Anyone riding with Hidradenitis Suppurativa

Just wondering if anyone else out there trys to control their HS and how do you deal with riding. I have had it since I was 13 and got alot worse around age 16-17. I hid it from my mother who now wonders how I rode all those years.

I have tried every doctor and even had radical surgery to remove a large portion of skin from both thighs. Now I am going to John’s Hopkins once a month for laser hair removal in hopes of scarring the hair folicle. Right now it seems to be doing pretty good and only have flare ups right after the laser treatment. I am wondering how this will be when summer comes.

I have taken off the last couple years of riding and now I am learning to ridesaddle in due to trying to relieve some pain that I have in one ankle.

I have never been officially diagnosed with it but am pretty sure I have a mild form of it.
I believe that mine is related to my PCOS. In the past I have found anecdotal links of HS to PCOS.
Once I lowered my carbs and was on diabetic meds for about 9 months it largely resolved. Diabetic meds are frequently used off-label for PCOS since PCOS effects glucose levels and insulin production.
I have the scarring in the armpits and rarely get a single pus filled thing for a few days.
I have seen pictures of bad case of HS and I was never that bad.

SonnysMom - I know a lot of women do say that it is directly linked with PCOS. Its good to know that yours cleared up from the meds!

I have HS, I was diagnosed when I was 18, so about four years ago. I have had it ever since I was about 12, sometime after I got my first period.

Thoroughout my teens, it mainly was just an abscess here, an abscess there. When I was 16, I had one in the perianal region that didn’t resolve for over a year. I had surgery to remove it. This last summer I had surgery to remove a series of sinus tracts and abscesses in my underarm, something I am still healing from.

I used to ride. Due to pain in my tailbone caused by another abscess, one that has since resolved, I quit riding about 3.5 years ago. I miss it terribly, but in the meantime I learned to carriage drive, until I had to stop that due to my surgery. :no: However, once my arm is 100%, I’ll go back to the driving. I want to ride again, and believe I should be able to, but now there is some fear I’m dealing with. Not fear because I’m afraid to ride, fear I’m afraid it is going to hurt.

I wonder now how I rode in my teens, I was a working student for an eventing trainer. I rode anywhere from 4-8 horses a day, after 2 hours weight lifting. I was fit, and I think that was what makes the difference. Ever since my first surgery, I agained a good 50 pounds partly because of depression and partly because I was not as active as I once was.

I try to read all academic articles on HS, and one that I particullarly liked was a review many articles divided by different doctors. There are many differing opinions on HS, one doctor feels that there may actually be 3 different diseases going on since there is no “typical HS” patient. There’s the “Obese, smoking, middle-aged woman” theory. These women with HS tend to stop having symptoms after they stop smoking, lose weight, and get to menopause. Lucky them.
There is also the connection to hormones, like the connection to PCOS. They tested me for PCOS, and the doctors were 100% sure I had it, and were also 100% sure I had diabetes. Tests came back as normal as possible, both blood sugar and hormones.
Then there is the autoimmune connection. That’s were I fit in. If you look at my family medical history, it’s riddled with autoimmune. I was a kid who constantly complained of joint pain. I am hugely sensitive to the sun, and have extreme bouts of chronic fatique. Before I had Kaiser, my doctor wanted to test me for Lupus and Crohn’s, since I show a number of symptoms of each. My primary also thinks I may have a mild form of Psoriasis, since I have had a constant rash on my back that has a psoriasis look to it. I’m an autoimmune mess. :lol:

Since I’m not currently riding, I can’t give you any definitive advice. What I can give is what family, trainers, and I have come up with when I try riding again:

  • Be very picky about saddles. Find one that is a couch. I have sat in countless models (not ridden, just in the tack store try on). My favorite currently is the Stubben Roxane S with the Biomex seat. I know Stubben’s are known for hard, hard seats, but I like their Biomex seat. My next favorite was surprisingly the M. Toulouse Aachen saddle with their knockoff of the Biomex seat.
    I’ve also tried: County, Custom Saddlery, and another brand that escapes me right now. While I liked them as saddles, I just looked at the fitters and said, "Look, you’re going to have to have another 3 layers of foam before this is going to work.
    I want to try talking to Trumbull Mountain about Black Country since I’ve heard that their endurance models are very well padded and they are happy to help with custom and odd saddles.

