Decoding the Skin: What Chemical Mapping Reveals About the Bacteria and Inflammation in Hidradenitis Suppurativa.

My name is Jaap, and I am a biomedical scientist that also used to live with severe Hidradenitis Suppurativa, the kind that takes over your life. Today, I am completely asymptomatic because I learned how to heal Hidradenitis Suppurativa from within. More importantly, I’ve had the privilege of helping many other individuals with HS get their lives back too.

The “Bacterial Fingerprint” Hiding in Your Skin

Have you ever felt like your body is speaking a language you can’t understand? The painful flares, the inflammation, the exhaustion, it’s like a series of alarm bells, but no one can seem to find the fire. For those of us navigating the world of Hidradenitis Suppurativa (HS), this feeling is all too familiar. We’re often told it’s a mysterious, chronic skin disease, but what if we could decode its secrets? What if we could actually see the chemical story it’s telling? This is where our journey begins today, as we explore how to treat Hidradenitis Suppurativa by looking closer than ever before.

A groundbreaking study by Dr. Fincher and his team, shows us something extraordinary: they used a high-tech method to map the chemical landscape of HS skin, revealing a fascinating story about the fats (lipids) and bacteria that live there. Understanding this is a game-changer for anyone seeking a natural treatment of HS, because it provides powerful, scientific clues that support the very foundation of what we do at HS Armor: healing naturally from the inside out and also why skin care is so important for everyone with hidradentis suppurativa.

Peering Inside the Skin: How Scientists Mapped the Invisible World of HS

Before we dive into what the researchers found, it’s important to appreciate how they did it. Frankly, the technology is incredible. First, a huge thank you to the entire research team for their meticulous work. They used a cutting-edge technique called Mass Spectrometry Imaging (MSI), which is a fancy way of saying they used a laser to create a chemical map of the skin.

Think of it like this: Imagine your skin is a country. MSI is like getting a detailed map that shows you exactly which cities are in trouble, what resources they have, and even the types of communication signals they’re sending out. This method, specifically one called NAPA-LDI-MSI, is especially good at seeing things that are usually invisible, like specific types of fats called neutral lipids. This is a huge leap forward because conventional methods often miss these crucial details.

The researchers took small skin samples from patients with severe (Hurley Stage III) Hidradenitis Suppurativa and compared them to healthy control skin. By analyzing the unique chemical fingerprints in different areas, they uncovered some stark differences.

Finding #1: HS Skin Has a Unique “Fatty” Signature of Bacteria

The first major discovery was in the type of fats (specifically triglycerides) found in the skin.

In the healthy control skin, the triglycerides were mostly made of “even-chain” fatty acids. This is the normal, expected type our bodies produce.

But in the HS skin, especially around the inflamed hair follicles, the story was completely different. The scientists found a huge increase(16 times more) of triglycerides made from odd-chain and short-chain fatty acids.

So, what does that mean for you?

Our bodies don’t typically make these odd-chain fats in large amounts. Their primary source? Bacteria. ⁽¹⁾

This is a massive clue. The chemical map revealed a clear fingerprint of an altered bacterial environment, or microbiome, right at the site of the HS lesions. It’s scientific proof that the bacterial landscape in HS skin is fundamentally different. This supports what many of us have suspected for years: that an imbalance in our body’s bacteria (dysbiosis) plays a key role in this disease.

This finding is visualized in the data from the study. In order to understand the figure below I will explain what these graphs are and what the dots represent.

Don’t let these chart below here intimidate you! They are a powerful way to visualize huge amounts of chemical data. In order to understand the figure below I will explain what these graphs are and what the dots represent.

• Charts (a) and (c) are “Scores Plots.” Think of them as the big-picture summary. In these charts, each single dot (a square or triangle) represents the entire chemical fingerprint of one specific skin sample. A computer analyzed thousands of molecules from that one sample and boiled it all down to a single point. The fact that the blue squares (Control samples) and red triangles (HS samples) cluster into two completely separate groups tells us their overall chemical makeups are consistently and dramatically different. The farther apart the groups, the bigger the difference.
• Charts (b) and (d) are “Volcano Plots.” These show us the specific details. In these charts, each single dot represents one individual molecule that the laser detected. Its position on the chart tells us two things:
  • Left vs. Right: Is the molecule more abundant in Control skin (left side, blue dots) or in HS skin (right side, red dots)?
  • Up vs. Down: How statistically significant is that difference? The higher up the dot, the more confident the scientists are that this difference is real and not just a random fluke.
• Figure by Dr. Fincher and his team

(a) and (c), the blue squares (Control) and red triangles (HS) are grouped far apart. This separation means the computer could easily tell the difference between the two types of skin based on their molecules. The farther apart the groups, the bigger the difference. The dermis region (c) shows an even greater separation, highlighting a profound change in the deeper skin layer. In panels (b) and (d), the red dots represent molecules that are significantly increased in HS skin, while the blue dots are molecules that are decreased. The sheer extreme vast amount of red dots on the right side of the charts shows a dramatic chemical shift in the HS skin.

