Alexa Fleckenstein M.D.

Less than a month ago, a young woman in her mid-twenties called me for “lumps in my armpit”. Now, that can be a thousand different things, not all easy to diagnose, some with dire prognosis. So, I told her I needed to see her. She came, and the diagnosis needed one look only: Hidradenitis suppurativa. This poorly understood skin disease can’t be confused with any other: The patient has multiple red swellings and scars in the axilla, sometimes at other areas, too. You could describe it as boils in the armpit. They are painful and disfiguring. Conventional medicine describes them as inflamed sweat glands (which is what “hidradenitis” means, and suppurativa means “leaking pus”). They are similar to boils, pilonidal cysts, chronic abscesses, fistulas and different kinds of cysts. They might be exacerbated by hormones, excessive sweating, and overweight. Genetic factors clearly play a role – hidradenitis suppurativa is more common in females, and in people of Mediterranean and African-American descend. Medicine might not understand the cause of it, but any layperson can see that hidradenitis suppurativa is a highly inflammatory disease. This young, pretty woman was slightly chubby – not badly, indeed. But I advised her to eat more vegetables with olive oil, and leave out all sugars and dairy products, as the most inflammatory foods. She also was bloated and had a family history of gluten problems, so I asked her to leave out gluten, too; at least for a few months. I also recommended anti-inflammatory fish oil and probiotics to help her poor, inflamed bowels to heal. What happened to the young woman? - Within two weeks, she was dramatically better and had lost some pounds, and all the bloating. I never counsel to lose weight; I recommend a better diet, and the weight loss will follow automatically. She was happy about the result. Unfortunately, then she went to a party where she indulged in all the wrong foods, including pizza, cheese, and sweets. The boils immediately recurred. I was not worried about the relapse: It only confirmed what she had learned: That what she eats has a beneficial or not so beneficial effect on her digestive system, and her health. – Her choice, really. I know that at this age, all the young woman wants is to look good and be able to were a sleeveless top, and there is nothing wrong with that. But I will make a prognosis – even if I might not be around to see the result: If this twenty-five year old will be able to stick to her resolutions (at least most of the time), she one day will be vibrant fifty-year old. If not, she will go the way most people go in our society that adores foods that I’d call “non-foods” – and she will experience obesity, diabetes, cancer and the myriad of chronic diseases that seem to pop out of nowhere as we age. – Let’s see which way she chooses … Read More