Before we begin: Hidradenitis suppurativa (HS), or acne inversa, is a chronic skin disease. It causes painful bumps in your armpits and groin. Learn about treatment.
This tutorial walks you through everything you need to know about hidradenitis suppurativa. We explain it in plain language, step by step, so whether you are a student, a patient, or simply curious, you will come away with a solid understanding.
We cover what it is, why it matters, how it is diagnosed, and what you can do about it. Key facts are called out along the way.
What is hidradenitis suppurativa (HS)? Hidradenitis suppurativa (HS) is a chronic skin disease. Another name for it is acne inversa. It causes painful, boil-like lumps that form under the skin. It often affects areas where the skin rubs together, such as your armpits and groin. The lumps become inflamed and painful. They often break open, causing abscesses that drain fluid and pus. As the abscesses heal, they can cause scarring of the skin.
What causes hidradenitis suppurativa (HS)? The lumps in HS form because of blockages of the hair follicles. The blocked hair follicles trap bacteria, which leads to inflammation and rupture. In most cases, the cause of the blockages is unknown. Genetics, environment, and hormonal factors may play a role. Some cases of HS are caused by changes in certain genes.
HS is not caused by bad hygiene, and it cannot be spread to others.
Who is more likely to get hidradenitis suppurativa (HS)? HS usually starts after puberty, usually in the teens or twenties. It is more common in:
Women
People who are Black
People with a family history of HS
People who are overweight or have obesity
People who smoke
What are the symptoms of hidradenitis suppurativa (HS)? The symptoms of HS include:
Small pitted areas of skin containing blackheads
Painful, red, lumps that get bigger and break open. This causes abscesses that drain fluid and pus. They may itch and have an unpleasant odor.
The abscesses heal very slowly, recur over time, and can lead to scarring and tunnels under the skin.
HS can be mild, moderate, or severe:
In mild HS, there are only one or a few lumps in one area of the skin. A mild case will often get worse, becoming a moderate disease.
Moderate HS includes recurrences of the lumps that get bigger and break open. The lumps form in more than one area of the body.
With severe HS, there are widespread lumps, scarring, and chronic pain that may make it hard to move.
Because of the difficulty of dealing with the disease, people with HS are at risk for depression and anxiety.
How is hidradenitis suppurativa (HS) diagnosed? There is no specific test for HS. It can be hard to diagnose in the early stages because it can look like pimples or acne. To make a diagnosis, your health care provider:
Will ask about your medical history and your symptoms
Will look at the lumps on your skin
May take a sample of the skin or pus (if there is any) and send it to a lab to be tested
Your provider may refer you to a dermatologist (skin doctor) to get a diagnosis or treatment.
What are the treatments for hidradenitis suppurativa? There is no cure for HS. Treatments focus on the symptoms, but they are not always effective for everyone. The treatments depend on how severe the disease is and may include:
Medicines, including steroids, antibiotics, pain relievers, and medicines that flight inflammation. In mild cases, the medicines may be topical (applied to your skin). Otherwise, the medicines may be injected or taken orally (by mouth).
Procedures or surgery to remove the lumps and scars or make the sores go away.
It may also help if you can avoid things that can irritate your skin, by:
Wearing loose-fitting clothing
Staying at a healthy weight
Quitting smoking
Avoiding heat and humidity
Being careful not to injure your skin
Also known as: Acne inversa, Suppurative hidradenitis.
Categories: Skin, Hair and Nails.
Source: National Institutes of Health — National Institute of Arthritis and Musculoskeletal and Skin Diseases.
Key Takeaways
Understanding hidradenitis suppurativa is an important part of taking charge of your health. Here is what to remember:
- Know the signs — Recognizing early symptoms can lead to earlier diagnosis and better outcomes.
- Talk to your provider — If you have concerns or a family history of this condition, bring it up at your next checkup.
- Stay informed — Medical knowledge evolves. Keep learning and asking questions.
- You are not alone — Many people deal with this condition. Support groups and educational resources can help.