Figure 2 Legend: This is the visual proof of the “bacterial fingerprint.” The images at the top are chemical maps. The green glow shows where specific triglycerides (TGs) are located. In the HS skin (bottom row of images), you can see bright green spots, especially for the TGs with odd-chain fatty acids (like TG(43:0), TG(45:0), TG(47:0)). These are the bacterial signature fats, and they are concentrated right where the trouble starts, in the hair follicle region. The graphs below compare the overall fat profile. The HS spectrum is dominated by these odd-chain fats, while the control spectrum has much higher levels of the normal, even-chain fats. It’s a tale of two completely different environments. Figure by Dr. Fincher and his team

To confirm this, the researchers used a powerful electron microscope to look for the bacteria themselves. And they found them, and you can see them below as small and short rod shaped structures on the hair itself and in the hair follicle.

Figure 4 Legend: Here, seeing is believing. On the left (a, c, e), you see a hair from a healthy control sample. It’s relatively clean. On the right (b, d, f), you see a hair from an HS sample. It is literally coated in sheets of bacteria. This isn’t just a few stray bacteria; it’s a thriving, established colony, confirming the chemical findings. Figure by Dr. Fincher and his team

Finding #2: The Immune System Sounds the Alarm with Special “Lipid Messengers”

The second groundbreaking finding relates to how our immune system responds to this bacterial imbalance. The researchers discovered a massive increase (in some cases over 400 times more) of specific lipids called galabiosyl-/lactosylceramides in the HS skin.

So what exactly are these molecules, and why is this so important? These lipids, specifically lactosylceramides (let’s call them LacCers), are a type of glycosphingolipid. They are a critical component of the outer membrane of our immune cells, particularly the neutrophils. As we know, neutrophils are the “first responder” infantry of our immune system, and they are found in overwhelming numbers in HS lesions.

The science here is fascinating. In neutrophils, these LacCers are not just randomly placed; they organize themselves into specialized microdomains within the cell membrane called lipid rafts. These rafts function as critical signaling platforms. They gather and concentrate the specific proteins and receptors a neutrophil needs to execute its functions, such as adhering to blood vessel walls to exit into tissue, recognizing pathogens, and initiating the oxidative burst to kill microbes. ⁽²⁾

Therefore, the enormous increase in LacCers seen in Hidradenitis Suppurativa skin is a direct biochemical signature of a massive, sustained neutrophil activation and infiltration. It’s a clear signal that the immune system is in a state of chronic war, constantly calling in legions of neutrophils to fight a perceived threat. This is why HS is an inflammatory disease at its core. It’s not just a simple infection; it’s a complex interaction between a dysbiotic microbiome and a systemic (meaning the whole body) inflammatory problem characterized by a hyper-reactive innate immune system.

Figure 3 Legend: This image maps out those immune LacCers “alarm bell” lipids from the neutrophil immune cells. In the control skin images (top row), you see almost no green, meaning these LacCers are barely present in the skin of healthy people. But in the HS skin (bottom row), the tissue is lit up with a bright green signal. This shows that the entire area is flooded with these immune-activating lipids, a direct result of the massive neutrophil response. From the image above, the lower part confirm this; the HS spectrum has huge peaks for these molecules (marked with red asterisks), while they are almost absent in the control. Figure by Dr. Fincher and his team

Figure 5 Legend: This final image shows us the result of that immune alarm. The top images (a, b) show the area where the hair exits the skin. The bottom images (c, d) zoom in on the skin surface itself. In the control skin (c), the surface is smooth. In the HS skin (d), the area is covered with small, spherical structures that the researchers identified as immune cells. Your body has literally sent an army of immune soldiers to the skins surface to fight the perceived threat. This is the inflammation translates to what we feel as pain, swelling, and redness. Figure by Dr. Fincher and his team

The “Knowledge Gap”: Where Conventional Treatment Falls Short

This research is brilliant. It gives us an unprecedented view into the molecular world of HS. But here’s the critical point, the “knowledge gap” that we so often see in conventional medicine. The paper concludes by highlighting how this technology can help us understand the host-pathogen relationship in HS. This is true and valuable.

However, the conventional approach would take this information and ask, “What drug can we create to block these LacCer lipids?” or “What new antibiotic can we use to kill these bacteria?”

Do you see the problem? That’s like trying to silence a smoke alarm without ever looking for the fire. It’s a downstream, symptom-suppressing approach. While pharmaceuticals and surgery can be powerful and necessary tools (a temporary shield to get you through a crisis) they don’t address the upstream question: Why is the fire there in the first place? Why is the bacterial environment out of balance, and why is the immune system so over-reactive?

The HS Armor Philosophy: Putting Out the Fire from Within

This is where our philosophy at HS Armor diverges and, I know from own experiences and from the clients have helped already that this is the path to lasting remission. We see this research not as a roadmap for a new drug, but as a powerful confirmation of our foundational, inside-out approach.

The fire in this case is the systemic, body-wide inflammation that creates the environment for hidradenitis suppurativa to thrive. The bacterial overgrowth and the immune system’s panicked response are symptoms of a deeper imbalance. At HS Armor, we focus on a holistic, multidisciplinary approach to put out that fire for good. We believe in building your defenses, layer by layer.

