What is Hidradenitis Suppurativa (HS)?

Hidradenitis Suppurativa (HS), a debilitating, chronic inflammatory illness, has long been a source of discomfort and distress for those who experience it. Often misunderstood, HS is a complex condition characterized by recurrent, painful abscesses that can develop anywhere hair follicles are found, apart from the palms of the hands, soles of the feet, and the red part of the lips. It is a condition that extends its impact well beyond physical pain, deeply affecting the mental and emotional wellbeing of those diagnosed. To date, no cure for HS exists, and treatment options remain limited. However, numerous off-label treatments and a growing number of HS clinical trials are being conducted, providing glimmers of hope for those living with this condition. These trials, surveys, and studies are essential, not just for the potential development of new treatments but also for increasing our understanding of HS and its impact on patients.

It’s essential to clarify that HS has never been classified as an autoimmune illness. This means that there is currently no strong or definitive evidence to suggest that HS is a product of the body’s immune system attacking its own cells, as seen in autoimmune diseases. However, recent research suggests that HS could potentially be an autoinflammatory illness, involving the body’s innate immune response. This distinction is still under investigation, and more research is needed to categorize HS definitively.

HS severity is often determined using the Hurley Stages, a three-stage classification system. But it’s crucial to note that HS is primarily a disease of follicular occlusion, not a sweat gland disease. This distinction is crucial in understanding the nature of HS and its treatment approaches. In addition to the physically evident symptoms, people living with HS may experience other symptoms such as fatigue, low-grade fever, and an overall feeling of being unwell, especially during a flare.

HS manifests uniquely in each individual, and potential triggers can vary significantly from one person to another. Certain triggers commonly discussed within the HS community include, but are not limited to, the following:

• Clothing
• Diet
• Climate
• Friction

Always remember that each person’s experience with HS is unique. What might trigger symptoms for one person may not have the same effect on another.

Perhaps one of the biggest challenges with HS is the misconceptions that surround it. It is not a sexually transmitted disease (STD), it is not contagious, it is not caused by poor hygiene, and it is not rare. HS does not discriminate; it can affect anyone regardless of race, gender, age, sexual orientation, geographic location, or blood type. It’s also common for individuals with HS to have other follicular skin conditions, immune-mediated inflammatory illnesses, and inflammatory illnesses. It is not uncommon for patients to have autoimmune illnesses alongside HS, further highlighting the complex interaction of HS with other bodily systems and disorders.

Living with HS is undoubtedly challenging. It calls for constant adaptability and strength, often against recurring physical pain and the psychological distress that accompanies it. It’s essential to remember that support is available, both through medical professionals and communities of individuals who share similar experiences; and, with ongoing research and an ever-improving understanding of this condition, there is hope. The future may bring not just improved treatments but also broader public awareness and acceptance, leading to an environment where individuals living with HS feel supported and understood.

Learn more about HS by visiting the Canadian Dermatology Association.