Understanding HS
Hidradenitis suppurativa (HS) (also called acne inversa), is a chronic skin disease involving the hair follicles and sweat glands. The hair follicles and sweat glands become blocked, trapping bacteria and leading to boil-like lumps that form under the skin. Areas where the skin rubs together are commonly affected, such as the armpits, groin, buttocks, and breasts. HS is not caused by bad hygiene, and it cannot be spread to others. In most cases, the cause of HS is unknown. Genetics, environment, and hormonal factors may play a role. HS usually starts after puberty, usually in the teens or twenties and is more common in those who are female, Black, overweight/obese, smokers, and have a family history of HS.
Symptoms of HS
Hidradenitis suppurativa (HS) can be mild, moderate, or severe. Symptoms include:
- Small pitted areas of skin containing blackheads.
- Painful pea-sized lumps that get bigger, become abscessed, break open and drain fluid and pus with an unpleasant odor.
- The abscesses heal very slowly, if at all, and can lead to scarring and tunnels under the skin.
Diagnosing HS
There is no specific test for hidradenitis suppurativa (HS), and it is often misdiagnosed in the early stages. The health care provider will review medical history, symptoms, and test the skin or pus from a lump (if any are present).
Treatment of HS
There is no cure for hidradenitis suppurativa (HS). It may help to avoid things that can irritate skin: wear loose-fitting clothing, maintain a healthy weight, stop smoking, avoid heat and humidity, use care to not injure skin. Treatment focuses on symptoms and depends on disease severity and includes medications, surgery, or both to help control symptoms and prevent complications. Medication treatment includes steroids, antibiotics, pain relievers, and medicines that fight inflammation. Medication may be applied topically to the skin, taken orally, or injected.
Although not FDA-approved to treat HS, if other treatments fail, infliximab (e.g., Inflectra®, Remicade®), administered into the blood stream intravenously, and immune globulin therapy administered into the blood stream intravenously (IVIG) have been used to treat severe cases of HS
References:
- Hidradenitis Suppurativa (Acne Inversa) | MedlinePlus
- Hidradenitis Suppurativa (Acne Inversa): Symptoms & Treatments | Cleveland Clinic
- Hidradenitis Suppurativa – Symptoms and Causes | Mayo Clinic
Last reviewed 12/02/2025
