Inflammation is associated with a variety of health conditions, including hidradenitis suppurativa (HS). Understanding inflammation, its causes, and its effect on HS can better help you manage the condition. Your CRP levels — that is, the amount of C-reactive protein in your system — are also part of the conversation.

Hidradenitis suppurativa, also known as acne inversa, is a chronic inflammatory skin disease characterized by painful, recurring bumps on the skin (known as abscesses) — typically in the armpits, groin, buttocks, and underside of the breasts. Inflammation also causes your liver to produce more CRP. High levels of CRP in your blood could indicate you have an inflammatory condition — including HS, among many others.

What Is Inflammation?

Inflammation isn’t a condition in and of itself, but rather a result of various illnesses. When body tissues are damaged, they release chemicals to make the immune system respond to that injury. The immediate symptoms of the ensuing tissue inflammation — discoloration, soreness, warmth (fever), and pain — are a result of the immune system’s response. Inflammation can also result when your immune system responds to foreign materials entering your body, like viruses or bacteria.

Most of the time, inflammation is acute. It will go away on its own in a short period of time, once an injury has healed or an invader has been defeated. However, in some cases, inflammation begins when there isn’t any injury or infection at all. Without the normal signal for the inflammation to start in the first place, the body doesn’t know when to stop fighting — so the inflammation persists. This is called chronic inflammation, and it generally results from the body perceiving normal tissue or cells as foreign.

Most conditions that involve the immune system are referred to as autoimmune diseases or autoinflammatory disorders. However, while HS inflammation does involve the immune system, researchers don’t know whether the condition involves an autoimmune reaction. Currently, HS is only known to be an autoinflammatory condition, not an autoimmune condition.

Inflammation and HS

The cause of hidradenitis suppurativa is poorly understood. Scientists have found evidence that HS is autoimmune in origin — in other words, the damage in HS is caused by the body’s immune system attacking its own tissues — but they have not yet solved the puzzle of why this process begins.

According to one theory, HS develops when the immune system overreacts to clogged hair follicles. Some researchers believe HS results when apocrine glands (sweat glands) develop abnormally, trapping secretions deep in skin tissue and triggering inflammation.

CRP Levels and HS

When inflammation occurs anywhere in the body, the immune system triggers the liver to produce C-reactive proteins. These proteins are sent through the bloodstream to help with the immune response. Once the inflammation passes, CRP levels return to normal. If you have an inflammatory disease, your body will continually produce CRP as part of its ongoing immune response, resulting in higher-than-normal CRP levels.

A doctor can measure your CRP levels, using a simple blood test. A high level can be an indicator of an inflammatory condition, including HS. CRP levels of 10 milligrams per liter or lower are considered normal.

HS is associated with higher levels of CRP than usually considered normal, but the association is not as well defined as it is with some autoimmune disorders. CRP may be tested as part of a series of laboratory tests, including others for HS. Higher CRP levels may also indicate infection or chronic illness, or they may be the result of physical trauma.

Other Inflammatory Conditions and HS

HS is associated with several autoimmune conditions. One study found that people with HS had a slightly higher chance of being later diagnosed with ankylosing spondylitis, a form of inflammatory arthritis. Two other forms of inflammatory arthritis, rheumatoid arthritis and psoriatic arthritis, were also slightly more likely to occur in people with HS. Another study found that HS was more likely to occur in those with inflammatory bowel disease, commonly known as IBD.

Mental Health and Inflammation in HS

HS can be a stressful condition, with symptoms including painful skin lumps, open wounds that won’t heal, and scarring. But stress is more than just a mental state; it has physical impacts as well. In the short term, stress releases cortisol, which decreases inflammation. This can help for a little while if you have an inflammatory condition, but over the long term, your body can get used to higher cortisol levels, which can ultimately lead to an increased risk of inflammation.

Additionally, stress can trigger depression and anxiety, which are risk factors for inflammation. Heart disease, diabetes, and other conditions are associated with those stress levels, especially with people who have a family history of such conditions.

Stress can’t simply be turned off and on, but there are techniques and lifestyle changes that can help reduce it. Many of them are relatively simple to incorporate into your daily life. They include:

• Exercising — The Mayo Clinic says that exercise can improve your mood and reduce symptoms of stress — with the added benefit of reducing heart-disease risks. (If your HS makes exercise difficult, talk to your doctor about what you can do for exercise safely.)
• Eating a nourishing diet — Unhealthy food might seem to temporarily alleviate stress, but it can make it worse over the long run.
• Using relaxation techniques — Yoga is probably the most well known of them, but there are simpler exercises involving breathing and visualization that can be used as well.

If stress, depression, and anxiety seem to rule your life and nothing seems to help, talk to your health care provider about your problems. You may need medication or another form of medical treatment.

Find the Support You Need

When you join myHSteam, you gain a community of more than 18,000 people living with HS. Members offer support and share advice about living with HS and other related health conditions.

Have you had a CRP test? Share your experiences in the comments below or on myHSteam.