Hidradenitis Suppurativa and the Lymphatic System

Hidradenitis suppurativa (HS) is a chronic skin condition that causes painful, swollen lumps and tunnels under the skin. It usually affects areas of the body with hair follicles, such as the armpits, groin, and under breasts.¹

In people with HS, the lymphatic system can become blocked or damaged. This can lead to a buildup of lymph fluid or inflammation and infection.²

What is the lymphatic system?

The lymphatic system is a network of vessels that carry lymph fluid throughout the body. Lymph fluid is made up of water, proteins, white blood cells, and other substances. This fluid is made in the tissues and drains into the lymphatic vessels.³

Lymphatic vessels carry lymph fluid to the lymph nodes. Lymph nodes are tiny organs that look like beans. The lymph fluid then drains from the lymph nodes into the bloodstream.³

Parts of the lymphatic system include:³

• Bone marrow
• Thymus
• Spleen
• Tonsils and adenoids
• Appendix
• Lymph nodes
• Lymphatic vessels

The lymphatic system is important for the body's immune system. The lymphatic system has several different functions:³

• Carries lymph fluid throughout the body
• Helps the body fight infection
• Helps maintain fluid balance
• Removes toxins and wastes from cells
• Helps absorb fat from the gut

How does HS affect the lymphatic system?

HS can cause the lymphatic vessels to become blocked or damaged. This can lead to a buildup of lymph fluid, most commonly in the groin area.^2,3

Lymph fluid that builds up in the tissues is called lymphedema. This can cause swelling, pain, and other problems.³

When HS flares up, it can lead to an infection of the lymph nodes. This can damage the lymphatic vessels and lead to lymphedema. HS can also cause scarring in the affected area. This scarring can block the lymphatic vessels and lead to lymphedema as well.²

What are the symptoms of lymphatic problems?

Lymph nodes are located all over your body. Some are close to the surface of your skin, and some are deep within your body. Swollen lymph nodes in the neck, armpits, and groin are often noticeable because they are close to the surface of the skin.³

The symptoms of lymphedema caused by HS may include:⁴

• Swelling – The affected area may become swollen and puffy, which may worsen over time.
• Heaviness or tightness – The swelling can cause a feeling of heaviness or tightness in the affected area.
• Discomfort or pain – The swelling and pressure may cause discomfort or pain in the affected area.
• Skin changes – The skin in the affected area may become thickened, hardened, or discolored.
• Reduced range of motion – The swelling can limit your ability to move the affected limb or joint.
• Recurring infections – Lymphedema can increase the risk of skin infections in the affected area.

If you experience any of these symptoms, speak with your doctor. Early treatment can help manage the symptoms and prevent complications.

How are lymphatic problems with HS treated?

There is no cure for HS, but there are treatments that can help to control its symptoms and prevent flares. Mild cases of HS may be treated with topical creams or ointments.

More severe cases may require antibiotics, surgery, or other treatments.⁵

If you have HS and develop symptoms of lymphedema, see a doctor for treatment. Treatment may include:^4,5

• Antibiotics to treat the infection
• Lymphatic drainage therapy to help move lymph fluid through the body
• Surgery to remove infected tissue
• Other treatments, such as compression garments or massage therapy