People with HS often have other health conditions that go along with it. The related conditions either have similar contributing factors or develop as a complication of HS.
Depression and Anxiety
People with HS are at risk for severe depression, anxiety, unhealthy body image, and social isolation.
Inflammatory Bowel Disease (Crohn’s)
People with Crohn’s disease are about 12 times more likely to develop HS. In many cases, a diagnosis of HS follows the onset of inflammatory bowel disease by 10 years. It’s thought that these conditions are linked by an abnormal immune response.
‘Anemia of chronic disease’ is a common finding in people with HS. This means a person might not have enough healthy red blood cells or iron. When there is a lot of inflammation, the body has a hard time making red blood cells and absorbing iron from the intestine. Also, people with HS can lose a lot of blood from their wound drainage, which further promotes anemia. Anemia can cause low energy, skin paleness and lightheadedness.
‘Metabolic syndrome’ is the term for a group of risk factors that occur together, including high blood sugar, abnormal blood lipids (such as cholesterol and triglycerides), high blood pressure and excess fat around the abdomen. Having metabolic syndrome makes the inflammation of HS worse and also puts people at risk for diabetes, heart disease and cancer.
We want to be very clear: being overweight or obese does not cause HS. However, people with HS who happen to be overweight often have more severe symptoms. This is because fat tissue produces molecules that drive inflammation, and the types of food that promote obesity (such as refined carbohydrates) also worsen HS. For some people, obesity can increase friction in the skin folds and promote irritation and plugging of the pores.
Heart and Kidney Disease
Chronic inflammatory disorders like HS can affect the heart and kidneys over time. It’s especially important to have your doctor screen your urine for protein on a regular basis.
A pilonidal sinus is a small ‘tunnel’ at the base of the spine near the top of the buttocks that contains hair and debris. It occurs when hair follicles grow deep into the skin, rather than out through the pore. As the hair builds up inside, it becomes infected and causes a painful abscess. People with HS commonly experience pilonidal disease, and both conditions involve clogging of the hair follicles.
Many people with HS also have a condition called acne conglobata. This is a highly inflammatory and severe type of acne where tender cysts and nodules join together deep underneath the skin form severe scars. It usually occurs on the face, chest, back, upper arms and thighs. Sometimes the skin lesions of acne conglobata can look similar to HS.
Dissecting Cellulitis of the Scalp
Dissecting cellulitis of the scalp is another condition that involves occlusion of the hair follicles. This condition involves interconnected pus-filled nodules on the scalp that lead to scarring and hair loss.
One of the most serious complications of HS is a skin cancer called squamous cell carcinoma. When an area of skin has been injured or diseased for a long time, it creates an unhealthy immune response that can permit cancer growth.
Scarring, Restricted Limb Mobility and Swelling
When HS occurs in the underarms and genital regions, the extreme pain and thick scarring can interfere with movement of the arms or legs. When the inflammation caused by HS is very severe and long-lasting, the lymph drainage routes within the tissues can become damaged or blocked. If the lymph fluid cannot flow freely, the fluid can build up in the tissues and cause a severe type of swelling called ‘lymphedema.’
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Dr. Ashley Biscoe
Dr. Alison Egeland
About Ashley and Alison
We are naturopathic doctors who are on a mission to provide trustworthy information and tools for the millions of people worldwide who suffer from hidradenitis suppurativa. After scouring the medical research and working with patients who have HS, we’ve developed a deep understanding of this condition and how devastating and painful it is. We created this site to share what we’ve learned (and continue to learn) so that we can help as many people as possible.