Acneiform & Rosacea
Hidradenitis Suppurativa
HS; acne inversa
More common than once thought
No — you cannot catch it or spread it
Not curable, but treatable and controllable
What Is It?
Hidradenitis suppurativa (HS) is a chronic condition causing painful, deep bumps and boils in areas where skin rubs together — the armpits, groin, buttocks, and under the breasts. Over time these can leak fluid and form tunnels and scars under the skin.
Signs & Symptoms
-
Painful, deep lumps or boils in skin folds
-
Bumps that may leak pus or blood and have an odor
-
Blackhead-like dots, often in pairs
-
Tunnels (tracts) forming under the skin over time
-
Scarring in areas that flare repeatedly
Why Does It Happen?
HS starts when hair follicles become blocked and inflamed, then rupture under the skin. The immune system reacts strongly, causing recurring painful lumps. Genetics, smoking, excess weight, and hormones all raise the risk. It is NOT an infection you caught, NOT caused by poor hygiene, and NOT contagious.
Treatment Options
Treatment reduces pain, calms inflammation, and prevents flares and scarring. Care is tailored to severity and often combines several approaches.
TOPICAL / ANTIBIOTICS
Antiseptic washes and antibiotic creams or pills to reduce inflammation.
HORMONAL THERAPY
Anti-androgen options that help some people, especially with hormonal flares.
BIOLOGICS
Targeted injections (e.g., adalimumab, secukinumab) for moderate-to-severe HS.
PROCEDURES
Drainage, laser, or surgery to treat persistent lumps and tunnels.
Tips for Managing It at Home
-
Wear loose, breathable clothing to reduce friction
-
Quitting smoking can meaningfully improve HS
-
Use gentle antiseptic washes; avoid harsh scrubbing or squeezing
-
Warm compresses can ease pain during a flare
When to Call Your Provider
-
Lumps become severely painful, swollen, or won't drain
-
Fever or spreading redness (possible serious infection)
-
Flares grow more frequent or new areas are affected
-
The condition affects your mood, sleep, or daily life
Sources & further reading
The information in this handout is based on general dermatology guidance from the reputable organizations below. These links are provided for patients who wish to read more from trusted sources.
American Academy of Dermatology (AAD). Hidradenitis Suppurativa: Overview. https://www.aad.org/public/diseases/a-z/hidradenitis-suppurativa-overview
Canadian Dermatology Association (CDA). Hidradenitis Suppurativa. https://dermatology.ca/public-patients/diseases-conditions/skin-conditions/hidradenitis-suppurativa/
DermNet. Hidradenitis Suppurativa. https://dermnetnz.org/topics/hidradenitis-suppurativa
MSD/Merck Manual. Hidradenitis Suppurativa. https://www.msdmanuals.com/professional/dermatologic-disorders/acne-and-related-disorders/hidradenitis-suppurativa
This handout is for general education and does not replace advice from your own provider. Always follow your provider’s specific instructions.
← Back to all handouts