Hidradenitis suppurativa (HS) is a chronic skin condition that causes painful lumps or boils. It often appears in areas where skin rubs against other skin, such as the armpits or groin. These lumps form when hair follicles become blocked, leading to inflammation and swelling. HS is not contagious.
At UPMC, our dermatology and plastic surgery specialists work together to provide comprehensive care. From medical management to surgical treatment, our goal is to reduce symptoms, prevent flare-ups, and improve your quality of life.
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What Is Hidradenitis Suppurativa?
Hidradenitis suppurativa (HS) is a rare, chronic skin condition that causes lumps or boils. It often appears near sweat glands where the skin rubs together, such as the armpits or groin. Blockages in hair follicles cause inflammation, resulting in swollen bumps. Hidradenitis suppurativa is not contagious.
What are the types of hidradenitis suppurativa?
Hidradenitis suppurativa can cause different types of skin problems, including:
- Abscesses — Pus-filled pockets that can break open and drain, causing a strong odor.
- Nodules — Lumps beneath your skin.
- Sinus tracts — Channels between abscesses and your skin’s surface.
How common is hidradenitis suppurativa?
Hidradenitis suppurativa affects about 1% of people in the U.S.
What causes hidradenitis suppurativa?
Hidradenitis suppurativa is an autoinflammatory condition that occurs when your body mistakenly attacks your hair follicles, causing scarring, inflammation, and abscesses.
Hidradenitis suppurativa risk factors
You may be more likely to develop hidradenitis suppurativa if you are:
- A woman (HS is three times more common in women than in men).
- A smoker.
- Overweight.
- Related to someone who has HS, as it is considered a genetic condition.
Complications of hidradenitis suppurativa
Without treatment, symptoms from hidradenitis suppurativa can get worse. Bumps on the skin can become infected and break open, causing pain and scarring. This skin disease can last for many months or years, often in the form of repeated outbreaks.
Other complications may include:
- Anemia — Low iron.
- Cellulitis — A common skin bacterial infection.
- Fistula — An abnormal connection between your skin and other organs.
- Lymphatic system damage.
- Mental health concerns, such as anxiety and depression.
- Sepsis.
- Skin cancer, in rare cases.
How can I prevent hidradenitis suppurativa?
There is nothing you can do to prevent hidradenitis suppurativa itself, but there are things you can do to reduce the chances of a HS flare-up, including:
- Avoiding scented lotions, deodorants, and skin creams.
- Avoiding sweating.
- Avoiding tight-fitting clothing.
- Maintaining a healthy body weight.
- Quitting smoking.
What triggers hidradenitis suppurativa?
Hidradenitis suppurativa triggers vary from person to person and may include:
- Foods, beverages, and ingredients, such as sugar, dairy, beer, and brewer’s yeast.
- Hormonal changes.
- Smoking.
- Stress.
- Sweating.
- Tight clothing.
What Are the Signs and Symptoms of Hidradenitis Suppurativa?
You may develop nodules that cause pain and abscesses that drain pus, leading to scarring.
Areas of your body that are commonly affected include your:
- Armpits.
- Breasts, especially the crease underneath.
- Buttocks.
- Genital and groin area.
- Inner thighs.
- Nape of your neck.
- Waistband area.
When should I see a doctor about my hidradenitis suppurativa symptoms?
If you have symptoms of hidradenitis suppurativa, you should schedule an appointment with your doctor — either your primary care provider or a dermatologist. Early treatment can reduce your risk of complications and improve your quality of life.
How Do You Diagnose Hidradenitis Suppurativa?
Your doctor will perform a physical exam and review your health and medication history to diagnose hidradenitis suppurativa. If you see your primary care provider, they may refer you to a dermatologist who has special training in managing hidradenitis suppurativa.
What to expect during your visit
If your doctor suspects hidradenitis suppurativa, they will:
- Ask about your symptoms.
- Perform a physical exam.
- Review your health history and medications.
Tests to diagnose hidradenitis suppurativa
There are no tests needed to diagnose hidradenitis suppurativa.
Hidradenitis suppurativa prognosis
Although there is no cure for hidradenitis suppurativa, ongoing treatment can help manage symptoms and improve quality of life. Most people with hidradenitis suppurativa experience flare-ups that come and go and require long-term treatment.
How Do You Treat Hidradenitis Suppurativa?
Treatment for hidradenitis suppurativa focuses on treating skin symptoms, managing pain, and preventing flare-ups.
Treatment options may include:
Skin care
Taking care of your skin is an important part of hidradenitis suppurativa treatment.
Skin care recommendations may include:
- Cleansing affected areas daily using special products recommended by your dermatologist.
- Using scent-free, gentle antiperspirants, body washes, and other skin products.
- Using topical creams or medications to reduce skin inflammation.
Pain management
Abscesses and nodules can be painful.
Your doctor may recommend pain management treatments, including:
- Pain medications.
- Pain-reducing skin lotions or ointments.
- Using heat or ice to manage pain.
Medications
Your doctor may prescribe medications as needed to treat symptoms, including:
- Antibiotics — Treat inflammation and infection, as needed.
- Biologics — Reduce your body’s immune response and help control inflammation.
- Medications to regulate hormones — Diabetes medication metformin and birth control pills may be used to stabilize hormone levels.
Surgery for hidradenitis suppurativa
UPMC plastic surgeons have developed a novel technique to effectively treat hidradenitis suppurativa.
After a preoperative consultation in our clinic, you’ll have a short surgery to remove the affected skin. Our surgeons then resurface the area with nearby healthy tissue. This results in skin that is clear of painful bumps and infections.
Other treatments for hidradenitis suppurativa
Other treatments to manage hidradenitis suppurativa and related symptoms include:
- Botox injections to reduce sweating.
- Laser treatments to remove hair and treat boils.
- Steroid injections to control inflammation.
- Surgical drainage of abscesses.
- Surgical treatment of sinus tracts.
Why Choose UPMC for Hidradenitis Suppurativa Care?
When you choose UPMC for hidradenitis suppurativa care, you will receive:
- Access to board-certified specialists — Our dermatology specialists are experienced in caring for people with hidradenitis suppurativa and related complications.
- Expert diagnosis and personalized care — Our team will develop a customized treatment plan to reduce your risk of complications and improve your quality of life.
- A full range of treatment options — We use the latest nonsurgical, minimally invasive, and surgical techniques to provide comprehensive care.
