Table of ContentsView AllTable of ContentsSymptomsComplicationsWhen to See a ProviderNext in Hidradenitis Suppurativa GuideHow Hidradenitis Suppurativa Is Treated
Table of ContentsView All
View All
Table of Contents
Symptoms
Complications
When to See a Provider
Next in Hidradenitis Suppurativa Guide
A pimple on the groin area can be a sign ofHidradenitis suppurativa(HS), a chronic skin condition that causes skin abscesses near hair follicles around the groin, armpits, breasts, and buttocks.
Hidradenitis suppurativa lesions begin as inflamed lumps that progress to larger lumps (called nodules) and abscesses that can rupture and leak pus.
This article discusses the symptoms and potential causes of hidradenitis suppurativa. It also discusses some of the complications this condition can cause.
An Overview of Hidradenitis Suppurativa
The most common symptoms of hidradenitis suppurativa include:
The condition most often develops in skin folds and areas that get a lot of friction, like your armpits, groin, and genital area. Breakouts are also common on the inner thighs, buttocks, and under the breasts.
If the condition progresses, breakouts may also appear on the nape of the neck, the waist (where the waistband of your pants rests), and the chest.
This photo contains content that some people may find graphic or disturbing.See PhotoHidradenitis suppurativa on the groin.DermNet / CC BY-NC-ND
This photo contains content that some people may find graphic or disturbing.See Photo
This photo contains content that some people may find graphic or disturbing.
Hidradenitis suppurativa can range from mild to severe. In mild cases, you may only have a handful of small bumps. Before they develop, you may notice a slight redness, itching, or burning in the area. In some cases, excessive sweating also occurs.
As the condition progresses, nodules get larger and more painful. Some nodules will heal on their own, while others develop into abscesses. They can rupture and leak fluid that has a foul smell.
Nodules and abscesses can grow and join with others, creating tunneling wounds underneath the surface of the skin called sinus tracts.
Hidradenitis suppurativa is a chronic condition, meaning that symptoms most likely will reoccur over many years.
While for some people the symptoms come and go, leaving periods of time where the skin is relatively clear, others have near-constant breakouts of nodules and abscesses.
Double-Ended Pseudocomedones
One defining symptom of hidradenitis suppurativa, especially in the later stages of the disease, is the development of double-endedpseudocomedones.
Double-ended pseudocomedones look like a typical “blackhead” except for a key feature—the blackhead is one lesion connected underneath the skin with two blackhead “heads” on either end. If you push on one end, the detritus may come out of either end.
These types of lesions do not develop with other conditions that resemble hidradenitis suppurativa, like folliculitis or simple abscesses, so this symptom is a strong clue that points to hidradenitis suppurativa.
What causes hidradenitis suppurativa?
Because of the deep-seated inflammation and open wounds this condition causes, hidradenitis suppurativa can lead to several complications.
Scarring
Due to widespread inflammation, hidradenitis suppurativa quite often causes scarring. Depending on the size, location, and severity of the breakouts, scars can range in severity from mild atrophic scars to deeper, more serious scarring.
It’s unfortunately common for this skin condition to cause very severe scarring. Cord-like scars can develop on the skin’s surface, following the line of skin damage that occurs underneath the surface.
Typically, the longer hidradenitis suppurativa is left untreated, or the more severe the case, the higher the risk of scarring.
The scarring isn’t just a cosmetic issue, although severe scarring can be disfiguring. Because the scar tissue runs deep and can be widespread, it may eventually restrict movement of the affected area.For example, severe scarring in the armpit area can restrict movement of the entire arm.
Fistulas—abnormal holes that connect two organs—can also develop, especially in thegenital area or around the anus.
Bacterial Infection
The wounds can also become infected with bacteria, oftenStaphylococcusorStreptococcus. In rare cases, the infection can become systemic (infects your bloodstream rather than just the local area).Signs of asystemic infectioninclude:
If you have signs of a systemic infection, call your healthcare provider immediately.
Squamous Cell Carcinoma
It can be harder to see skin cancer on skin that is inflamed or scarred. Talk to your healthcare provider about the possible risk of developing squamous cell carcinoma, and the best way to be screened for your particular situation. Keep in mind, however, that this is a very rare complication of hidradenitis suppurativa.
Other Cancers
Research published in 2020 identified an elevated risk of multiple types of cancer in people with hidradenitis suppurativa, including:
Keep in mind that an increase in risk doesn’t mean that you will develop any of these cancers.
When to See a Healthcare Provider
Abscesses are actually quite common, and most people will get at least one at some point in their life. They’re very treatable, but it’s when those abscesses recur that you and your healthcare provider should start exploring the reasons why.
You should see your healthcare provider when you have:
A diagnosis of hidradenitis suppurativa is usually based on a person’s symptoms, medical history, and a physical exam. A healthcare provider may also run a few tests to rule out other conditions, including a blood count, a culture of the wound to look for signs of infection, or a skin biopsy.
There isn’t a cure for hidradenitis suppurativa, but a healthcare provider can create a personalized treatment plan to help manage your symptoms. It may include skin care, medication, infection treatments, wound care, and pain control.In severe cases, a healthcare provider may prescribe a medication like metformin, a diabetes drug that is used to reduce inflammation.
Summary
See your healthcare provider if you develop painful abscesses anywhere on your body, especially if they are widespread, severe, or getting worse. Although there is no cure for hidradenitis suppurativa, the condition can be managed.
