Medically reviewed by Steven Daveluy, M.D.
The past decade or more of research suggests and supports HS as a chronic inflammatory follicular occlusion disease which occurs at the dermal level (dermal - relating to the skin or dermis).
Many wonder about HS and glands, which you can read more about here. When referring to glands and gland removal we are most notably discussing the apocrine glands.
The apocrine glands in the skin are the scent glands, and their secretions usually have an odor. They are located in the deep dermis, but still located in the dermis in the infundibulum of the hair follicle. Apocrine glands open into the hair follicle, leading to the surface of the skin
and are found only in specific locations on the body including:
Axillae (armpits)
Areola of the nipple area
Ear canal
Perianal (anus area)
Genitoanal region/groin
Wings of the nostril
Specialized types of apocrine sweat glands on the eyelids are called Moll's glands
Apocrine glands form in utero (fetus stage). They don’t begin working until puberty when the hormonal stimulations start taking place. This further proves hidradenitis suppurativa is not primarily a gland illness as it has been proven and research has shown that you can develop hidradenitis at any age, even before puberty.
If the apocrine glands become involved; it would be due to secondary reasons (inflammation, tunneling, etc.), NOT because HS is a gland illness.
YOU NEED HAIR FOLLICLES IN ORDER TO DEVELOP HS LESIONS, BUT YOU DO NOT NEED APOCRINE GLANDS TO DEVELOP HS LESIONS. HS IS NOT A GLAND DISEASE.
The following DOES NOT mean that HS is a gland illness:
Just because “HS may be more common in the areas where these apocrine glands are present” does not make HS a gland illness. Learn more on our follicular occlusion article noted below.
Just because you may have “had your glands removed” this does not make hidradenitis suppurativa a gland illness.
Just because a physician who may not be well educated in HS says “it's a gland illness”, it does not mean HS is a gland illness. Please refer them to our clinician section HERE.
Just because outdated literature on a website says; "it's a gland illness, infection of the sweat glands, or a sweat gland illness”, that does not make hidradenitis suppurativa a gland illness.
HS IS NOT A GLAND ILLNESS, INFECTION OF THE SWEAT GLANDS,
OR A SWEAT GLAND ILLNESS
Understanding this and passing this info and knowledge on to others will help lessen the time to diagnosis. The misconception that HS is a gland illness means that many who suffer with HS in places outside the apocrine gland areas are not believed to have HS. This means many additional years of suffering due to misinformation because as we know, HS can impact anywhere on the body there are hair follicles.
Hair Follicle 101
The structural, pilosebaceous, or hair follicle units are found everywhere "ON" the body except the palms of hands, soles of feet and red part of lips.
The hair follicle unit begins at the surface of the epidermis. For follicles that produce terminal hairs, the hair follicle extends into the deep dermis, and sometimes even subcutis (bottom layer of tissue / skin or beneath the outer skin where most of the fatty cells are).
More Info on Hair Follicles
Hair follicle consists of the hair follicle itself with an attached sebaceous gland and arrector pili muscle. It's an impressive little unit with a pretty important job. *Please do not confuse the word hair follicle unit with having visible hair. You do not need to have hair or hair growth to develop hidradenitis suppurativa. It's not about hair; there can be an aggravated factor for some people but it's not about the hair.*
Why This is Important
Misunderstanding the role of glands in HS leads to misdiagnosis or longer time to a diagnosis.
With an average time to diagnosis of 7 years currently, we need to ensure that accurate information is being shared. Sharing this information that hidradenitis suppurativa is a gland illness, infection of the glands infection of the sweat glands or other related misinformation about glands; causes many patients with HS to go undiagnosed.
Important:
• HS does not just develop where hair grows - it can develop anywhere there are hair follicles.
• HS does not just develop where there are glands - HS is not a gland illness.
• Skin folds have little to do with the development of HS; meaning, HS can develop whether you have skin touching skin, or skin folds.
HS Inside the Body?
HS is not the only type of follicular occlusion; there are several follicular occlusions including acne conglobata, dissecting cellulitis of the scalp and pilonidal sinus. Follicular occlusion illnesses do not occur inside the body, which includes Hidradenitis Suppurativa. The inflammation HS causes can affect other parts of the body.
If you are developing mouth abscesses or cysts, please see your dentist and/or oral surgeon right away. If you are developing abscesses inside your body (i.e., found during an exam or on a scan) please speak to your physician about a potential diagnosis of Crohn's Disease. There are various types of vaginal cysts. If you are getting "abscesses" or cysts inside of your vagina and or chronically, please talk to your doctor.
Having the correct information is important in order to obtain proper help with your condition. We don't want you to assume you have hidradenitis suppurativa inside your body; inside of our body is simply lacking the structural, pilosebaceous, or unit of a hair follicle.
References and research:
Related Articles:
Content in this article is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay seeking treatment because of something you have read on this website.
Written by Denise Fixsen
Edited by Brindley Brooks
Medically Reviewed by Steven Daveluy, M.D.