self-care.
Medical Treatments
Medical strategies that may be used to treat HS include:
- Antibiotics
- Corticosteroids, such as prednisone, can have serious side effects if used for long periods of time. Sometimes, a doctor will inject these in a simple office procedure.
- Immune system suppressants, such as cyclosporine, a drug that’s often prescribed for transplant patients
- Oral retinoids, which affect the biology of the skin
- Antiandrogens, which block testosterone, because hormonal shifts sometimes trigger HS
Biologics are strong medications that can also be used to treat HS, however, they may not be right for everyone. Your doctor will determine how severe your HS is and make a decision. In most cases, your doctor will recommend you try other options first.
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If your HS has progressed to a later stage, you may need a wide excision, which involves removing a specific area of affected glands and a wide margin of healthy tissue surrounding it. The point of a surgically "deroofed" lesion is to remove the skin covering the lesion(s) so that they can be treated.
Self-Care
Medical treatments are helpful, but they aren't your only option. Here are some self-care strategies that may be helpful:
Steer Clear of triggers
Certain factors can trigger HS flares. Knowing what they are and taking measures to avoid them is key, Everyday Health notes. Common HS triggers include:
- Heat
- Sweat
- Physical exertion
- Skin-on-skin friction
- Stress
- Smoking
Here are some lifestyle changes that may prevent and ease your HS symptoms:
- Reach and maintain a healthy weight.
- Quit smoking.
- Get good quality sleep.
- Eat a healthy diet.
As you are adjusting your diet, opt for an anti-inflammatory diet that includes fresh fruit, leafy greens, coffee and dark chocolate. These foods are helpful in minimizing the severity of chronic inflammatory diseases.
Practice good hygiene
No HS is not caused by not being clean. However, a good hygiene routine can help keep your symptoms under control. Try using antibacterial washes that contain chlorhexidine and benzoyl peroxide and exfoliating cleansers with salicylic acid.
Wear loose clothing
Loose-fitted clothing will help prevent friction, which is a trigger for HS, because your clothes are less likely to rub against your skin.
Use absorbent pads and foam dressings
Absorbent patches, gauze, and foam dressings help soak up sweat and discharge from lesions. However, don't just buy any dressing. Pick one that is flexible and will conform to areas such as the armpit without creating friction.
You should also change your dressings regularly, so the area doesn’t become moist.
Apply a warm compress
This should be done 10 minutes at a time to help reduce the pain and swelling of active flares.
Change up your shaving routine
Avoid shaving areas that are prone to HS. This will prevent ingrown hairs from forming. If you must get rid of your hair, consider laser hair removal, which eliminates the hair follicles.
Get support
Need help finding your supportive community of people who understand what you are going through?
Visit the Hidradenitis Suppurativa Foundation.
