Hidradenitis suppurativa (HS) is an inflammation of the skin in the body folds, especially the armpits and groin. It looks like acne (pimples). Hidradenitis suppurativa is an unpleasant condition for people who are affected. This is not only because of the pain caused by the inflammation, but also because it makes ugly and can smell unpleasant.


Due to closure of the exit of hair follicles, the hair follicles become inflamed. The sebacious glands, sweat glands and other skin structures can also get inflamed. The exact cause of the inflammatory process is not known. Several factors may play a role in the emergence and worsening of the disease. Hidradenitis suppurativa has a clear link with smoking of cigarettes. The impression is that many female patients with hidradenitis suppurativa have overweight. There are indications that male sex hormones are important in the development of the inflammations, but it’s unknown how this exactly works. It seems that hereditary factors also contribute to the development of hidradenitis suppurativa. The condition usually begins during or after puberty, often between the ages of twenty and twenty-five years. Hidradenitis suppurativa is not contagious.


Hidradenitis suppurativa is characterized by painful inflammations in the body folds, especially the armpits and groin. The fold under or between the breasts, pubic mound, scrotum, labia, the area around the anus and buttocks may also participate. In the beginning, the inflammation looks like a small boil. Later it’s getting bigger and deeper and can even burst, releasing large amounts of sebum and pus. Healing of the skin can leave scarring. In the longer term, passageways may arise in the skin, which are called sinuses. Also large comedones (blackheads) occur and cysts (cavities in the skin) can be formed. The suppurating discharge from cysts, inflammations and sinuses can cause an unpleasant smell. The inflammations in hidradenitis suppurativa are larger than in ordinary pimples.


Generally, the doctor can make the diagnosis of hidradenitis suppurativa directly on the basis of the signs and symptoms. Once in a while, a piece of tissue (biopsy) can be taken away under local anesthesia for microscopic examination, in order to exclude other disorders.


There are several options to treat hidradenitis suppurativa, but no treatment can solve the problem quickly and permanently. Even when treatment is successful, the disease can often come back. A combination or a sequence of treatments and treatment methods is the best approach in many cases.


The long-term prospects are, unfortunately, not so good. The symptoms can usually be reduced, but the disease cannot be cured completely.