  • Look for a different discipline. When I was really having a lot of issues, I was ridding dressage exclusively. Ironically, I made the switch from Eventing to Dressage because we thought it was more “kind” on the behind. Now in hindsight, I did much better when I was exclusively a jumper (yes, I’ve switched disciplines a lot). So, when I try riding again, I’m either going to go with eventing, and do my dressage in a close contact, or go with hunter/jumpers. It’s the constant 3 point contact of western and dressage that makes it so irritating to me. I want to get out of the seat quickly and efficiently to give my behind some rest.

  • Padded underwear… Dover’s has it… That’s all I’m going to say about that.

  • Take it slow, read your body. If you’re hurting so much, don’t push for an intense lesson. Just do walk work.

  • Try carriage driving. It’s something horse-y you can do if your body just can’t handle riding that day.

PM me if you have any questions, or just want to talk.

Thanks Appy! You and I sound a lot alike! Mine started out with a Pilonidal Cyst on my tailbone. Had 3 surgeries to get rid of that one over a 3 year period. My advice for that if yours comes back is to have it removed but don’t let them stitch you back closed. I left mine open and it healed from the inside out for about 6-7 months. I have not had a problem with it for 4 years.

My flares are more in my groin area than in my armpits even though I get them there also. I was the overweight girl who smoked and they all blamed that but I have lost 70 lbs and back to healthy weight and quit smoking but the skin has not changed! Go figure. I was on antibotics for about three years until January. My current Derm took me off and refered me to Johns Hopkins for the laser hair removal. She studied and researched it so I felt for once that I finally met someone who understood my problem. Needless to say with being on so many different antibotics for so long it has caused other health problems. I know have Psuedo tumor Celebri which we believed was caused by being on Doxci (sp). Last January, I had such a bad headache for a week in my eyes my doc sent me to a nuero opt. She did a MRI to rule out a tumor in my brain then sent me for a lumbar puncture. My opening pressure was 25 so they drained some spinal fluid off to release the pressure that was pushing on my optic nerve. Since then I have been on a diuretic things have been ok. They also wanted me to lose weight to make the symptoms go away but they don’t either!

I was like you in my teens being fit until I graduated high school and got an office job. Then the weight went on and I got married and divorced. Last June I was fed up with it and decided I was going to lose weight. I went on medifast and lost 70 lbs without exercising because I was tired of going for a walk and then 2 days later I couldn’t walk because I had a flare up. I have been maintaining my weight for about 4 months now and I can’t believe how good it feels to ride again without all that extra baggage!

I am hoping that the laser treatments will work for me! There is a lot of research that was done on it so I hope you will check it out. I also have Kaiser and was lucky that I found such a great derm. At least if it doesn’t work totally I got free laser hair removal :yes: Theyare doing my groin, armpits and underneath my breasts. And so far my armpits have not had a lump. I only got lumps there and never had any tracts. My groin has slowed the flares and closed some old abcesses that would never heal so to me that is progress. I have only had 3 treatments and are due for 3-5 more. I will keep you updated on how that turns out.

One of the reasons I am choosing to learn to ride sidesaddle was hoping that I wouldn’t have that impact like you do riding astride. Your weight is more based on your back of your thigh instead of your groin area.

I hope you recover quickly from you latest surgery and wishing you a pain free day!

OP- interestingly I also have had 3 surgeries for a Pilonidal cyst.

App- I have had a diagnosis of basically an over active immune system. My body was bored and attacking my colon and liver. Being on predinsone for 1.5 years packed on over 40 lbs. Plus Immuran which is an immune suppressant drug used for patient after transplants has “cured” me.

I am overweight but always a non-smoker. On the other hand being overweight tends to go hand in hand with PCOS. I had the abcesses long before I was middle aged.

OP- good luck with the laser treatments. I had laser treatment of my chin to get rid of excess facial hair caused by the PCOS. Nothing like being female and having a beard to shave daily. :no:

SonnysMom - The doctor I am seeing down at JH said that HS, Pilonidal and acne are all related also. And of course I have all three. I hate being 28 and having really hugh acne cysts on my chin all the time! And with not being on an antibotic that just makes it crazy. All the doctors want to put me on accutane but I cant because of the Psuedo Tumor and now I have so many medication contradictions from it. It gets so frustrating sometimes! I say all the time that I wish I could just have new skin and not be blessed with the same skin my dad had (I just got a worse case)!

