Hidradenitis suppurativa is a long-term condition that causes recurrent sores and lumps to appear on your skin. For most, it’s a frustrating and painful condition to live with.
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Hidradenitis suppurativa (HS) is a long-term dermatological condition that causes painful lumps to appear on your skin, usually due to blocked hair follicles. There’s no cure for hidradenitis suppurativa, but the condition can be improved and managed with medications and lifestyle changes. It tends to develop in areas where you have a lot of sweat glands, and where skin frequently rubs together, such as your armpits, groin or under your breasts.
It’s not fully known what causes hidradenitis suppurativa, but smoking, obesity and a family history of it are all thought to make it more likely. It’s also more common in people in their twenties and thirties. Diagnosis and treatment of hidradenitis suppurativa is normally carried out and supervised by a dermatologist.
Who gets hidradenitis suppurativa?
Anyone can get hidradenitis suppurativa, but there are some risk factors that can make it more likely, including:
Age. It more commonly affects people in their twenties and thirties.
Sex. Women are more likely to get the condition than men.
BMI. People who are obese are more likely to get it.
Smoking. Tobacco use can increase the frequency and severity of HS flare-ups.
Family history. About 33-40% of people with HS report having an affected first-degree relative.
These risk factors suggest that a combination of genetic, environmental and behavioural factors can have an influence on its development.
The most common group of people to get HS are women in-between puberty and menopause, and flare ups also seem to run in tandem to menstrual cycles, which points to hormone levels being a factor. People with obesity are also at greater risk, due to the increased likelihood of skin rubbing against itself, increased sweat production and retention, and hormone changes.
Smoking is also thought to increase the risk of hair follicles being blocked, and family history being a factor suggests that genes can play a role.
How common is hidradenitis suppurativa?
Hidradenitis suppurativa is a fairly common condition, with estimates ranging from 1%-4% of the general population getting it at some point in their lives. It’s thought that more people might have it than is reported because it’s difficult to diagnose, but also because people often wait for several years before seeking advice after their symptoms start.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
Hidradenitis suppurativa
What causes hidradenitis suppurativa?
The exact cause of hidradenitis suppurativa is unknown, but the symptoms usually develop from blocked hair follicles. It’s not linked to an infection or poor hygiene, and you can’t catch it from someone else.
What are the symptoms of hidradenitis suppurativa?
The symptoms of HS can range from mild to severe, and these are usually separated into ‘Hurley stages’. Hurley stage I is the mildest form of the condition, where you only have isolated bumps with no sinus tracts, and Hurley stage III is the most severe form of the condition, where you have multiple bumps with a lot of sinus tracts and scars, covering a large area.
Hidradenitis suppurativa usually begins with blackheads, spots filled with pus, and firm, pea-sized lumps that appear in the same place. New lumps will then often form nearby. If these are not controlled with treatment, larger lumps can also appear and spread. As the condition progresses, tunnels under the skin called sinus tracts can develop which can break out on the surface and leak pus.
HS can be a very painful condition, and it tends to develop in either the armpits, groin area, buttocks or below the breasts. These symptoms go through cycles of severity known as flare ups.
Can hidradenitis suppurativa lead to other problems?
When HS isn’t well-managed with treatment, it can lead to further problems. The affected areas can become infected, but pus is often present with the condition, so this doesn’t always mean that there’s an infection. Hidradenitis suppurativa can also cause scars, especially when the condition becomes more severe. It can also cause swelling, restricted movement, arthritis and, in rare cases, a form of skin cancer called squamous cell carcinoma. The longer the condition is left untreated, the more likely these secondary problems are to occur.
And because it’s a lifelong, recurring condition that can have a big impact on your life, it can also lead to adverse psychological effects and feelings of isolation. Anxiety and depression are particularly common among people with HS, as they struggle to manage their symptoms or may be conscious of them.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
Hidradenitis suppurativa
What medications are there for hidradenitis suppurativa?
HS is a long-term condition, so you might have to try a number of different treatments depending on how severe your symptoms are.
Often antibiotics are used (even when there’s no infection). If the lumps are particularly inflamed and painful and you have a bacterial infection, then a one-to-two week course of standard antibiotics can be recommended. But if no infection is present then a course of low-dose antibiotics can be recommended for at least three months, to reduce inflammation and the number of lumps that develop. Antiseptic washes are also commonly prescribed alongside other treatments to keep the area clean while you change the dressing.
Retinoids are another option. These are vitamin A based treatments that can only be prescribed by a dermatologist. These treatments aren’t safe to take if you are (or might become) pregnant, so you’ll need to be monitored on them to make sure they continue to be safe for you.
