Print Overview Hidradenitis suppurativa Enlarge image Close Hidradenitis suppurativa Hidradenitis suppurativa Hidradenitis suppurativa usually appears as one or more red, tender bumps that fill with pus. It most commonly occurs in the armpits (shown), groin, between the buttocks and under the breasts. Hidradenitis suppurativa (hi-drad-uh-NIE-tis sup-yoo-ruh-TIE-vuh) is a condition that causes small, painful lumps to form under the skin. The lumps usually develop in areas where your skin rubs together, such as the armpits, groin, buttocks and breasts. The lumps heal slowly, recur, and can lead to tunnels under the skin and scarring. Hidradenitis suppurativa tends to start after puberty. It can persist for many years and worsen over time, with serious effects on your daily life and emotional well-being. Combined medical and surgical therapy can help manage the disease and prevent complications.Products & ServicesBook: Mayo Clinic Family Health Book, 5th EditionNewsletter: Mayo Clinic Health Letter — Digital EditionShow more products from Mayo Clinic SymptomsHidradenitis suppurativa can affect one or several areas of the body. Signs and symptoms of the condition include: Blackheads. Blackheads appear in small pitted areas of skin, often appearing in pairs. Painful pea-sized lumps. The condition usually starts with a single, painful lump under the skin that persists for weeks or months. More bumps may form later, usually in areas where you have more sweat and oil glands or where the skin rubs together, such as the armpits, groin, buttocks and breasts. Leaking bumps or sores. Some bumps or sores get bigger, break open and drain pus with an odor. Tunnels. Over time, tunnels might form under the skin, connecting the lumps. These wounds heal very slowly, if at all, and drain blood and pus. Some people with this condition experience only mild symptoms. The course of the disease is highly variable. Excess weight and being a smoker are associated with worse symptoms, but even people who are thin and don't smoke can experience severe disease. When to see a doctorEarly diagnosis of hidradenitis suppurativa is key to getting effective treatment. See your doctor if your condition: Is painful Makes it difficult to move Doesn't improve in a few weeks Returns within weeks of treatment Appears in several locations Flares often Hidradenitis suppurativa is not just a boil, and many people with this condition also have related conditions. People with hidradenitis suppurativa benefit from a health care team with medical and surgical dermatologists at the core. Other specialists are involved as needed.More InformationHidradenitis suppurativa care at Mayo ClinicWhat are the signs and symptoms of hidradenitis suppurativa? Request an appointment There is a problem with information submitted for this request. Review/update the information highlighted below and resubmit the form. From Mayo Clinic to your inbox Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. Click here for an email preview. Email ErrorEmail field is required ErrorInclude a valid email address Learn more about Mayo Clinic’s use of data. To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail. Subscribe! Thank you for subscribing! You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. Sorry something went wrong with your subscription Please, try again in a couple of minutes Retry CausesHidradenitis suppurativa develops when hair follicles become blocked. The exact cause for this isn't known. Experts think it could be connected to hormones, genetic predisposition, cigarette smoking or excess weight. Hidradenitis suppurativa is not caused by an infection or being unclean, and it can't be spread to other people. Risk factorsFactors that increase your chance of developing hidradenitis suppurativa include: Age. The risk of hidradenitis suppurativa is higher for people in their 20s and 30s. Sex. Females are more likely to develop hidradenitis suppurativa than are males. Race. Ethnicity or race might affect risk level. In the United States, the condition's prevalence is disproportionately high among Black people. Family history. A tendency to develop hidradenitis suppurativa can be inherited. Certain conditions. Hidradenitis suppurativa 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. Smoking. Smoking tobacco has been linked to hidradenitis suppurativa. ComplicationsPersistent and severe hidradenitis suppurativa can cause complications, including: Infection. The affected area is susceptible to secondary infection, but the presence of pus is common in hidradenitis suppurativa and doesn't necessarily mean infection. Scars and skin changes. The wounds may heal but leave ropelike scars or pitted skin. Restricted movement. Sores and scar tissue can cause limited or painful movement, especially when the disease affects the armpits or thighs. Skin cancer. Squamous cell carcinoma has been reported with long-term hidradenitis suppurativa, particularly in people whose condition involves the perianal area. Swelling in the arms, legs or genitals. The most common sites for hidradenitis suppurativa also contain many lymph nodes. Scar tissue can interfere with the lymph drainage system, which can result in 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. By Mayo Clinic Staff Hidradenitis suppurativa care at Mayo Clinic Request an appointment Diagnosis & treatment June 14, 2022 Print Share on: FacebookTwitter Show references AskMayoExpert. Hidradenitis suppurativa. Mayo Clinic; 2020. Kohorst JJ, et al. Patient satisfaction and quality of life following surgery for hidradenitis suppurativa. Dermatologic Surgery. 2017; doi10.1097/DSS.0000000000000942. Orgill DP. Surgical management of hidradenitis suppurativa. https://www.uptodate.com/contents/search. Accessed Feb. 15, 2021. Alikhan A, et al. North American clinical management guidelines for hidradenitis suppurativa: A publication from the United States and Canadian Hidradenitis Suppurativa Foundations: Part I: Diagnosis, evaluation, and the use of complementary and procedural management. Journal of the American Academy of Dermatology. 2019; doi:10.1016/j.jaad.2019.02.067. Alikhan A, et al. North American clinical management guidelines for hidradenitis suppurativa: A publication from the United States and Canadian Hidradenitis Suppurativa Foundations: Part II: Topical, intralesional, and systemic medical management. Journal of the American Academy of Dermatology. 2019; doi:10.1016/j.jaad.2019.02.068. Clindamycin (topical): Drug information. https://www.uptodate.com/contents/search. Accessed Feb. 16, 2021. Bolognia JL, et al., eds. Folliculitis and other follicular disorders. In: Dermatology. 4th ed. Elsevier; 2018. https://www.clinicalkey.com. Accessed Feb. 22, 2021. Hidradenitis suppurative. American Academy of Dermatology. https://www.aad.org/public/diseases/a-z/hidradenitis-suppurativa-overview. Accessed Feb. 18, 2021. Ferri FF. Hidradenitis suppurativa. In: Ferri's Clinical Advisor 2021. Elsevier; 2021. https://www.clinicalkey.com. Accessed Feb. 18, 2021. Hidradenitis suppurativa (HS). National Institute of Arthritis and Musculoskeletal and Skin Diseases. https://www.niams.nih.gov/health-topics/hidradenitis-suppurativa-hs. Accessed Feb. 22, 2021. Hidradenitis suppurativa. Genetic and Rare Diseases Information Center. https://rarediseases.info.nih.gov/diseases/6658/hidradenitis-suppurativa/. Accessed Feb. 22, 2021. Ingram JR. Hidradenitis suppurativa: Management. https://uptodate.com/search/contents. Accessed Feb. 15, 2021. Ingram JR. Hidradenitis suppurativa. Pathogenesis, clinical features, and diagnosis. https://uptodate.com/search/contents. Accessed Feb. 15, 2021. Maarouf M, et al. The role of nutrition in inflammatory pilosebaceous disorders: Implication of the skin-gut axis. Australasian Journal of Dermatology. 2019; doi:10.111/ajd.12909. Hogue L, et al. Basal cell carcinoma, squamous cell carcinoma, and cutaneous melanoma in skin of color patients. Dermatologic Clinics. 2019; doi:10.1016/j.det.2019.05.009. Alavi A (expert opinion). Mayo Clinic. May 6, 2021. 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