Common symptoms
These are examples of possible symptoms. The diagrams show a simplified side view of the skin, not stages in a fixed sequence of progression. [1][2]
Lumps and swelling
Firm lumps can develop beneath the skin and may be painful.
Pus collecting or draining
Abscesses, which are collections of pus, may develop. Fluid or pus may drain, sometimes with an odor.
Tunnels beneath the skin
Tunnel-like passages, also called sinus tracts, may form beneath the skin. Repeated inflammation can also leave scars.
Symptoms vary between people. Not everyone develops all of these symptoms.
Commonly affected areas
HS commonly affects areas where skin rubs together, such as the armpits and groin. [1][2]
- 1Armpits
- 2Under the breasts
- 3Groin
The groin area
- 4Buttocks
The area around the anus and the perineum can also be affected.
Colors and numbers indicate approximate locations. Not all areas are affected at once, and symptoms may occur in places not shown.
HS often begins after puberty. [2]
Causes
The causes are not yet fully understood. Several factors are thought to be involved, including blocked hair follicles and immune system activity. [1][2]
Associations with genetic background, smoking, and body weight have also been reported, but no single factor explains why HS develops. [2]
You do not need to blame yourself or think that you did not wash properly.
Diagnosis and treatment
Recurring lumps or swelling: speak with a dermatologist
Other conditions can look similar. Rather than deciding from appearance alone that it is HS, speak with a dermatologist. The clinician will assess your skin, the affected locations, and your symptom history. [3]
What to tell your clinician
- When and where symptoms began
- How often similar symptoms have returned
- Pain, drainage, and difficulties in everyday life
Notes or photos, if you have them, can help you explain.
Preparing for your first appointmentTreatment is tailored to your symptoms
Options include the following. Discuss a treatment plan with your clinician based on your condition and its effects on daily life. [1][3]
Medicines
Medicines such as antibiotics and biologic treatments may be used according to your symptoms.
Procedures and surgery
These may be used for persistently affected areas or tunnels beneath the skin.
Wound care and pain management
Discuss suitable dressings and ways to relieve pain with your healthcare team.
The illustrations show examples of treatment materials. The treatment and care each person needs will differ.
Effects on daily life
Pain and drainage can affect clothing choices, work, and going out. Some people also feel anxious about symptoms returning or find it difficult to explain their condition to others. [4]
Clothing and movement
Clothes touching the skin, raising your arms, or sitting can be painful.
Work and going out
You may need to adjust plans around appointments or symptoms.
Emotions and relationships
You may face difficulties or anxieties that others cannot see.
Challenges differ between people. Tell your clinician about the effects on everyday life as well as your skin symptoms.
Record symptoms and appointment notes on Living with HSPatient leaflet
This resource can help you organize your daily experiences and prepare for appointments while living with HS. Use it to reflect on your situation or as a reference during a consultation.
It does not provide clinical judgments.
Read the leaflet (PDF)
Our role at HS Voices Connect Japan
HS Voices Connect Japan works to connect the voices of people living with HS with healthcare, research, and society.
HS is still not widely known. We believe each patient's experience can offer insights to improve healthcare and support systems.
We hope accurate information about HS reaches more people and helps reduce isolation.
About the information on this page
The explanations and diagrams were prepared with reference to the following professional organizations and public institutions.
- [1] Japanese Dermatological Association: Guide to the Management of Hidradenitis Suppurativa 2020
Definitions, symptoms, diagnosis, and treatment basics. PDF in Japanese.
- [2] NIH / NIAMS: Hidradenitis Suppurativa (HS)
Symptoms, affected areas, causes, and associated factors. In English.
- [3] American Academy of Dermatology: Hidradenitis suppurativa — diagnosis and treatment
Diagnosis, treatment, and wound care. In English.
- [4] Guy’s and St Thomas’ NHS: Physical, emotional and social effects of HS
Physical, emotional, and social effects. In English.
Sources checked:
This page has not been medically reviewed by a physician. The diagrams are simplified for explanation and cannot be used to diagnose HS or assess severity. Please consult a healthcare professional about your own symptoms and treatment.
