Acne inversa, also called hidradenitis suppurativa, is a chronic inflammatory skin disease characterized by painful nodules, pustules and abscesses. Severe cases, which feature oozing, degradation of skin and scarring, can be debilitating. According to the Hidradenitis Suppurativa Foundation, Inc., the disorder affects 1 percent of the world's population. MayoClinic.com notes that although there is no cure for acne inversa, proper treatment can stop the disease from progressing.
Acne Inversa Features
Acne inversa occurs around the hair follicles, usually in places where there are a large number of oil and sweat glands. Although the armpits, groin and anal area are the most common locations, MayoClinic.com notes that acne inversa can break out anywhere that skin rubs together. Symptoms start after puberty -- sometimes with a single bump -- and can develop into multiple blackheads, pustules and deep-seated boils that can persist for years. Other symptoms of acne inversa include itching, burning and excessive sweating.
Stages
Stage 1 of acne inversa features lesions and sinus tracts, or tunnels, into the skin; there will be separation between the tunnels. HSF, Inc. notes that three-quarters of all acne inversa cases never progress beyond this stage. In Stage 2, the sinus tracts connect to each other, forming a network under the skin. Excess, thickened scar tissue is also present. In Stage 3, large areas of suppurating, fibrous tissue develop.
Treatment
Treatment depends on the severity of the disease, with Stage 1 often being treated with topical corticosteroids. MayoClinic.com suggests using antibacterial soap and warm compresses for mild Stage 1 cases. Stage 2 may be treated with local excision surgery or laser evaporation, while Stage 3 often requires wide excision surgery, radiation therapy and skin grafts. HSF, Inc. adds that the disease has inflammatory and bacterial components; both immunosupressive drugs and antibiotics may be tried.
Causes
MayoClinic.com notes acne inversa develops when sebaceous glands and hair follicles become blocked with dead skin cells and sebum. Infection and inflammation caused by bacteria also play a role. Doctors don't know for sure what causes the follicles to become blocked. In a scholarly article by I. Jansen et al in the November, 2001 issue of "Journal of the European Academy of Dermatology and Venereology," the author says a defect in the follicular epithelium is responsible. HSF, Inc, noting that there is a familial history in 1 out of 3 cases, say genetics can be a factor.
Misconceptions
HSF, Inc. states that in spite of incorrect social and medical views, acne inversa is not caused by being dirty, having poor hygiene or making unhealthy lifestyle choices. Jansen concurs, stating that smoking and being overweight are not consistently associated with acne inversa.
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