Can axillary suppurative hidradenitis be completely cured with treatment? A comprehensive overview including surgery and hospital information

A lump that can be felt inside the armpit, pimples, recurring pus and inflammation…
If these symptoms persist, it may be necessary to suspect axillary hidradenitis suppurativa.

 

Pyogenic hidradenitis is a chronic inflammatory skin condition, particularly affecting areas such as the armpits, groin, and buttocks.
Repeated abscesses with pain occur frequently in areas where the skin folds and do not heal well.

It is a disease that is difficult to detect, taking an average of 7 years just to diagnose.
Early treatment and consistent management can definitely improve quality of life.

 

What is suppurative hidradenitis?

 

Hidradenitis Suppurativa, also known as 'pus sweat gland inflammation,' is a rare skin condition.

It mainly begins in areas with a lot of sweat glands and friction, such as the armpits or perineum.
It is a chronic inflammation that repeatedly causes inflammation, pus, and fistulas (pus channels), leaving scars.

 

Although the prevalence rate in our country is low, including unreported patients, it is estimated to be over 0.1%.
Among them, axillary suppurative hidradenitis is one of the most common forms.

 

 

Initial symptoms of axillary suppurative hidradenitis

 

At first, it looks like a simple boil.

A red, firm lump develops, and after a few days, it fills with pus, bursts, and causes severe pain.

 

It seems to temporarily improve as pus is discharged, but
Soon afterward, pus accumulates again or the inflammation spreads to the side area.

The day after staying up all night or drinking heavily, I tend to relapse easily in stressful situations.

 

 

Causes and Genetic Possibility of Suppurative Hidradenitis

 

The exact cause has not yet been determined, but
It is believed that immune system abnormalities, genetic predisposition, hormonal imbalance, and skin friction act in combination.

 

It is particularly suspected to be an autoimmune disease where lymphocytes attack sweat glands (apocrine glands).
Smoking, obesity, and stress are the main factors that worsen the condition.

 

[Diagnosis Criteria and Tips for Choosing a Hospital]

 

Recurrent more than twice within 6 months
Inflammatory nodules occurring deep within the skin
- Mainly occurs in specific areas such as the armpits and groin.

 

 

All three conditions must be met for a diagnosis.
Diagnosis can be made at a dermatology, breast surgery, or general surgery specialty hospital.

In cases of deep lesions, ultrasound examination can also be used to determine the presence of a fistulous tract.

 

 

Comprehensive Guide to the Treatment of Suppurative Hidradenitis

 

Treatment for axillary suppurative hidradenitis mainly involves medication and surgery.
Treatment strategies also vary depending on the stage of symptoms.

 

✔️ Pharmacological treatment – antibiotics, steroids, biological agents

 

- Antibiotics: used short-term when infection is present
- Steroids: Effective in reducing inflammation, but long-term use raises concerns about side effects.
Biological agents (e.g., Humira): The most potent treatment that suppresses inflammation by inhibiting TNF-α.

 

The disadvantage is the cost. Even after insurance coverage, it is an expensive treatment that costs several million won.

✔️ Is complete recovery possible through surgery for suppurative hidradenitis?

 

The correct answer is "Possible, but with caution."

If the affected area is small, removing the lesion through surgery can potentially lead to a near-complete cure.
However, if the surgical area becomes larger, skin grafting may be necessary.
To prevent recurrence, lifestyle habit improvements must be implemented simultaneously.

✔️ Lifestyle habit improvements for complete recovery

 

- Absolutely no smoking
- Weight loss
- Avoid tight clothing and environments with excessive sweating

 

 

The key to curing suppurative hidradenitis is maintaining healthy lifestyle habits.
In particular, smoking is a major cause that definitely induces the worsening of symptoms.

 

 

 

How to handle suppurative hidradenitis and military service issues?

 

Suppurative hidradenitis is one of the common conditions that often occur even during military service.
Due to the characteristic of recurrent inflammation and pus rupture in the armpits or groin,
Wearing training uniforms, friction, sweat, and stressful military environments can easily worsen symptoms.

 

According to the actual military service classification standards of the Military Manpower Administration,
Suppurative hidrocystitis is related to the item "Injection 128, Acne, and Suppurative Hidrocystitis."
It is determined based on the item "149 Anorectal Diseases – Mucosal and Suppurative Hidradenitis."

 

 

- Fully cured through surgery → Grade 1 (Active duty)
- If recurrence occurs after surgery → Grade 3 (Active duty)
- If symptoms are present → Grade 7 (Re-examination)
- In cases where high-altitude symptoms significantly interfere with daily life → Grade 4 (supplementary service, military exemption)

 

 

In other words, frequent recurrences and severe scarring, or,
If daily life is significantly affected by suppurative hidradenitis, exemption from military service is possible.
However, to prove this, it is important to obtain objective evidence such as a dermatological diagnosis, medical records, and photographs.

Make sure to receive medical treatment early if you are before enlistment or during service.
It is advantageous to properly prepare the documents required for military service classification.

 

 

 

 

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