Acne Inversa—Inverted Acne?

Think acne only develop in your face? Then you don't know acne inversa.

FYI: It's not an inverted acne!

Acne inversa is a chronic inflammatory skin condition that can occur after puberty. It is also known as Hidradenitis suppurativa or simply HS. It usually starts in areas where there is skin-to-skin contact, such as armpits, the top of the inner thigh, the groin and under the breasts. It can also develop in the region where sweat and oil gland can be found.

Similar to acne, the inflammation of acne inversa may be associated with infection, which, in turn, may cause pus to form.

Like acne, Acne inversa has also different stages:

• Stage 1: The formation of single or multiple areas of inflammation and pus without sinus tracts and scar formation.

• Stage 2: Single or multiple pus develops, possibly at widely separated areas of the body. Sinus tracts form and there is scarring.

• Stage 3: Multiple pus develops across an entire area of the body. Sinus tracts may connect otherwise separate abscesses.

The causes of acne inversa are not yet known. It develops when sweat glands become clogged, either by perspiration or because incomplete development makes it difficult for them to drain properly. The trapped fluids are then forced into the surrounding tissue, causing inflammation and infection.

Individuals with tightly curled hair, such as those of African ancestry, are at an increased risk of developing acne inversa. And ingrown hairs can predispose someone to developing acne inversa, as well.

Although obesity does not cause HS, it can make it worse. Stress, the onset of the menstrual period, extreme heat or excessive perspiration can also increase symptoms.

One reason hidradenitis suppurativa (HS) is most likely under-diagnosed is that it can look like other conditions, such as boils, carbuncles or skin infections. It is painful and can be disabling. It is rarely fatal, except when an overwhelming systemic infection develops in an immunocompromised person.

The symptoms of acne inversa are:

•    Single or multiple areas of inflammation and pus, similar to acne in appearance.

•    Non-inflamed, hard lumps under the skin that are very painful to the touch and may persist for years. These lumps have the potential to become inflamed, and, in some people with acne inversa, they can get as large as a baseball.

•    Painful, rounded deep-rooted inflamed lumps. These sores heal slowly or not at all, causing scarring. They can also chronically seep fluid, leading to the development of sinus tracts, or tunnels under the skin. This, in turn can lead to further inflammation and lumps. Bacterial infection is also possible.

There is no known cure for acne inversa, but the symptoms can be lessoned with various treatments. Several options have been found to be helpful in some cases. These are some relieve for acne inversa:

•    Reduce the presence of bacteria on the skin by applying topical antibiotics, antiseptics or acne preparations.

•    Wear loose clothing to prevent skin irritation.

•    Loose weight to reduce the number of areas where there is skin-to-skin contact.

•    Oral antibiotics, such as flucloxacillin, dicloxacillin, clindamycin or rifampicin, which may be prescribed to reduce bacterial infection.

•    Tetracycline or metronidazole, which may be prescribed to reduce inflammation.

•    Sometimes surgery is necessary to drain infected areas or remove scarred tissue. Surgery is reserved for only very severe cases.