What does hidradenitis suppurativa look like?

HS can cause:

Deep, painful nodules
Boil-like lumps
Abscesses
Blackhead-like spots
Areas that repeatedly drain
Tunnels beneath the skin
Thick or rope-like scars
Restricted movement from pain or scarring

Common locations include the:

Underarms
Groin
Inner thighs
Buttocks
Genital or perianal area
Beneath the breasts
Lower abdomen

Early HS may resemble acne, an ingrown hair or an isolated boil. A clue is that the inflammation repeatedly develops in the same areas.

What causes hidradenitis suppurativa?

HS involves blockage and inflammation around hair follicles. The exact reason it develops is not completely understood.

Genetics, hormones and immune-system activity may contribute. Smoking and friction can worsen HS in some patients, and the condition is more common among people with excess body weight. However, HS can affect people of any weight, and it does not result from inadequate washing.

The drainage may contain bacteria, but HS itself is not primarily a bacterial infection.

How is HS diagnosed?

There is no single test for hidradenitis suppurativa. Diagnosis is based on:

The appearance of the lesions
Their location
How often they return
The presence of drainage, tunnels or scars
Your medical and family history

A culture may be collected when infection is suspected. A biopsy is rarely needed unless another condition must be excluded.

Because HS is sometimes mistaken for recurrent boils, diagnosis may be delayed.

How is hidradenitis suppurativa treated?

Treatment depends on severity and may combine medication, procedures and daily skin care.

Options may include:

Topical clindamycin
Oral antibiotics
Corticosteroid injections
Hormonal therapy for selected patients
Biologic medication
Other immune-targeting medication
Laser hair reduction
Removal of persistent tunnels
Surgical treatment for extensive disease
Pain and wound management

Simply draining an abscess may provide temporary relief but does not treat the underlying condition.

How can I manage HS at home?

Avoid squeezing or attempting to drain lesions. Wear loose, breathable clothing and reduce rubbing in affected areas.

Use cleansers and dressings recommended by your provider. Warm compresses may reduce discomfort, but active inflammation often requires medical treatment.

Seek prompt care for fever, rapidly spreading redness or severe worsening pain.

Schedule an HS consultation

Early treatment may reduce pain, drainage, scarring and the formation of additional tunnels. The Dermatology Clinic can determine the severity of your HS and develop a long-term treatment plan. Contact us today to get scheduled.