Our focus is on highly effective evidence-based nutrition and lifestyle change, and natural therapies and practices.

• Foundational Nutrition: This research screams a key question: what is feeding these bacteria and fueling the immune overreaction? The answer often lies in our diet. By identifying and removing inflammatory trigger foods and nourishing our bodies with anti-inflammatory nutrients, we can change the very environment in which these bacteria live.
• Strategic Lifestyle Changes: We work to lower systemic inflammation through managing stress, optimizing sleep, and reducing toxic exposures. A calm body is less likely to have a hyper-reactive immune system.
• Natural Therapies & Skincare: We harness science-backed natural compounds that help balance the immune system and reduce inflammation from the inside, while using targeted natural skincare to soothe the skin and support healing from the outside.
• Community support and accountability: Healing rarely happens in a vacuum. Making significant lifestyle changes can be challenging, and you don’t have to do it alone. By connecting with others on a similar journey, you gain encouragement, share wisdom, and find the accountability needed to stay consistent and motivated. This shared experience is a powerful force for lasting transformation.

This is a core principle we put into practice every day in the HS Armor community. We don’t just silence the alarm; we systematically find and extinguish the sources of the fire.

Key Takeaways

• HS is linked to a bacterial fingerprint: Groundbreaking research shows that HS skin has a unique chemical lipid signature indicating a significant imbalance in the skin’s microbiome, with a massive overgrowth of specific types of bacteria.
• Your immune system is in overdrive: HS involves a dramatic immune response, flooding the skin with special “lipid messengers” that call immune cells into the area, creating the chronic inflammation we experience as flares.
• Don’t just silence the alarm, find the fire: While this research could lead to new drugs, its most powerful lesson is that we must address the root cause, the systemic inflammation that allows this environment to exist.
• Healing from within is the key: The most effective long-term strategy is a natural, holistic approach that focuses on diet, lifestyle, skincare, wound healing, and natural therapies to reduce inflammation, restore balance to the body and heal.

Conclusion: You Are the Healer

This complex science ultimately brings us to a simple, empowering truth: your body has an incredible capacity to heal. Research like this doesn’t just give us clues about the disease; it gives us a roadmap for recovery. It confirms that the path to a permanent cure for Hidradenitis Suppurativa isn’t about finding a magic bullet, but about systematically rebuilding your body’s foundation of health.

It’s about taking back control. Seeing how these foundational changes have helped many other HS patients truly brings this research to life. Healing is not only possible; it is your fundamental human potential.

References

1. Fincher, J. A., Jones, D. R., Korte, A. R., Dyer, J. E., Parlanti, P., Popratiloff, A., Brantner, C. A., Morris, N. J., Pirkle, R. K., Shanmugam, V. K., & Vertes, A. (2019). Mass Spectrometry Imaging of Lipids in Human Skin Disease Model Hidradenitis Suppurativa by Laser Desorption Ionization from Silicon Nanopost Arrays. Scientific Reports, 9(1), 17508. https://doi.org/10.1038/s41598-019-53938-0
2. Iwabuchi, K., Nakayama, H., Iwahara, C., & Nakauchi, H. (2015). Properties and functions of lactosylceramide from mouse neutrophils. Glycobiology, 25(6), 655–668. https://doi.org/10.1093/glycob/cwv008

Important Medical Disclaimer

1. Not Medical Advice: All content and information on this website is for informational and educational purposes only. It does not constitute medical advice and is not a substitute for professional diagnosis, treatment, or consultation with a qualified healthcare provider.

2. My Role and Qualifications: I am a biomedical scientist and PhD candidate and share information from that perspective, combined with my personal experience as a patient with Hidradenitis Suppurativa. However, I am not a medical doctor, physician, or registered healthcare professional. Do not consider our relationship a doctor-patient relationship.

3. Consult Your Doctor: Always seek the advice of your medical doctor or another qualified health professional with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If you suspect you are experiencing a medical emergency, or a severe infection, do not rely on this website or the HS Armor community, please call your local emergency services or go to the nearest emergency room immediately.

4. A Critical Warning on Medication: Pharmaceutical drugs are a crucial tool in managing Hidradenitis Suppurativa for many people. Under absolutely no circumstances should you ever alter, reduce, or stop taking your prescribed medication without the explicit direction of the doctor who prescribed it. Doing so can be dangerous. Always consult with your doctor before doing anything related to your treatment plan.

5. No Liability: Your use of this website and reliance on any information provided is solely at your own risk.

6. Individual Results May Vary: Every patient’s biological baseline, genetics, and adherence to the protocol is different. Therefore, I cannot guarantee specific results, cures, or timelines for your Hidradenitis Suppurativa.

7. Scientific and Expressive Freedom: The articles published on this blog are distinct from formal peer-reviewed academic literature. They serve as an independent platform for my personal viewpoints, scientific hypotheses, and philosophical reflections as an independent scientist and HS patient. While grounded in biomedical research, I exercise a degree of expressive freedom to translate rigid academic data into insights from a patient perspective. These writings are my personal meditations on the science of HS and should be read as my individual perspective, not as universally accepted clinical consensus or formal peer-reviewed literature.