Painful inflammatory cysts, pus and sinus tracts on a patient with Hidradenitis Suppurativa.
Original photos from 'Extended Hidradenitis Suppurativa of the Underarms' by E. Rallis, B. Mousatou, P. Papadakis and K. Verros.
My skin sweat pores, genetically, have a strange problem: They are convoluted, not unlike the tube under a sink, contrary to being straight like in any normal human being. I have no idea how they developed thus. Neither does anyone else.
The exact disease from which I suffer is called Hidradenitis Suppurativa.
What usually happens with this condition, is, no matter how many showers I take per day, eventually, these pores get blocked by fine debris, cotton from clothes and/or dust, and as a result the entire smegma/sweat gland, cannot find its natural outlet, forcing the formation of a cyst, which fills with pus, and only when the internal pressure gradient from the pus exceeds the skin support gradient, the cyst bursts.
The cyst fills gradually with white blood cells, which for some reason appear as if they are committing suicide. There is no bacteria inside the sweat gland, well perhaps there are certain staphs in there since we all carry them one way or another, and the fact that the place is anaerobic, makes the things much worse.
I have been to all sorts of doctors, who cannot provide a logical explanation for the formation of my cysts. I have had such cysts removed from my underarms, from my butt and from my pubic areas. Doctors are of course very blunt about the whole thing, they just hack through the cyst with a scalpel, drain it, and joyfully tell you to put such and such a material on the scar for such and such number of days. When you ask them about explanations, they simply raise their hands, and say, "it's just your skin type".
My skin, appears to be adapting to the process, by forming stronger and more resilient cyst bulbs every time. That is, the cyst walls, as time goes by, get more and more resilient. As a result, the internal pressure gradient needed to force a burst, becomes higher and higher.
Disappointed by the whole predicament, which has no solution whatsoever, I patiently wait for the cyst to show signs of wall deterioration, so I can pierce it with a syringe. Sometimes the cyst reaches sizes of 10-15ccs and the pain becomes unbearable. So my regular morning procedure, is to swallow 4 Advils, light a cigarette, and wait until they take affect. When they do, I carefully clean my syringe with Manuka oil, which is 98% effective on most staph positive organisms, and slowly pierce the walls of the cyst. Considerable pressure is sometimes needed to break the skin wall of the cyst.
Then, as the needle is in, I stop in increments and test by sucking to see if I've reached the core of the cyst. I need to do this, since the wall of the cyst sometimes can be as thick as 2cms and I have no way to tell externally.
When I reach the cyst bottom, it gets easier. Then, I only need to suck up the pus. The syringe usually fills completely, but the pain immediately goes away, as the internal pressure vanishes. When the cyst forms on my butt, it usually receives additional pressure from me sitting or pressing it otherwise, so it creates additional chambers under the skin, so sometimes I have to revolve the syringe in the chamber to get the entire volume of pus out.
I have to continue the above procedure three times a day, until the cyst walls become thin enough for the cyst to break by itself. Since the outside cyst wall is usually 2-3cms thick, this can take up to two weeks.
Well, here I am after one week of going through with another one. The natural reaction to all this, even with the aid of painkillers, is for the body to want to sleep. All the time. So, admittedly, I've been sleeping 20-24 hours a day, waking up only to eat and shit.
After the pain continues for 2-3 days, the brain somehow gets drugged by something. I don't know what it is, probably some sort of internal endorphin production. There is a continuous "buzzing" sensation on everything I perceive, and I have lost all interest in most of the things I do, whilst the pain is in effect.
Even sleeping while in pain is ominous. The brain is generating weird nightmares, that tie in peculiar ways to the hot spot of the whole process, by conjuring weird images related to my predicament.
Lately, around 30 - 35, hidradenitis suppurativa started spreading to other parts of my body. I now have cysts all over, including genitals, butt cheeks and arm pits. Places that hurt the most, because they are full of glands. When a cyst forms on my armpits, my whole arm becomes swollen and almost disabled. When they form on my scrotum, the entire area becomes disabled, including the genitals themselves. When they form on my butt, I cannot sit, stand, sleep, eat, except swallow 4 advils every 2 hours and wait. Wait, until the cyst breaks.
I now have some standard equipment in my house to help me deal with the problem: Lots of disinfected needles and syringes and tincture iodine. When it comes, I prepare myself accordingly.
So here comes another one: On my left butt cheek. First, it's just a nuisance. I just feel the discomfort when I sit on chairs that don't have pillows.
Then it starts hurting, but I cannot really pierce it, because the cyst walls are not defined yet.
In about 3 -4 days time, the pain becomes intolerable, so I start taking advils. First one per two hours, then two per two hours, until I reach the limit of four per two hours. The brain starts producing endorphins on the side, sensing that something is really wrong.
Eventually, after a week of pain, the brain get completely drugged from a week's worth of advils and the endorphins. It starts malfunctioning. I just want to sleep. And not wake up. Unfortunately, I *do* wake up, and the feeling from waking up in this state, is probably worse than the actual pain from the cysts.
Gradually the pain becomes so strong that I start having thoughts of random violence.
So I get up, at 3:35 am and swallow the last 2 advils in the bottle. I smoke a couple of camels until they start taking effect, and make the final decision to once again go through with "the procedure". By now, the cyst on my butt cheek has a volume of almost 50 ccs. I can't walk even.
So I carefully disinfect the syringe, by plunging it into the iodine, doing the in-out routine for the hundredth time. Then, if I am really lucky, I can reach the cyst with one of my hands. It's easier if I can reach it with my right hand, but many times I can only reach it with the left. So I bite my lips, and feel the walls of the cyst, which now have a thickness of one inch. It's really hard to pierce through with the syringe, because they get thickened in order to accommodate the increased internal gradient and because every time I had sat on something, the cyst expanded internally, breaking the existent skin walls and allowing new ones to form at a greater radius. Except that the old walls never really go away, rather, they become part of the new expanded walls.
Then, the syringe goes in. I am reversing the sucking action every now and then, in order to find out if I've reached the cyst center. If I am lucky, the syringe dips in the first time. If I am not, I am just sucking empty air, cause the needle tip is in muscle. This last time I was lucky, even though I sucked through using my left hand. So I suck around 20ccs of pus out of it, take the needle out and empty it on the sink. Then I re-disinfect the syringe. Repeat as often as needed, until the cyst empties some. Again, if I am lucky and the cyst walls are not convoluted, I manage to empty the larger part. If not, I empty something like 40-60%.
I then head back to bead and pray that I don't wake up next morning. Unfortunately, I again wake up. The procedure will have to be repeated as often as needed.
As a last resort, I went to the hospital of venereal diseases here in Athens and they gave me some sort of antibiotic, which seems to be working. And I say "seems", because at least the pus does not stink of rot anymore and because once a cyst forms, it stays there forever, blocking itself over and over again through time, until the entire pore sack is removed surgically. Obviously, I cannot go once a week to a surgeon to remove every new cyst that forms. And judging from the doctors' predictions, it is clearly impossible to predict where a new cyst will form.
The long term prediction for hidradenitis suppurativa is not good. I will have to deal with this problem until I die. Here's a list of powerful antibiotics which can potentially help patients with this disease:
If everything fails and the disease keeps coming back, try this remedy. I have tried it and the results are very good.
Can you even BEGIN to imagine what one's life feels like when one is in CONSTANT pain, almost 24/7/365? No you can't. You can't POSSIBLY imagine that.
You think you've got a painful disease? Tell me about it.