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Have hidradenitis suppurativa. Noticed painful bump between anus and vagina. Could it be hemorrhoids?

DOCTOR OF THE MONTH - Mar 2013
Mar 2013
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I'm a 27yo female and I have a large lump under the skin between my anus and vagina, I noticed the pain a couple days ago and it makes it very uncomfortable to sit and sometimes walk. This is the first time I've ever noticed something like this. It is very painful to touch. I also have hidradenitis suppurativa but I don't believe that this is from that. I do believe I have hemorrhoids... why I have these I'm not sure! I have made an appointment to see my doctor but it's not until Monday. Any suggestions on what this could be and how to ease the pain in the mean time?
Posted Thu, 7 Feb 2013 in Infections
 
 
Answered by Dr. Aarti Abraham 1 hour later
Hello
Thanks for writing to us.

Given your history, I would not rule out Hidradenitis suppurativa. I wonder if you have reasons to believe that this lump is distinct . Hidradenitis suppuritiva commonly occurs around hair follicles where many oil and sweat glands are found, such as the armpits, groin and anal area. It may also occur in areas where skin rubs together, such as the inner thighs, under the breasts or between the buttocks. It presents commonly as a lump/bump that is painful to touch. The area mentioned by you is also a common site for its occurence. Hidradenitis suppurativa develops when the oil (sebaceous) glands and hair follicle openings become blocked with fluid, dead skin cells and other matter released from surrounding sweat glands. When these substances mix with the oil from the sebaceous glands, they can become trapped and push into surrounding tissue. Bacteria can then trigger infection and inflammation.

It's not known why this blockage occurs, but a number of factors — including hormones, genetics, being female, cigarette smoking and excess weight — may all play a role. Sometimes hidradenitis suppurativa occurs with other diseases, such as Crohn's disease or Graves' disease.

You need to consult your gynecologist who would diagnose this condition by examination, appropriate culture/skin tests and blood tests. Treatment could be antibiotics, painkillers and steroids if indicated.

Haemorrhoids also would cause such a lump, but you would have other symptoms like noticing blood in stools, abdominal pain, constipation, straining on stool etc.

A perineal abscess due to surrounding infection or infection of a hair follicle , or an ingrown hair, also presents in this way.

You need to consult your gynecologist to have the exact diagnosis, and the appropriate medication.

In the meanwhile, you should try warm compresses, warm Sitz bath, and OTC analgesics like Tylenol or topical analgesic creams like Icy Hot cream.

However, these are temporary measures, and the earlier you see your doctor, the better, as infections and abscesses can worsen in a matter of days.

Take care and feel free to ask for further clarifications.

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