Hidradenitis suppurativa, or HS, is a long-term inflammatory skin condition that causes painful lumps, abscesses, tunnels under the skin and scarring. It commonly affects the armpits, groin, buttocks and areas under the breasts. It is not contagious and is not caused by poor hygiene.
Symptoms
Early signs include tender pea-sized lumps or blackheads in typical areas. Lumps may rupture and drain fluid or pus. Repeated inflammation can form connected tunnels and thick scars. HS can resemble boils but tends to return in the same areas.
Why early diagnosis matters
Early treatment can reduce pain, flare-ups and permanent scarring. HS is different from ordinary acne, although both involve hair follicles. Diagnosis is usually clinical; bacterial swabs may be used when secondary infection is suspected.
Treatment
Treatment depends on severity and may include antiseptic washes, topical or oral antibiotics for their anti-inflammatory effects, hormonal treatment, biologic medicines, laser procedures, deroofing or surgery. Pain, wound care and emotional wellbeing also need attention.
Daily care
Use gentle skin care, loose clothing and suitable absorbent dressings. Avoid squeezing lesions. Smoking cessation and gradual weight management may reduce severity for some people, but HS can affect people of any weight and must never be blamed on lifestyle.
When to seek medical advice
See a clinician for recurring painful lumps, drainage or scarring in skin folds. Seek prompt care for rapidly spreading redness, fever, severe pain or feeling very unwell, which may indicate secondary infection.
Sources
Reviewed: 28 August 2026