Hidradenitis Suppurativa (HS)

Hidradenitis suppurativa—often called HS—is a chronic skin condition that causes painful

bumps, abscesses, and sometimes draining tunnels beneath the skin. These breakouts most

commonly appear in areas where skin rubs together: the underarms, groin, buttocks, inner thighs, and under the breasts. For many patients, HS can feel confusing, painful, and even isolating. You might wonder if it’s something you did or if you’re alone in this. Please know you’re not alone, and this is not your fault. HS is a medical condition driven by inflammation, and effective treatments and support are available.

Hidradenitis suppurativa is not caused by infection or poor hygiene, and it’s not contagious. It

develops when hair follicles deep in the skin become blocked, leading to inflammation, swelling,

and sometimes rupture under the skin. Over time, this can cause nodules, abscesses, and sinus

tracts (tunnels under the skin). The condition can come and go in cycles—periods of flare-ups followed by calmer phases. Without proper care, HS can worsen over time, but with the right treatment plan, most patients can achieve major relief and long-term control.

The exact cause isn’t fully known, but researchers believe several factors play a role:

• Follicular blockage: When a hair follicle becomes trapped, the immune system reacts, leading to inflammation.
•  Inflammation and immune system overactivity: HS is now understood as an inflammatory disease, not simply a skin problem.
•  Hormones: HS often begins after puberty and can fluctuate with hormonal changes, such as menstrual cycles or menopause.
•  Genetics: About one-third of people with HS have a family member who also has it.
•  Lifestyle factors: Friction, heat, stress, and smoking can worsen symptoms, but they are not the cause.
• The key takeaway: you didn’t cause your HS, and there are ways to bring it under control.

HS can vary from person to person, but common signs include:

• Tender or painful bumps that feel deep under the skin
• Areas that drain pus or blood
•  Recurrent “boil-like” spots that return in the same places
•  Scarring or thickened skin over time
•  Itching, burning, or pain in affected areas

If you recognize these symptoms, it’s important to see a dermatologist who understands HS.

Early diagnosis and treatment can make a tremendous difference. The earlier we begin

treatment, the better we can control and prevent progression.

While there’s no single “cure” for HS yet, there are many effective treatments that can reduce

pain, shorten flares, and help prevent new ones from forming.

Treatment is customized for each person depending on severity, medical history, and lifestyle.

Treatment options may include:

• Topical and oral medications: Anti-inflammatory creams and short courses of antibiotic pills can calm the skin and reduce bacteria.
•  Hormonal therapy: For most women, spironolactone help regulate hormonal triggers.
•  Biologic injections: These advanced medications, such as secukinumab and

                  bimekizumab, can dramatically reduce inflammation and flare frequency.

• Procedures and surgery: For severe or persistent lesions, minor procedures or laser

                treatments can drain or remove affected areas and prevent scarring.

• Lifestyle support: Small daily choices—wearing loose clothing, managing stress,

                stopping smoking, and maintaining a balanced diet—can help reduce

                irritation and flare-ups.

Together, these treatments can help you take back control of your skin and your comfort.

Living with HS can be emotionally exhausting. It’s common to feel frustrated, anxious, or even

embarrassed. Please remember: this condition does not define you, and help is available.

Managing HS is about more than treating the skin—it’s about improving your quality of life and

helping you feel confident again. Our goal is to work with you, not just to treat your symptoms but to understand how HS affects your daily life. Healing happens best when you feel heard, supported, and cared for. If you’ve been struggling with painful bumps that don’t seem to go away, you deserve answers and relief. With today’s advances in dermatology, there is 

more hope than ever for HS.

If you think you may have hidradenitis suppurativa—or if you’ve already been diagnosed and are

looking for a caring, personalized treatment plan—Dr. Brown and her team are here to help.

Together, we’ll create a plan to calm inflammation, ease pain, and help you live more

comfortably in your skin. You don’t have to face HS alone.