TL;DR:
- Acne inversa is a chronic inflammatory skin disease causing painful nodules, fistulas, and abscesses, commonly in sweat gland areas (underarms, groin, buttocks, scalp).
- Symptoms include burning, itching, pus-filled nodules (0.5 mm–2 cm), unpleasant odor, and scarring after healing.
- Causes: Hormonal, immunological, bacterial issues, genetics, and lifestyle factors like obesity, smoking, and irritants (deodorants, depilatories).
- Treatment:
- Lifestyle: Wear loose natural fabrics, quit smoking, maintain healthy weight/diet.
- Pharmacological: Antibiotics, anti-inflammatories (ibuprofen), anesthetics (lidocaine), and biologic drugs (adalimumab).
- Surgical: Deroofing, laser therapy (CO2/neodymium), or tissue excision.
- Proper skin care (antiseptic, gentle products) helps but doesn’t cure. A dermatologist should oversee treatment based on severity.
Skin problems affect many people of all ages, not just teenagers in adolescence. One such condition is acne inversa, which is one of the chronic inflammatory skin diseases. How to recognize it and how to proceed to bring yourself relief and improve the appearance of your skin?
Inverted acne – what is it?
Acne inversa, also known as purulent apocrine sweat gland inflammation, is a chronic skin disease. It occurs not only on the face, but inverted acne under the arms or on the labia is an equally common location of skin lesions. The condition is difficult to treat, can recur, and looks unsightly. What's more, skin lesions can cause pain and discomfort.
What does inverted acne look like?
Inverted acne are quite characteristic skin lesions. They are nodules, fistulas and abscesses, deeply embedded and also involving the hair follicles. These lesions are painful and usually develop in the area where the sweat glands are located. Thus, inverted acne on the buttocks, under the arms, on the labia, as well as in the groin or on the scalp is the most common location. If you have doubts that the skin lesions present on your skin are inverted acne, the images available online should clear up your doubts.
The first symptoms of inverted acne.
Acne inversa gives symptoms that can be easily noticed. First of all, subcutaneous nodules that cause pain should be of concern. They are small in size from 0.5 mm to 2 cm and filled with pus. In some people, even before the nodule appears, there is a burning sensation and itchy skin in the area. The nodules that appear on the skin grow and fuse together. After they burst, pus and blood with a rather unpleasant odor flow out of them. On the other hand, healed lesions leave scars. In addition to purulent nodules, so-called open blackheads, which are thickened lesions with a black dot, may also appear on the skin. If inverted acne appears in the groin or under the arms it can be particularly troublesome. Friction and movement will further aggravate the pain felt.
Causes of the appearance of inverted acne
Chronic inflammation of the apocrine sweat glands is a complex condition that can be triggered by a variety of factors. To date, the causes have not been clearly identified, and new studies are providing information on further causes and risk factors affecting the appearance of acne inversa.
Main causes of inverted acne
Reverse acne and the causes of its appearance vary. However, immunological and hormonal factors are cited as the main reasons. In addition, the condition occurs due to disorders of the hair and sebaceous apparatus, or disorders of the bacterial flora of the skin. In addition, genetics also plays a large role in the occurrence of inverted acne.
Risk factors
An unsuitable lifestyle can also contribute to the development of inverted acne or to the severity of its symptoms. Inverted acne on the head, face, underarms, or groin may appear more often in obese people, as well as those who smoke tobacco. In addition, purulent skin lesions can accompany people with diabetes or autoimmune diseases. It is also worth being aware that deodorants and chemical depilatories can also contribute to the condition or aggravate its symptoms.
Reverse acne treatment
Inverted acne and its treatment is a complex and lengthy process. Depending on the extent of the lesions, non-pharmacological, pharmacological and surgical treatments are used. Inverted acne and home remedies to alleviate its symptoms are also an effective way to combat the problem.
Treatment to alleviate symptoms
If inverted acne appears on the labia, underarms, or groin area, a good solution is to choose airy clothes made of natural materials. In addition, smokers should curb their habit immediately. It is also crucial to ensure a correct body weight. In the case of inverted acne, diet allows not only to lose excess weight, but also to help normalize metabolism and provide the body with essential vitamins and minerals.
Pharmacological treatment of inverted acne.
Acne inversion and its pharmacological treatment depends on the number and stage of skin lesions. For mild symptoms, it may be sufficient to implement appropriate antibacterial skin care products. On the other hand, more advanced inflammation requires the use of medications for inverted acne. Among others, antibiotics and anti-inflammatory drugs such as ibuprofen or anesthetics with lidocaine are used. Biologic drugs for acne inversa are also used. This is adalimumab administered by injection.
Treatment of inverted acne.
Specialized surgical and aesthetic medicine treatments are also available to treat inflammatory skin conditions. These include deroofing, which involves removing tissue over the fistula. An alternative is laser therapy with a CO2 or neodymium yag laser. In more advanced stages of the disease, surgical excision of inflamed tissues is also performed, or in difficult cases the affected tissues are excised down to the depth of the muscle fascia and the fistula is removed. More details on these treatments can be explored in the aesthetic medicine section offered by the OT.CO Clinic.
How to care for skin with acne inversion?
To be able to reduce the symptoms and discomforts associated with inflamed skin, it is crucial to take the right steps. Biological treatment of inverted acne, pharmacological treatment, or treatments are not enough. Daily skin care is also important.
Cosmetics to help with reverse acne skin care.
The treatment process is worth supporting with proper skin care. First of all, reverse acne and herbs are a good combination. It is worth reaching for natural cleansing cosmetics, without artificial fragrances and irritants. It is worth reaching for products containing antiseptics, such as zinc pyrithione or triclosan, for example.
Which doctor to go to with acne inversion?
Home care can alleviate the symptoms of inverted acne, but will not be effective in curing it completely. Where to treat inverted acne? You can go to your primary care physician, who will assess your skin health and make a referral to a specialist. Usually a visit to a dermatologist is recommended, who will select the appropriate medication and, in the case of advanced lesions, direct you to surgical or surgical treatment. How to treat inverted acne depends largely on the causes that caused it and the stage of progression.
Conclusion
Acne inversa is a persistent, painful condition that affects more than just teenagers. It can appear in common areas like underarms, groin, or scalp, causing significant discomfort. Understanding its symptoms, risk factors, and treatment options—ranging from lifestyle changes to medical interventions—can improve your quality of life. If you think you have this condition, seek a dermatologist’s guidance for personalized care. Taking proactive steps and choosing the right treatments can help manage symptoms effectively. Don't ignore it—addressing it early makes a difference.
