Acne inversa

Acne inversa occurs under the armpits, among others.

Synonyms: Hidradenitis suppurativa, Pyodermia fistulans sinifica, Acne tetrad

English: acne inversa, hidradenitis suppurativa


Acne inversa is a skin disease that mainly affects areas that have many sweat glands. These include the armpits, the skin under the breasts, the inner thighs, the groin and genital regions.
In these areas, acne inversa can lead to chronic abscesses, cysts and severe infections with wounds the size of tennis balls in some cases, which cause corresponding scarring. Acne inversa is not contagious.


The acne inversa has the commonly known clinical picture acne, which is particularly evident in the puberty due to the frequent occurrence of Pimples distinguished on the face, nothing in common.
Rather, acne inversa is a skin disease whose origin is not clear. It is believed to be a genetically related disease is caused by some Behaviors can be made even worse.

More information on the subject Acne inversa can be found in the skin particle acne.


Often the Acne inversa with seemingly harmless pea-sized nodules or smallest inflammation in the flexion regions on the body, where many Sweat glands and two areas of skin are on top of each other, usually in the Armpit, in the Groin region or in Genital area. With a corresponding tendency, this inflammation can spread around the specific sweat glands Hair follicles further spread and close Abscesses lead, which can also be the size of a tennis ball.
Besides these extremely painful swellings there is often one too darker discoloration the skin over the abscesses. If the abscess opens, it is often smelly secretion out. In the further, more severe course of acne inversa can also Fistulas arise. Fistulas are filled with ducts pus or Wound secretionthat were not previously in the body and are formed by the disease. These fistulas need to be frequent surgically can be treated and great scar leave. The combination of symptoms often causes those affected to withdraw and socially isolate what is Suffering of the sick further increased.


First, in general, all of the above should be mentioned Risk factors how Smoke or Obesity should be avoided so that the acne Iiversa can possibly regress. Depending on Severity the disease can be more likely conservative or operational be treated.
The administration of medication is one of the conservative therapeutic approaches Antibiotics and Corticosteroids. Sometimes the onset of acne inversa can also be due to an increased amount of it male sex hormones be favored. In this case, therapy with is recommended Antiandrogenic drugsto lower the level of male sex hormones in the blood. Further therapeutic approaches consist in taking Vitamin A and Zinc supplements.

A new therapeutic approach, especially widespread in Europe, is the Irradiation of the affected skin areas through the Radiologists. However, the risk for Skin cancers be observed by the irradiation.

If the problems occur chronically and the formation of fistulas leads to strong accumulations of pus and extensive painful inflammation, an operation is often only an option. During this operation, the infected areas are cut out over a large area. If the wound does not heal on its own or if the cut out area is too large, the defective area must be covered with a flap of skin from another area of ​​the body.

Enzyme peels can also help to ensure the purity of the skin and allow the pores to breathe. One example of this is the Dr. Severin enzyme peeling from the pharmacy.

root cause

As mentioned earlier, this is the cause of that Acne inversa still unclear. However, it is believed that the acne inversa due to a Cornification disorder of the top layer of skin (epidermis) arises. This means that the topmost skin cells, the so-called Horn cells, continue to multiply uncontrollably and thereby the Execution walks clogging of the sweat glands on the hair. Because of this constipation it comes to Inflammationthat of bacteria can be colonized. This creates the characteristic of acne inversa Cracks and Abscesses in the skin.

Furthermore, it is assumed today that the emergence of the Acne inversa genetically is conditional. Evidence of this is given by the increased occurrence within certain families. But others too Risk factors can create a Acne inversa favor. This includes above all Smoke and Obesity. In overweight patients it occurs because of the humidity in skin folds to a higher likelihood of an outbreak of acne inversa. As with most skin conditions, too stress, wrong or clothing that is too tight such as wrong and unhealthy diet favor or worsen acne inversa.


It often takes a long time to get the correct diagnosis Acne inversa is put as the acne inversa easily with other clinical pictures like Fungal infections or simply Abscesses the sweat glands can be confused. To make sure that the symptoms are really acne inversa, an affected area should get one Tissue sample which are then taken from the dermatologist under the microscope can be examined closely.

Prophylaxis and prognosis

Since it is assumed that the Acne inversa mainly genetically is conditional, there are few prophylactic measures. However, you know that both Smoke as well as Obesity promotes the development of acne inversa, so these behaviors should be avoided.

By those resulting from the disease scar can it to Contractures and Fibrosis come so the Mobility is restricted. Will be especially in the difficult chronic Stage of inverse acne occurring Fistulas not treated, so can out of it Skin cancer arise. Likewise, it can be too strong Infections, Anemia (anemia) up to sepsis and Multiple organ failure come, so that the acne inversa can potentially be fatal. However, this is rare today as the infections are good antibiotic or surgically can be treated.

In clinical studies, anti-inflammatory drugs such as infliximab or etanercept are currently being tested, which are expected to result in new treatment success.