ASK THE DOC

Surgeon and lecturer Dr Sarah Rayne weighs in on recurring abscesses and how to deal with tick bites.

I have a history of abscesses in my groin, pubic and armpit area. I have drained them several times in the past few months, but they keep coming back. They tend to heal on their own; only three have ever required medical intervention. Do I need to see a dermatologist?

A: Unfortunately, it sounds as if you suffer from a condition called hidradenitis suppurativa, a very uncomfortable-sounding name for an uncomfortable condition that is difficult to cure but has lots of treatment options. It’s a kind of acne that affects the skin in glandular or ‘sweaty’ areas of the body: under the arms, in the groin, around the bum. The glandular skin becomes inflamed and constantly develops boils. These can be sore and red; they can become infected and give out pus, or cause deeper abscesses. As they heal, they cause scarring that can make the skin look and feel worse. It’s not a very well-understood condition but it tends to affect women more than men and is worse during the reproductive years, so it may be hormonal in some way.

There are some simple ways to help reduce the frequency of infections, such as avoiding smoking and losing weight. Good hygiene, including antibacterial wash and prompt treatment of infections, will also help. It would be a good idea to be in touch with a dermatologist as they will be up to date with new treatments, but you could also look up one of the support groups online, such as the Hidradenitis Suppurativa Trust (www.hstrust.org).

We have a house full of animals, so tick bites are bound to happen. About three months ago I discovered a tick between my toes, and when I removed it, I saw that it had left a tiny mark. It continues to itch to this day. Should I be concerned?

A: It’s true that ticks are a common part of life in most of the country, and most readers may have come across one on themselves or an animal during a walk in the country. Ticks are spider-like parasites that hang around on the top of a grass blade until a two- or four-legged meal (that’s you or your pet) comes along. It then hitches a ride. It burrows into the skin until it finds a blood vessel and takes a nice, long drink… once it’s had enough, it lets go and drops off.

There are two problems with ticks: the damage they do when biting you, and the diseases (such as African tick bite fever or Lyme disease) that they leave behind, which can make you really ill. Simple measures for avoiding ticks are useful for avoiding snakes too. Always walk with arms and legs fully covered. Check yourself and your pet when you get home, remembering to look in warm cracks, like between toes (well done to you!), and the groin.

When you find a tick, remove it carefully using a tick remover or angled tweezers, making sure you don’t squeeze it (you can force infected saliva into your wound) or detach the head from the body. If that happens, the mouth parts can be left behind, burrowed into your skin. It sounds like this might be the case with you. The body will treat this like any splinter and so the itching and redness is part of the body’s way of trying to force it out. It would be worth seeing a doctor to have a proper look. In the meantime, make sure this area doesn’t develop an infection, so watch out for pain, swelling or redness.✤