The exact cause of hidradenitis suppurativa is unknown, but we do know that there are genetic influences and imbalances of the innate immune system involved. We also know that bacteria may play a secondary role in this condition, but they are not the true cause.

An HS lesion develops when there is inflammation followed by a buildup of keratin protein deep inside the hair follicle. Keratin is the main protein that makes up our hair, skin and nails. The hair follicle becomes clogged, enlarged, and eventually ruptures. The ruptured contents then spread to the nearby hair follicles and sweat glands. This creates a chronic inflammatory response and causes abscesses (deep pockets of pus and bacteria) to form. The wounds can also form “tunnels,” which are called sinus tracts.

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, obesity, polycystic ovarian syndrome (PCOS), as well as in smokers. High testosterone (androgen) levels contribute to this condition by increasing hair thickness, slowing wound healing and increasing oil production in the skin – all of which promote clogging of the hair follicles.

Birth control pills that contain high levels of the synthetic hormone progestin can trigger hidradenitis suppurativa in some women. Food allergies can also play a role, especially allergies to brewer’s yeast (Saccharomyces cerevisiae) and wheat. There’s also research showing that lithium, a common psychiatric medication, can trigger HS and other skin conditions.

There is a strong association with Crohn’s disease and hidradenitis suppurativa. Crohn’s disease is an autoimmune condition that causes severe inflammation and damage to the intestines. Nearly 40% of people with hidradenitis suppurativa also have Crohn’s.

HS is not a “hygiene issue”

We want to stress that HS is not a “hygiene issue.” It is caused by a complex interaction between:

• genetics
• the immune system
• hair follicles
• friction
• hormones
• diet
• gut health
• bacteria, fungus and other microbes
• …and more

What Can You Do to Help HS?

In addition to the standard treatment options, there are a lot of effective natural approaches for hidradenitis suppurativa.

At our clinic, we take a comprehensive approach including clinical nutrition, herbal medicine, digestive support and lifestyle modifications. There is no “one size fits all” approach, but the goal is to REMOVE the factors that are contributing to your condition (inflammatory foods, infections, environmental toxins, etc.) and ADD the support that will allow your body to heal.