What is HS: Inflammatory/Follicular Occlusion

Updated: Jun 30

The skin is composed of an epidermal layer, hair follicles, sebaceous glands, and sweat glands, which can descend into the underlying dermis. HS is primarily a follicular occlusion disease with secondary involvement of the apocrine and eccrine glands.

The sebaceous glands are located in the dermis, the middle layer of the skin, and they develop from the epithelial cells of the hair follicle itself (the external root sheath of the hair follicle). Sebaceous glands are the most closely related to hair follicles and are located throughout the entire body. Sebaceous glands are the oil secreting glands of your body, which is why they are also called the oil glands. They are a type of holocrine simple saccular (alveolar) gland and their function is to secrete a substance called sebum. Sebum is a mixture of fatty substances, entire sebum-producing cells, and epithelial cell debris.

Eccrine glands are the most numerous types of sweat glands and are found almost everywhere on the body. These are the true sweat glands in the sense of helping to regulate body temperature. In other words, sweating causes the loss of body heat and thus cools us down on a hot day or when performing strenuous exercise. This is because as the water in sweat evaporates it takes body heat with it. They secrete moisturizing factors such as water, lactate, urea, sodium and potassium to maintain skin hydration. Secreted sweat mixed with sebum on the skin surface forms a moisturizing lipid layer. Recent studies have further demonstrated that sweat glands secrete several antimicrobial peptides, including dermcidin, cathelicidin and lactoferrin, which help to control skin flora and fight skin infections

Apocrine glands are a subtype of exocrine secretory glands and are found in many locations such as the axillae, areolae, and anogenital region. These glands, unlike the eccrine glands, serve virtually no role in the regulation of body temperature. These are also the glands largely responsible for body smells, as their excretions are converted by skin bacteria into various chemicals we associated with body odor.

The reason HS can develop and be more common in apocrine glands areas is because it has the most abundant amount of hair follicles. Follicle occlusion can happen anywhere there are hair follicles, in any part of the sweat gland regions, which is anywhere of the body. Hair follicles can be found anywhere on the body with the exception of the soles of the feet palms of the hands and on the lips.

Depending on the amount of inflammation and the depth of your HS, sweat glands may become irritated or triggered secondarily and can contribute in making things worse, however, they are not the primary role in HS. Most people get clogged hair follicles from time to time, but if you have HS, your body is overreacting to those blockages and triggering the innate immune signals.

Reference this article for image by: https://www.frontiersin.org/articles/10.3389/fimmu.2018.02965/full


This is an awareness article for educational purposes only and is not intended to replace the advice of your doctor or other health care provider.

Written by Denise Panter-Fixsen

Edited by Brindley Kons

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