Uncommon skin disease has no uniformly effective treatment

Very often we are too uncomfortable to ask our healthcare providers questions about our own health. Sometimes we ask the question and do not understand the answer or don't want to challenge the answer given. Recognising this, Body & Soul has partnered with Johns Hopkins Medical Centre to provide you with answers to questions you have about your health.

If you have such questions please e-mail them to gazettehealth@yahoo.com and we'll have an expert from Johns Hopkins answer it.

Body & Soul will feature a question with its answer once a month. To protect your privacy no names will be published.

The question for this month was answered by Ginette Hinds of the Department of Dermatology at Johns Hopkins Bayview Medical Center. Dr Hinds was assisted by Natalia Vlassova of Johns Hopkins Mercy Hospital.

Q: I often develop boils in my armpits and groin area. I have no idea why this happens. I thought it might be because I am overheated, but the boils occur even in cold weather. What causes them?

A: The boils in your armpits and groin area are most likely the result of an uncommon skin disease called hidradenitis suppurativa, an inflammatory skin condition that usually begins after puberty and is more common in females than males. HS is characterised by frequent boils in the places you mention, and also on the buttocks, and they tend to leave scars. The boils can be very painful as they enlarge, but once they “come to a head” and leak their contents, the pain subsides. Some people with HS also have severe acne, cysts on other areas of the skin and painful boils on the scalp.

Q: What causes HS?

A: HS is caused by inflammation of the hair follicles that reside deep in the skin. Although scientists do not yet know exactly why this inflammation occurs, they do know that HS can run in families, and that obesity, sweating, smoking and stress can aggravate it. HS is not caused by poor hygiene, and it is not contagious.

Q: How can you prevent HS flare-ups?

A: There is no cure for HS at this time, but here are a few things that can help minimise the frequency and severity of the boils:

l Stop smoking

l Lose weight

l Avoid tightfitting clothing, antiperspirants and shaving if you notice that they incite flare-ups of the condition.

Q; How is HS treated?

A: There is no uniformly effective treatment for HS, and physicians will likely try different therapies depending on the severity and extent of disease.

Common treatments may include hot compresses applied to the boils; antiseptic washes with chlorhexidine or benzoyl peroxide, topical and systemic antibiotics, zinc supplements, steroid injections into the boils, laser hair removal and surgery to remove the boils.

HS can be debilitating and can cause embarrassment and social isolation. It's important to discuss symptoms and treatment options with your physician. There is still a lot to be learned about this disease, and several research studies are being conducted by Dr Hinds. Johns Hopkins Bayview also hosts a HS support group that meets three to four times a year. For more information on the support group meetings e-mail stovecat@yahoo.com.

http://www.royalgazette.com/article/20130129/ISLAND05/701299999