Hidradenitis suppurative on the breasts occurs when hair follicles fill with sweat, keratin, and bacteria. This causes them to become blocked and inflamed.

Hidradenitis suppurativa is an inflammatory skin disease that causes bumps, lumps, pimples, and abscesses under the skin. It commonly occurs under or between the breasts.

It mainly occurs in areas with lots of sweat glands and where skin or fabric rubs against the skin. The breasts are one of the most common sites of hidradenitis suppurativa due to their many sweat glands.

Read on to learn what hidradenitis suppurative on the breasts is, its causes, treatment options, and more.

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Hidradenitis suppurativa, also known as acne inversa, is a skin condition that causes hair follicles to become blocked and inflamed. It can cause painful lumps and deep abscesses under the skin. These tunnels can leak pus and spread the infection.

Although experts do not fully understand why it happens, it mainly occurs in areas of the body with many sweat glands. Hair follicles get clogged with keratin, a protein found in hair, skin, and nails. Both keratin and sweat accumulate in the follicles, allowing bacteria to thrive.

Eventually, the hair follicle will burst, causing a nodule or abscess.

Hidradenitis suppurativa often starts as small lumps under the skin. At first, it can look like acne, appearing as a mixture of blackheads, lumps, and cysts.

As it progresses, hair follicles become more inflamed. Pus-filled boils develop and may burst.

In most cases of hidradenitis suppurative on the breasts, the lumps occur under or between the breasts. Sweat can easily become trapped in hair follicles in these areas. If the skin rubs against skin or fabrics, such as a tight sports bra, it can cause further irritation.

Hidradenitis suppurativa can occur in many areas of the body. It typically develops in areas with lots of sweat glands and where skin rubs against skin. Other areas where hidradenitis suppurativa may occur, other than the breasts, include:

  • armpits
  • groin area
  • around the anus
  • skin between the genitals and buttocks
  • inner thighs

Less common areas of hidradenitis suppurativa include:

  • face and neck
  • back
  • front or back of the legs

Experts do not fully understand why some people get hidradenitis suppurativa, but they think genetics may play a role. More than one-third of people with it have a close family member with the condition.

There may also be a connection with hormones, particularly in females. It typically starts after the onset of puberty and often settles down after menopause.

People with hidradenitis suppurativa are also more likely to have metabolic syndrome. Metabolic syndrome is a group of conditions that, when occurring together, increase a person’s risk of stroke, diabetes, coronary heart disease, and other health concerns.

It is not always possible to prevent flares of hidradenitis suppurativa. However, people who are prone to the condition can take some steps to prevent flare-ups in the breast area:

  • Use mild, unscented soaps and lotions.
  • Apply antiperspirant to reduce sweating.
  • Wear loose-fitting, breathable clothing to reduce friction against the skin.
  • Use an antimicrobial soap, especially to clean on and under the breasts.
  • Wear bras and sports bras that fit correctly and do not rub or chafe.
  • Wash breasts with a gentle cleanser and avoid scrubbing, which can make the skin more inflamed.

Diagnosing hidradenitis suppurativa can be difficult. It can look like other skin conditions, especially in the early stages. If there is pus, a sample may be taken to learn about any bacteria present. Otherwise, the diagnosis is made through observation and medical history.

There are several treatment options, and a person’s management plan will depend on symptom severity. Doctors may recommend:

  • Antibiotics: Oral or topical antibiotics can treat an infection or reduce skin inflammation.
  • Hormone therapy: These may be helpful for people who notice flares around their menstrual periods.
  • Steroids: For severe cases, injected or oral steroids can help to reduce inflammation and pain.
  • Biologics: This class of medications blocks specific proteins that trigger the inflammatory response.
  • Surgery: When medications are not enough or if lesions do not heal, a doctor may recommend surgical removal of affected areas of skin.
  • Laser hair removal: This treatment destroys hair follicles and may be helpful in the early stages.

Learn more about how to treat hidradenitis suppurativa.

Hidradenitis suppurativa is an inflammatory skin condition that commonly affects areas with many sweat glands, such as under and between the breasts. Although it can be difficult to manage, several treatments are available.

People can also prevent flare-ups by using gentle skin products, wearing loose-fitting clothing, and staying cool.