Other treatment options include:
injecting a type of steroid (triamcinolone) into the sores to reduce swelling and inflammation;
hormonal treatments like contraceptive pills if you have milder symptoms that flare up around your periods; or:
biologics, which are immunosuppressive treatments that can be prescribed by a dermatologist if your symptoms are severe.
Is there a ‘best’ treatment for hidradenitis suppurativa?
Treatment is very much based on individual cases. Early stages of the condition tend to be best treated with medications, whereas surgery might be a better option for more severe or persistent cases.
It’s also important to note that with long-term conditions it may take a while to find the treatment plan that works best for you, and you might need to try a few different ones along the way. You might also need to adjust what treatment you use if your condition changes. That being said, many people are able to keep their symptoms well-controlled and minimise flare ups if they find the right treatment early enough.
Does hidradenitis suppurativa always need treatment?
To effectively control and maintain the symptoms of more advanced HS, treatment is usually necessary (at least during flare-ups). However, milder cases of the condition can be managed with lifestyle adjustments and self-care measures. These same measures are also recommended to minimise flare-ups and improve symptoms for people with a more advanced form of the condition, too.
Non-medicinal measures that have been shown to help with HS symptoms include:
losing weight if you’re overweight;
quitting smoking if you’re a smoker;
regularly using an antiseptic wash; avoiding shaving the affected areas;
wearing loose fitting clothes; and: holding a warm flannel against the sores to encourage the pus to drain.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
Hidradenitis suppurativa
FAQ: Hidradenitis suppurativa
Have something specific you want to know? Search our info below, or ask our experts a question if you can’t find what you’re looking for.
How is hidradenitis suppurativa diagnosed?
Answer:
Hidradenitis suppurativa usually needs to be diagnosed by a dermatologist. This is because they’ve had the necessary training to identify the differences between HS and other conditions that cause similar symptoms. This is why it can often take people a long time (sometimes years) to get an accurate diagnosis of HS. Some people may also feel conscious or embarrassed of their symptoms and put off seeking a diagnosis.
When a dermatologist does diagnose HS, however, all that tends to be required is a physical examination alongside some questions about your symptoms and health history. Further tests aren’t usually needed.
Can you get side effects from hidradenitis suppurativa treatment?
Answer:
As with any treatment, HS medications do have the potential to cause side effects. However these side effects will be dependent on the type of treatment that you’re using. Low dose antibiotics, for instance, will be far less likely to cause significant side effects than stronger medications like retinoids or biologics.
Is there a permanent cure for hidradenitis suppurativa?
Answer:
As HS is often a chronic (long-term) condition, treatment tends to be aimed at improving symptoms rather than curing it. And while not all treatments will be guaranteed to improve symptoms, the range of treatment options means that there’ll usually be one that works to at least minimise them for you. It’s not a given that treatments will be effective forever, though, and surgery might be needed for advanced forms of the condition where medicines and self-care measures haven’t worked. Certain surgical procedures, such as ones that ‘unroof’ the tunnels, often don’t need to be repeated in the same place – but that doesn’t mean that they cure the condition.
What’s the best diet for hidradenitis suppurativa?
Answer:
The best diet in general (not just for HS) is one that includes plenty of fruit, veg and vitamins, and a minimal amount of refined sugar and processed foods. Eating a well-balanced diet with plenty of nutrients is good for your body and your overall health.
The American Academy of Dermatology has reported on the findings of dermatologists who’ve been running small studies on how diet might affect HS. They acknowledged that although more research still needs to be done, these factors could have an influence:
Weight loss: overweight individuals with HS report an improvement in their symptoms when they lose weight
Mediterranean diet: those who have a diet consisting mainly of fruits, vegetables, seafood, olive oil, whole grains and beans seem to be less likely to get HS than those that don’t
Plant-based: Research suggests that people with less diverse gut bacteria are more likely to have HS, and it’s thought that people who eat a plant-based diet have more diverse gut bacteria than those who don’t
Dairy-free: In a small study where HS patients cut out dairy, 83% reported symptom improvement
Why should I buy hidradenitis suppurativa treatment online with Treated?
Answer:
With the stress of chronic conditions like hidradenitis suppurativa, the last things you need are lengthy waits for doctor’s appointments or shortages of treatment. That’s why when you talk to our dermatologist about your health, we’ll offer treatments tailored to your needs, sent on a schedule that works for you.
It’s all online, so you don’t need to leave home if you’re struggling with flare-ups, and you’ll get access to ongoing care from our experts throughout your treatment. So you can message us about whatever you like, any time.
Disclaimer: The information provided on this page is not a substitute for professional medical advice, diagnosis, or treatment. If you have any questions or concerns about your health, please talk to a doctor.
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