By: Kathy Hubbard
“I’m now 53 and have just recently stumbled on an article about hidradenitis suppurativa (HS) and started reading it and it was a true revelation. This was the answer to the biggest mystery of my life, what is causing these huge boils I’ve had in the strangest places since I was a teenager,” a person wrote on www.hsdisease.com’s website.
Hidradenitis suppurative is a condition that causes small, painful lumps to form under the skin. “The lumps usually develop in areas where your skin rubs together,” Mayo Clinic explains.
“The name comes from Greek (hidros, sweat; aden, gland; -itis, inflammation) and Latin (suppurare, to form or discharge pus,” the website says. “The disease was named officially in 1854 by a French doctor. He thought that inflammation of the sweat glands caused pus and scarring. Doctors now think that HS comes from problems with hair follicles, which are near sweat glands.”
The symptoms of HS (aka acne inversa) begin with small bumps, often described as looking like boils, pimples or cysts. They are mostly found in the armpits, groin, under the breasts, on inner thighs, on the buttocks, and in the anal and genital areas. One might notice a small, pitted area of skin containing blackheads.
“Itchy or painful bumps return again and again when the disease flares,” hsdisease.com says. “HS can lead to painful abscesses and sinus tracts, which are narrow tunnels extending under the skin from a wound. A discharge of pus and an odor often make HS discomfort worse. After healing, wounds can leave scars.”
Once thought rare, the Hidradenitis Suppurative Foundation estimates that between one to two percent of the U.S. population have this skin disease. HS affects women three times more often than men, and it’s classified as an autoinflammatory condition.
Mayo Clinic explains that “the risk of hidradenitis suppurativa is high for people in their teens and twenties. Females are more likely to develop HS than males. Ethnicity or race might affect risk level. The condition occurs mostly in Black people, possibly due to genetic factors. A tendency to develop hidradenitis suppurativa can be inherited. HS is more common and severe in people who are overweight. It also has an association with severe acne, arthritis, diabetes, metabolic syndrome and inflammatory bowel disease, and smoking tobacco has been linked to HS.”
Medlineplus.gov explains that blocked hair follicles trap bacteria, which leads to inflammation and rupture. In most cases, the cause of the blockages is unknown. Genetics, environment, and hormonal factors may play a role. Some cases of HS are caused by changes in certain genes. HS is not caused by bad hygiene and cannot be spread to others.”
Mayo Clinic tells us that persistent and severe HS can cause complications such as long-term pain; a secondary infection; scars and skin changes; restricted movement; skin cancer; swelling in the arms, legs or genitals; psychological effects and social isolation.
“The location, drainage and odor of the sores can cause embarrassment and reluctance to go out in public, leading to anxiety or depression,” Mayo Clinic says.
They say that “early diagnosis of hidradenitis suppurativa is key to effective treatment.” And one should seek professional healthcare when the condition is painful; it makes it difficult to move; it doesn’t improve in a few weeks; returns within weeks of treatment; appears in several locations, or if it flares often.
“Hidradenitis suppurativa is not just a boil, and many people with this condition also have related conditions. People with HS benefit from a strong healthcare team. Unfortunately, there isn’t a simple test to diagnose the condition. And there is no cure,” Mayo says.
However, don’t be dismayed. There are medicines, procedures and surgery that can help. Medline says that it also might help to wear loose fitting clothes, stay at a healthy weight, quit smoking, avoid heat and humidity, and be careful not to injure your skin.
The person who posted about his revelation found that changing his diet changed his HS and his life. He said, “I decided to quit sugar and anything with high fructose corn syrup for weight loss purposes … I also switched over to drinking nothing but water. My skin is the healthiest it’s been since before I was a teenager.”
Kathy Hubbard is a member of the Bonner General Health Foundation Advisory Council. She can be reached at [email protected]. This article was written for publication in the Bonner County Daily Bee on October 8, 2025.
