What is hidradenitis suppurativa?
Hidradenitis suppurativa (HS) is a long-term skin condition that causes painful lumps beneath the skin. These lumps can become inflamed, drain fluid, and leave scars over time. HS most often develops in areas where skin rubs together, such as the armpits, groin, buttocks, or under the breasts.
The condition is not contagious and is not caused by poor hygiene. Although HS can come and go in cycles, early treatment may help control symptoms and reduce skin damage.
Experts do not fully understand what causes HS, but the condition is linked to inflammation and blocked hair follicles. Several factors may increase the risk of developing it, including:
- Family history
- Smoking
- Excess body weight
- Hormonal changes
- Friction in skin folds
Symptoms
Hidradenitis suppurativa symptoms can vary from mild to severe. Many people notice flare-ups that improve and then return later.
Common symptoms include:
- Painful bumps or boils under the skin
- Swelling and tenderness
- Draining pus or fluid
- Unpleasant odor from affected areas
- Skin thickening or discoloration
- Scars or tunnels beneath the skin
How is it diagnosed?
A healthcare provider can often diagnose hidradenitis suppurativa with a physical exam and review of your symptoms. They will look at the location of the sores, how often they occur, and whether scarring is present.
In some cases, additional testing may help rule out infection or other skin conditions. This may include lab testing of drainage from the lesions or blood work.
How is it treated?
Treatment for hidradenitis suppurativa focuses on reducing pain, controlling inflammation, and preventing new flare-ups. Your care plan will depend on how severe the condition is and how often symptoms occur.
Early treatment may include:
- Antibiotic creams or pills
- Anti-inflammatory medicines
- Steroid injections for painful lesions
- Gentle skin care and avoiding skin irritation
- Weight management and smoking cessation support
For more advanced HS, treatment may involve biologic medications that target the immune system, laser procedures, or surgery to remove damaged tissue.
Because HS is a chronic condition, ongoing care is often important. Many people can manage symptoms successfully with the right combination of treatment and lifestyle changes.
