Acne Inversa (Hidradenitis Suppurativa) Treatment at Pine Belt Dermatology

Dr. Eugene Conte • October 18, 2018

Acne inversa is a chronic, painful, and inflammatory skin disease that affects a young and active population. The disease involves painful, deep abscesses and chronic, draining sinus tracts. Acne inversa is also called hidradenitis suppurativa, or “HS for short, and it can often be misdiagnosed by doctors who are not familiar with the disease. Acne inversa is sometimes mistakenly thought of as an orphan disease. While it is not an orphan disease in terms of its prevalence, it often is a lower priority in comparison to other dermatological conditions in terms of notice, interest, and developing research. A dermatologist will be able to identify the condition quicker than other providers simply because we are familiar with it and know what signs and symptoms to look for. Unfortunately, for most people who have HS, on average, they will see five doctors before they see a dermatologist that identifies the disease. Among dermatologists AI/HS is considered a prototypical skin disease. This is because once you are aware of the disease it is most often easy to see and easy to feel.

Acne inversa takes not only a physical toll on patients, but emotional and social ones as well. Patients with this disease have been shown to suffer higher levels of mental health difficulties, in particular depressive symptoms, even when compared to patients with other skin diseases.

Signs and symptoms of acne inversa are very apparent, which is why patients who have it may struggle socially and emotionally with the condition. The lesions itch, are painful, suppurate (which means the sores have discharge or pus), and scar, disfiguring the skin. Patients most often describe the sores as “boils”. This is an interesting description because it is often associated with uncleanliness, which is a mythical factor in HS. Patients who have the disease are made to feel that it is the result of poor hygiene, and this is not at all true. Hidradenitis is not a disease associated with hygiene. Another symptom that is the most obvious hallmark of the disease is the restriction to the skin areas affected. The disease is essentially limited to areas of skin where there is a high concentration of hair follicles and apocrine glands (i.e the underarm, groin, buttocks, nape of neck and scalp, and mammary glands). While the disease originates in follicles it is not a disease triggered by infection.

Hidradenitis Suppurativa | Pine Belt Dermatology

Facts regarding Acne Inversa/Hidradenitis Suppurativa:

Patients with HS face a host of comorbidities – depression, metabolic syndrome, auto-immune disorders, endocrine disorders, etc.
200,000 cases occur in the United States each year
While HS may look like bad acne, the disease occurs in places you would not expect acne (underarm, groin, breasts, anus, etc.).
Causes serious scars.
Women are three times more likely to develop the disease than men.
Women are most likely to get them on the genitals and around the anus.
The cause of the disease is not known.
1/3 of patients with the disease have a relative who also has the disease.
Diagnosis can be simple if seen by a dermatologist.
Smoking can significantly increase the severity of the flare-ups.
Losing ~10% of body weight has shown to reduce the risk of flare ups.
Wearing looser-fitting clothes can prevent irritation.
Overweight or obese people are at greater risk of experiencing flare-ups.
The disease is not contagious.
Individuals of African and Hispanic decent have a higher prevalence of the disease than other ethnic groups.
Humira, a treatment that is primarily used for patients with psoriasis, has shown tremendous results when treating patients with hidradenitis suppurativa.

Data shows that there is a large prevalence of hidradenitis suppurativa in the Pine Belt and surrounding areas. As stated above, the causes of the disease are unknown, but there are many treatment options available as long as you are able to get a proper diagnosis. My colleagues and I have extensive experience treating hidradenitis suppurativa. If you suspect you or a loved one may have this painful disease, do not hesitate to come to one of our offices. We also have a HIPAA secure mobile app that will allow one of us to see you virtually. Regardless of what skin condition you have, myself or one of the other providers can help you achieve healthy skin.

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When a ‘Rash’ Might Be Something More Serious

April 13, 2026

When a ‘Rash’ Might Be Something More Serious At Pine Belt Dermatology & Skin Cancer Center, we recognize that rashes are common and frequently resolve quickly with minimal treatment. However, some rashes may signify underlying conditions that require prompt medical attention. Identifying when a rash is more than a minor irritation is key to protecting your health. Comprehending Common vs. Concerning Rashes Most everyday rashes result from irritants, allergies, heat, or minor infections and typically improve within a few days with over-the-counter treatments. However, if a rash lasts longer, worsens, or appears with other symptoms, it may signal a more serious issue. Identifying the difference between a routine rash and one that requires medical evaluation helps avoid complications and ensure appropriate care. Warning Signs to Watch For Certain features may indicate a rash requires clinical assessment, including: Rapidly spreading or worsening rash Severe pain, swelling, or blistering Signs of infection such as pus, warmth, or red streaks Fever or flu-like symptoms accompanying the rash A rash that does not improve after several days of treatment Dark, purple, or bruised-looking areas on the skin For example, a rash with fever may indicate a viral or bacterial infection, whereas painful blistering can suggest conditions such as shingles. In rare cases, rashes may signal autoimmune disorders or severe allergic reactions. Rashes That May Point to Underlying Conditions Some rashes may be linked to broader health concerns, including conditions that cause inflammation in the skin and other organs: Allergic reactions that may escalate into further severe responses Infections that spread beyond the skin if untreated Medication reactions that require immediate adjustment Persistent or unusual skin changes may be early signs of skin cancer or precancerous conditions, especially if they do not heal or continue to change over time. Why Early Evaluation Matters Delaying care for a worrisome rash may allow the underlying condition to progress. Early diagnosis improves treatment outcomes and helps prevent discomfort and complications. A dermatology specialist can assess the rash’s appearance, location, and progression, and may recommend diagnostic tests if needed. This approach assures treatment addresses the underlying cause, not just the visible symptoms. When to See a Dermatology Specialist If you are unsure about your rash, it is best to err on the side of caution. Consider seeking care if: The rash is persistent, painful, or unusual in appearance Over-the-counter treatments are not effective You experience additional symptoms such as fever or fatigue The rash interferes with your daily comfort or quality of life At Pine Belt Dermatology & Skin Cancer Center, our experienced providers supply comprehensive skin evaluations and customized treatment plans. We take time to understand your symptoms and deliver clear, effective solutions tailored to your needs. Protecting Your Skin and Your Health While many rashes are minor, some may be early warning signs of more serious health concerns. Monitoring skin changes and pursuing prompt medical advice can produce a notable effect. If you notice a rash that does not seem right, do not ignore it. Schedule a consultation with Pine Belt Dermatology & Skin Cancer Center for expert evaluation and peace of mind. Your skin is an important indicator of your overall health, and taking it seriously supports ongoing well-being.