Hidradenitis Suppurativa is a long-term skin condition where painful lumps or boils keep coming back. These lumps can sometimes burst and leak pus, leaving scars. It’s also called “acne inversa” because it looks like acne but occurs in body folds.
Nodules – These are firm, painful lumps under the skin. They may feel tender and can grow over time.
Abscesses – These are pus-filled bumps that can burst or drain. Sometimes, they have a strong, unpleasant odor.
Sinus tracts – In long-standing HS, tunnels may form under the skin, connecting different lumps or abscesses. These tracts can leak fluid and cause scarring.
HS boils usually appear in areas where skin touches skin and sweat glands are present. Common spots include:
Armpits
Groin
Genitals
Buttocks
Around the anus (butthole)
Crease under the breasts
Inner thighs
Waistline
Back of the neck (nape)
These areas are prone to friction, sweat, and trapped hair follicles, which can trigger painful lumps.
We don’t know the exact cause, but it’s not due to poor hygiene. It happens because it’s linked to inflammation, blocked hair follicles, hormones, and genetics. The body’s immune system also plays a role.
While HS can affect anyone, females are more likely to develop it than males. It often starts in young adults (20s–30s).
Other risk factors include:
Excessive hair growth (hirsutism): Can block hair follicles, triggering HS.
Family history of HS: Having a close relative with HS raises your chances.
Hormonal changes: Fluctuations in estrogen and androgens (common after puberty, before periods, and before menopause) can worsen HS.
Smoking: Strongly linked to flare-ups.
Obesity: Extra weight increases skin friction and sweating, making HS more likely. While being overweight can worsen Hidradenitis Suppurativa, even people with normal weight can have it.
No. Hidradenitis Suppurativa is not an infection that spreads from person to person.
People with HS develop
Painful lumps under the skin (like boils) and leak pus
Heal slowly
Blackheads in small clusters
Tunnels under the skin (sinus tracts) in severe cases
Scarring after healing
Unfortunately, Hidradenitis Suppurativa is a chronic (long-term) condition. Lumps may heal, but new ones often come back. Early diagnosis and treatment can help control it and reduce flare-ups.
Treatment depends on how severe your symptoms are.
doctors may suggest
Skin care plan:
Gentle antiperspirants (less irritating for sensitive skin).
Daily antiseptic wash to keep skin clean.
Retinoids (vitamin A–based medicines that calm inflammation).
Special body washes recommended by a dermatologist.
Pain relief:
Ice packs or warm compresses for comfort.
Lidocaine creams/ointments to numb pain.
OTC or prescription pain meds.
Complementary approaches (diet changes, relaxation, acupuncture).
Referral to a pain specialist if pain is severe.
Medical therapies:
Antibiotics (not for infection, but to reduce inflammation; sometimes used for months at low doses).
Adalimumab (a biologic that calms the immune system).
Metformin (a diabetes medicine that helps regulate hormones and insulin).
Birth control pills (to stabilize hormone fluctuations and prevent flares).
Botox injections → reduce sweating that can trigger boils.
Steroid injections → shrink painful lumps.
Laser hair removal → reduce hair follicle blockages.
Laser surgery → remove HS boils.
Deroofing surgery → removes the “roof” of tunnels/sinus tracts.
Incision & drainage → to release pus and relieve abscesses.
Along with medical treatment, certain daily habits can help reduce HS flares and make the condition easier to manage:
Wear loose-fitting, breathable clothes (cotton is best) to reduce friction and sweating.
Avoid tight waistbands, bras, or underwear that rub against skin.
Keep affected areas clean and dry.
Skin Products & Hygiene
Use gentle, fragrance-free cleansers.
Avoid harsh deodorants or shaving in areas with active boils (try trimming instead).
Consider antiseptic or antibacterial washes if recommended by your dermatologist.
Maintain a healthy weight
Quit smoking.
Manage stress – stress can trigger inflammation. Try yoga, meditation, or breathing exercises.
Some people find HS flares after eating dairy or high-glycemic foods (like white bread, sweets, and fried food). Keep a food diary to spot your personal triggers.
Eat an anti-inflammatory diet rich in fruits, vegetables, whole grains, and omega-3 fatty acids (fish, walnuts, flaxseeds).
Limit alcohol, which may worsen inflammation.
See a dermatologist regularly to track your condition.
Don’t pop or squeeze boils - this can worsen scarring and infection.
Tip: Self-care doesn’t replace medical treatment, but it can reduce flare-ups, help medicines work better, and improve quality of life.
It can, because the pain, drainage, and scars may affect confidence and comfort. But with proper treatment, flare-ups can be reduced, and quality of life can improve a lot.
Hidradenitis Suppurativa usually does not disappear without treatment. Early medical care can prevent it from worsening and reduce scarring.
Right now, there is no permanent cure. But many people benefit from medicines, lifestyle changes, and biologic treatments that calm the immune system and can greatly control the disease, reduce pain, and prevent new lumps from forming.
Hidradenitis Suppurativa is a long-term skin condition that causes painful, recurring lumps. It’s not due to poor hygiene and not contagious. While HS has no cure, the right mix of skin care, early treatment, lifestyle changes, and sometimes advanced medicines or procedures can well-manage it by controlling symptoms, reduce pain, and prevent new flares - allowing people to lead a more comfortable life.
So the key is to consult your Dermatologist early and stick to a care plan tailored to your needs.
Disclaimer: This article is only for general patient information and is not intended for self medication. There is no legal liability of IADVL arising out of any adverse consequence to the patient. Subsequent to its use for self treatment of the disease images adjust for the depiction of the condition and is not to be used for any other purpose.
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