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Why Do I Keep Getting Red Lumps
in the Armpits? (Cysts)

By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

Article printed on page 27 in the October 25-26, 2003 issue of
The Mississauga News under the feature: Health & Wellness, Doctor's Corner.
Dr K

There is a medical term for those lumps, cysts or abscesses that can progress into large draining painful lumps. It is a condition called Hidradenitis Suppurativa or Acne Inversa in some parts of the world. It is a debilitating form of inflammation that is occurring in your armpit. As well, it can appear in the groin or under the breasts. The problem centers on sweat or apocrine glands, and is influenced by hormones. A cycle of inflammation and swelling ensues in the area around the glands. Females are affected more often, particularly after the onset of puberty. Flare-ups tend to occur around the menstrual period. Infection is not the primary cause but is often co-existent in severe cases. It sometimes results after clandestine efforts at home treatments fail, be it squeezing or employing the needle-candle-alcohol back-alley special trick. The cysts can become large, painful and most embarrassing. They lead to time lost from work and school.

Many patients present themselves with the misleading belief that a simple lancing or surgical excision will result in a cure. For an isolated lesion, surgery may help but can result in disfigurement through scarring. Further frustration ensues when a new nodule subsequently appears in the area adjacent to the excised one.

Persons with Hidradenitis Suppurativa often have slightly raised circulating androgen levels along with lowered progesterone levels. The apocrine glands are the sites of another common problem called acne and some people suffer both. Hidradenitis Suppurativa is a chronic and remitting condition. Support groups have been established to educate and help sufferers.

Treatment is difficult and requires a collaborative effort between family doctors and specialists. Antibiotics, hot compresses and analgesics are often used first. Other approaches are more calculated and involve medications such as isotrentinoin (Accutane), dexamethasone or birth control pills, all in an effort to modify the hormonal influence. There are instances of even more desperate measures such as radiation therapy and botox injections which have been tried with varied success. Persons afflicted with Hidranitis Suppurativa require a great deal of support and understanding. It is often much more than a simple boil under the armpit.


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