May, 2024

Also known as acne inversa or Verneuil’s disease, Hidradenitis suppurativa (HS) is a chronic, autoinflammatory relapsing skin disease.

It is characterized by painful, inflamed lesions, found typically found in areas where skin rubs together, such as the armpits, groin, buttocks, and under the breasts. It occurs when hair follicles become blocked and inflamed, leading to the formation of abscesses, cysts, and sometimes even scarring.

It is important to understand that HS is not the same as regular acne (acne vulgaris). Hidradenitis suppurativa affects approximately 1%-4% of the population, and the incidence is on the rise. Females are affected much more often than males.

Living with HS can be challenging and embarrassing not only due to being in chronic pain, but it is also visibly unaesthetic. It is hard enough to live with a health condition, but to feel self conscious by how you look makes that much more challenging!

It is important to understand that HS is not the same as regular acne (acne vulgaris).

Signs and Symptoms

Most people with hidradenitis suppurativa notice the onset of symptoms between 11-30 years of age.

The earliest symptoms are usually pain, itching, burning, redness and increased sweating in the area.

Later, lesions appear as small, painful bumps and pustules that turn into deep, inflamed nodules and boils. Over weeks or months, the lesions become progressively swollen. Eventually, the lesions may rupture and release pus and bloody fluid. The process happens over and over, and may eventually lead to severe scarring and restricted movement. 

Where does HS come from? 

The exact cause of hidradenitis suppurativa is not fully understood, but it is believed to involve a combination of genetic, hormonal, and environmental factors.

The disease process involves a buildup of keratin protein deep inside the hair follicle. The follicle becomes clogged, enlarged, and eventually ruptures, creating a chronic inflammatory response and increasing abscess formation.

There are several known risk factors for developing hidradenitis suppurativa.

We tend to see this condition in people with metabolic imbalances such as high insulin, diabetes and obesity, as well as in smokers. High testosterone contributes to this condition by increasing hair thickness, slowing wound healing and increasing sebum (oil) production in the skin.

Oral contraceptives (birth control pills) can cause hidradenitis suppurativa in some women. Food allergies should be explored, especially brewer’s yeast and wheat, which are found in practically all patients with hidradenitis suppurativa.

There is a strong association with Crohn’s disease and hidradenitis suppurativa. Nearly 40% of people with hidradenitis suppurativa also have Crohn’s, and it has been theorized that Crohn’s lesions around the anus may actually be hidradenitis suppurativa lesions.


What are the treatment options?!

Treatment for hidradenitis suppurativa typically involves a mix of antibiotics, anti-inflammatory medications, and immunosuppressive drugs to help reduce inflammation and prevent infection. In more severe cases, surgery may be necessary to remove affected skin and tissue.

Unfortunately, this approach does not always solve the issue, and doesn’t dig deeper into WHY the person has the condition to begin with.

Furthermore, one major problem with the standard treatment approach is that antibiotics will worsen the immune system imbalance that is fueling the autoinflammatory response in the first place. Immune-suppressing drugs have dangerous side-effects and may lead to serious infections, liver failure, cancer and lupus-like syndromes.

Our Approach

While there isn’t a specific “functional medicine protocol” for hidradenitis suppurativa (HS), here are some aspects that we might cover together:

Comprehensive evaluation: With every patient I conduct a thorough evaluation of the individual’s health history, lifestyle factors, diet, stress levels, environmental exposures, and any underlying imbalances that may be contributing to HS.

Address Gut health: There is growing evidence of a connection between gut health and skin conditions like HS. We might assess and support gut health through dietary changes, probiotics, prebiotics, and other interventions to promote a healthy gut microbiome and reduce inflammation.

Nutritional support: Diet can play a significant role in inflammation and immune function, so a functional medicine approach to HS may include dietary modifications to reduce inflammation and support healing. This might involve avoiding potential trigger foods (such as processed foods, sugar, and dairy) and emphasizing whole, nutrient-dense foods rich in anti-inflammatory compounds.

Detoxification support: Supporting the body’s natural detoxification pathways may help reduce the burden of toxins and inflammation, potentially benefiting individuals with HS. This could include strategies such as optimizing liver function, promoting lymphatic drainage, and reducing exposure to environmental toxins.

Stress management: Stress can exacerbate inflammation and immune dysfunction, so stress management techniques may be recommended to help manage HS symptoms. These are personalized; it could be journaling, exercise, yoga, breathwork, etc!

Natural remedies: we might include anti-inflammatory foods, herbals and supplements like zinc, turmeric, tea tree oil, aloe vera and more in order to help the skin heal and calm the inflammation

Above all: Functional medicine is highly individualized, so treatment recommendations would vary based on the unique needs and underlying imbalances of each person with HS.

Are you looking, or know someone, that is dealing with HS or another chronic health condition? We want to help!

Contact us at whisperhealthnow@gmail.com and let’s set up a complimentary Getting to Know You Call and see if our practice can help you!