This is general health information only and is not a substitute for advice from your GP or healthcare professional.
1. What is hidradenitis suppurativa?
Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that causes painful, recurrent lumps, nodules, abscesses, and tunnels under the skin. It most commonly affects areas where skin rubs together, such as the armpits, groin, buttocks, and under the breasts.
2. What causes hidradenitis suppurativa?
HS begins with inflammation and blockage around hair follicles rather than being caused by poor hygiene. The exact cause is not fully understood, but genetic, hormonal, immune, and environmental factors can all contribute. HS is not simply a bacterial infection and is not contagious.
3. What are the symptoms of hidradenitis suppurativa?
Typical symptoms include painful deep lumps, recurrent boils or abscesses, drainage of pus or blood, unpleasant odour, and scarring. Over time, repeated inflammation can lead to interconnected tunnels called sinus tracts developing beneath the skin.
4. Who is more likely to develop hidradenitis suppurativa?
HS can affect anyone, but it commonly begins after puberty and is more frequent in women. Having a family history of HS increases the risk. Smoking, excess weight, hormonal factors, and metabolic conditions are also associated with HS and may contribute to more severe disease.
5. Is hidradenitis suppurativa caused by poor hygiene?
No. HS is not caused by being unclean and cannot be prevented simply by washing more frequently. Excessive scrubbing, squeezing lesions, or using harsh skin products may actually irritate the skin and worsen symptoms.
6. How is hidradenitis suppurativa diagnosed?
There is no single blood test or imaging test that confirms HS. Diagnosis is usually made clinically based on the typical lesions, their location, and the pattern of recurrence. Early diagnosis is important because effective treatment can reduce inflammation, scarring, and the development of chronic tunnels.
7. How is hidradenitis suppurativa treated?
Treatment depends on the severity and extent of the disease. It may include topical or oral antibiotics, anti-inflammatory treatments, hormonal therapy in selected patients, biologic medicines, and procedures such as drainage or surgical removal of persistent affected areas. Weight management and stopping smoking, where relevant, can also improve disease control.
8. Can hidradenitis suppurativa be cured?
There is currently no simple cure for HS, but the condition can often be controlled with appropriate long-term treatment. Early treatment can reduce the frequency of flare-ups and help prevent permanent scarring and sinus tract formation.
9. Is hidradenitis suppurativa associated with other health conditions?
Yes. HS is associated with several other inflammatory and metabolic conditions, including obesity, type 2 diabetes, metabolic syndrome, inflammatory bowel disease, arthritis, depression, and anxiety. People with HS may therefore benefit from a broader health assessment rather than treatment of the skin alone.
10. When should I see a doctor?
You should see a doctor if you develop recurrent painful lumps or abscesses in the armpits, groin, buttocks, or other skin-fold areas, particularly if they repeatedly drain or leave scars. Early medical assessment is important because effective treatment can reduce the risk of progression and long-term scarring.