Signs and Symptoms of Hidradenitis Suppurativa

Medically Reviewed By William C. Lloyd III, MD, FACS
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Hidradenitis suppurativa (HS), also known as acne inversa, is a scarring skin condition that affects more women than men. It’s marked by bumps that become painful, pus-filled boils, which disappear and then come back. Acne inversa is often mistaken for other skin disorders, such as typical acne.

Who gets hidradenitis suppurativa?

Acne inversa typically starts after puberty, most commonly in the 20s. Women tend to get acne inversa three times more often than men. And the condition can be related to hormonal changes; for example, women can have flare-ups before their menstrual period. Weight gain, stress, and smoking can also trigger outbreaks. Acne inversa may also run in families. The good news? It tends to go away during pregnancy and fade for good after menopause.

Skin Clues for HS

If you have acne inversa, it’s not uncommon to see many types of specialists and to be misdiagnosed with conditions, such as acne or staph. On average, patients wait seven years before receiving a firm diagnosis. In the meantime, the condition can grow worse and affect your quality of life.

Getting the right care from the start can help you better manage the disease. See a dermatologist right away if you notice any of these signs and symptoms.

Sores in crevices. Unlike regular acne, acne inversa bumps typically occur where skin touches skin. The most common areas on the body where acne inversa shows up include:

  • In the genitals, anus, and surrounding area
  • The upper thighs
  • Under the breasts (women)
  • Under your arms

Women tend to have breakouts on their upper thighs and genitals, while men are more likely to get them on their genitals and anus. The pimples may be single or in a cluster. These painful sores can flare up and stick around, lasting 7 to 15 days, then disappear and reappear again. It’s possible to have outbreaks on more than one area of your body at a time.

  • Oozing sores. The pimples can gradually enlarge and burst under the skin, causing fluid to drain beneath the surface.
  • A foul smell. If acne inversa boils erupt and become infected, they can give off an odor. The pus can also leak through your clothes.
  • Scarred skin. When acne inversa breakouts reappear in the same spot, over time, this can take a toll. From repeated flare-ups and healing, deep, tunnel-like scars can form on your skin and inside your body. Your skin can become thick, dense and spongy. Depending on the outbreak area, the scarring may affect your mobility. It can hurt to sit or even move.

What to Do for HS

If you have an outbreak, follow your doctor’s instructions. Treatment, including home remedies and medication, can help manage acne inversa. Wash daily with antibacterial soap. Avoid wearing tight-fitting clothes and shaving the affected areas—and don’t pinch your pimples. It can make acne inversa worse. Stopping smoking and losing weight if you’re overweight can also help. In more severe cases, medication and surgery may be needed.

Key Takeaways

  • Hidradenitis suppurativa is a scarring skin condition that affects more women than men.
  • It’s marked by bumps that become painful, pus-filled boils, which disappear and then come back. The pimples may be single or in a cluster, lasting 7 to 15 days.
  • HS bumps typically occur where skin touches skin. Women tend to have breakouts on their upper thighs and genitals. Men are more likely to get them on their genitals and anus.
  • The pimples can gradually enlarge and burst under the skin, causing fluid to drain beneath the surface.
  • HS is often mistaken for staph or typical acne. Getting the right care from the start can help you better manage the disease. See a dermatologist right away if you notice any of these symptoms.
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2022 Aug 18
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