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What You Need to Know About Hidradenitis Suppurativa



Hidradenitis suppurativa (HS) is a chronic inflammatory disease that causes cysts to form under the skin. These cysts can be painful and may rupture and leak fluid or pus. Some people develop tunnel-like tracts under the skin connecting the lumps. According to the U.S. National Library of Medicine (NLM), HS affects about 1 in 100 people and is more common in women than men.


For people who develop HS, also known as acne inversa, the appearance of cyst-like lesions can be confusing. When Francisco Kerdel, MD, founder of Florida Academic Dermatology Center in Coral Gables, sees new patients with HS, “the most common history that we get is that they get recurrent boils and they have to go to the emergency room for them to be drained,” he says.

Here’s what everyone with hidradenitis suppurativa should know about managing and treating the chronic skin disease:


1. Hidradenitis suppurativa typically develops in areas where skin rubs together.

The disease commonly flares up in the armpits, groin, buttocks, and in women, underneath the breasts. Hair follicles in those areas become blocked, triggering an inflammatory process that can affect apocrine glands, special sweat glands that happen to be prevalent in areas of the body most affected by HS. There may also be a secondary effect from bacterial overgrowth and the damage that occurs in the site then damages the apocrine glands.


2. Hidradenitis suppurativa can be misdiagnosed or mistaken for other conditions.

HS can be mistaken for ingrown hairs, bacterial Infections, and folliculitis. In the buttocks, HS can present like pilonidal sinus disease, an inflammatory condition that causes an abnormal skin growth in the crease of the buttock. In the genitals, HS can be misdiagnosed as sexually transmitted infections.

Because HS can look like a number of other conditions, the American Academy of Dermatology (AAD) recommends seeing a board-certified dermatologist to receive an accurate diagnosis. To diagnose HS, your dermatologist will review your symptoms and medical history. The