OP- wow, if I had your Kaiser, I would be much happier. When I was on Kaiser, they refused to diagnosis me with anything. I went to a non-Kaiser derm, who then sent me to be a case study with a Dermatological Group, where I finally got diagnosed. And then, Kaiser refused to accept the diagnosis for over a year! Once they finally accepted it, they refused to do any experimental treatment, said anti-biotics and surgery were the only thing they would approve. I said no to anti-biotics. My abscesses have been cultured over and over and the cultures always come back negative for everything! I only said okay when surgery was needed.

I’ve wanted to do the laser therapy for a while, and now that I’m a new insurance I think it is finally going to happen. I just switched this March. Like I’ve said, I’ve read almost every research article out there about HS. I can’t wait to try the laser. Also, I would like to try some sort of anti-TNF drug, which will hopefully help all my other immune problems.

HS is part of the acne triad. But sometimes I feel like that labeling does a disservice to the patients. I’ve had doctors look at me like “It’s JUST acne.” It’s not just acne, it’s a serious disease that if it doesn’t go in check can severely worsen quality of life.

My flares are mostly in the groin. I’ve had only one in the armpit, but that one has been the worst so far. It was so debilitating that my right (dominant) arm was useless for almost a year before the surgery, and now it’s almost been a year after. I now have full function of my hand, the abcess was putting pressure on some nerves so my hand would go numb when I drove. Not a safe thing when your driving a hot, green driving horse! But this summer, my goal is to get back into the horses. My mare has had two years off, I’m feeling pretty good, time the mare goes to work.

I’m overweight as well and trying hard as hell to lose it. I don’t lose with just diet, my body just goes into starvation mode. So I have to exercise. My heaviest was 230 lbs, size 20. I’m now 199 lbs, size 16. My first goal was to get under 200, next goes is to get out of the “Obese” BMI range. So about 180. Dream range would be 155lbs. I’ve learned now to just push through the pain and exercise if I have an active flare. I just make sure I put plenty of gauze to pad the area and I always wear compression shorts and shirts so I have no skin rubbing on skin.

My saving grace, I kid you not, when I have an active flare is medical honey. I use the brand MediHoney. It’s expensive but it’s helped the abscesses rupture more quickly, helps with the pain, heal more quickly and with less scarring. I started using it on my surgical incision this summer because the incision kept ripping open, it’s the only thing that helped it close. My surgeon was amazed, and said to keep using it. I tried it on an abscess that just would not rupture or heal. Next morning, it popped with NO pain! And soon healed with less of a scar than normal. (This was a recurrant abscess) If you are going to try it however, make sure you use medicial honey made for wound care.

I don’t think sidesaddle would work for me, my goal is to keep pressure off that tailbone so that Pilonidal abscess doesn’t come back. I think huntseat/forward riding is going to be it for me.

It’s just an embarassing disease! I hate being 22 years old and unable to shave. Plus, I hate how it has taken my passion away from me. I’m hoping I can go back to riding, but I also have to realize that may not happen.

You all are to be admired and given a hand to endue this condition. i will never feel sorry for my problems again.
Sidesaddle is softer that regular saddles for the most part so do try it.

Thank you Trying. I had a two day clinic this weekend and was riding sidesaddle. I do love it and today my skin seems to be doing okay. I small active flare and yesterday did have some pressure on my scar from the pilonidal but today feels fine.

Appy - I will have to try the medihoney! Where do you get it? Can you get it online?

Sorry, it took me so long to respond, been away at a conference.

You can buy the MediHoney at medical supply stores or possibly have them shipped to your pharmacist.
Here’s the company’s website:
http://www.dermasciences.com/products/advanced-wound-care/medihoney/inside-the-u-s/

I believe you can order from the website. It’s great. I currently have an abscess that just ruptured that was huge, and now have a gaping hole and sinus. The honey keeps the wound in a good “healing” state, right pH, osmosity, anti-bacterial/microbial/fungal. For a gaping wound, it looks rather healthy! LOL