How Hidradenitis Suppurativa Is Diagnosed
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Lee EY, Alhusayen R, Lansang P, Shear N, Yeung J.What is hidradenitis suppurativa?Can Fam Physician.2017;63(2):114-120.Lacarrubba F, Musumeci ML, Nasca MR, Verzì AE, Fiorentini F, Micali G.Double-ended pseudocomedones in hidradenitis suppurativa: Clinical, dermoscopic, and histopathological correlation.Acta Derm Venereol.2017;97(6):763-764. doi:10.2340/00015555-2601National Institute of Arthritis and Musculoskeletal and Skin Diseases.Hidradenitis suppurativa (HS).Guet-Revillet H, Coignard-Biehler H, Jais JP.Bacterial pathogens associated with hidradenitis suppurativa, France.Emerg Infect Dis.2014;20(12):1990–1998. doi:10.3201/eid2012.140064Fabbrocini G, Ruocco E, De Vita V, Monfrecola G.Squamous cell carcinoma arising in long-standing hidradenitis suppurativa: An overlooked facet of the immunocompromised district.Clin Dermatol. 2017;35(2):225-227. doi:10.1016/j.clindermatol.2016.10.019Jung JM, Lee KH, Kim YJ, et al.Assessment of overall and specific cancer risks in patients with hidradenitis suppurativa.JAMA Dermatol. 2020;156(8):844-853. doi:10.1001/jamadermatol.2020.1422American Academy of Dermatology Association.Hidradenitis suppurativa: Diagnosis and treatment.Additional ReadingSaunte DML, Jemec GBE.Hidradenitis suppurativa: Advances in diagnosis and treatment. JAMA.2017 Nov 28;318(20):2019-2032. doi:10.1001/jama.2017.16691
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Lee EY, Alhusayen R, Lansang P, Shear N, Yeung J.What is hidradenitis suppurativa?Can Fam Physician.2017;63(2):114-120.Lacarrubba F, Musumeci ML, Nasca MR, Verzì AE, Fiorentini F, Micali G.Double-ended pseudocomedones in hidradenitis suppurativa: Clinical, dermoscopic, and histopathological correlation.Acta Derm Venereol.2017;97(6):763-764. doi:10.2340/00015555-2601National Institute of Arthritis and Musculoskeletal and Skin Diseases.Hidradenitis suppurativa (HS).Guet-Revillet H, Coignard-Biehler H, Jais JP.Bacterial pathogens associated with hidradenitis suppurativa, France.Emerg Infect Dis.2014;20(12):1990–1998. doi:10.3201/eid2012.140064Fabbrocini G, Ruocco E, De Vita V, Monfrecola G.Squamous cell carcinoma arising in long-standing hidradenitis suppurativa: An overlooked facet of the immunocompromised district.Clin Dermatol. 2017;35(2):225-227. doi:10.1016/j.clindermatol.2016.10.019Jung JM, Lee KH, Kim YJ, et al.Assessment of overall and specific cancer risks in patients with hidradenitis suppurativa.JAMA Dermatol. 2020;156(8):844-853. doi:10.1001/jamadermatol.2020.1422American Academy of Dermatology Association.Hidradenitis suppurativa: Diagnosis and treatment.Additional ReadingSaunte DML, Jemec GBE.Hidradenitis suppurativa: Advances in diagnosis and treatment. JAMA.2017 Nov 28;318(20):2019-2032. doi:10.1001/jama.2017.16691
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Lee EY, Alhusayen R, Lansang P, Shear N, Yeung J.What is hidradenitis suppurativa?Can Fam Physician.2017;63(2):114-120.Lacarrubba F, Musumeci ML, Nasca MR, Verzì AE, Fiorentini F, Micali G.Double-ended pseudocomedones in hidradenitis suppurativa: Clinical, dermoscopic, and histopathological correlation.Acta Derm Venereol.2017;97(6):763-764. doi:10.2340/00015555-2601National Institute of Arthritis and Musculoskeletal and Skin Diseases.Hidradenitis suppurativa (HS).Guet-Revillet H, Coignard-Biehler H, Jais JP.Bacterial pathogens associated with hidradenitis suppurativa, France.Emerg Infect Dis.2014;20(12):1990–1998. doi:10.3201/eid2012.140064Fabbrocini G, Ruocco E, De Vita V, Monfrecola G.Squamous cell carcinoma arising in long-standing hidradenitis suppurativa: An overlooked facet of the immunocompromised district.Clin Dermatol. 2017;35(2):225-227. doi:10.1016/j.clindermatol.2016.10.019Jung JM, Lee KH, Kim YJ, et al.Assessment of overall and specific cancer risks in patients with hidradenitis suppurativa.JAMA Dermatol. 2020;156(8):844-853. doi:10.1001/jamadermatol.2020.1422American Academy of Dermatology Association.Hidradenitis suppurativa: Diagnosis and treatment.
Lee EY, Alhusayen R, Lansang P, Shear N, Yeung J.What is hidradenitis suppurativa?Can Fam Physician.2017;63(2):114-120.
Lacarrubba F, Musumeci ML, Nasca MR, Verzì AE, Fiorentini F, Micali G.Double-ended pseudocomedones in hidradenitis suppurativa: Clinical, dermoscopic, and histopathological correlation.Acta Derm Venereol.2017;97(6):763-764. doi:10.2340/00015555-2601
National Institute of Arthritis and Musculoskeletal and Skin Diseases.Hidradenitis suppurativa (HS).
Guet-Revillet H, Coignard-Biehler H, Jais JP.Bacterial pathogens associated with hidradenitis suppurativa, France.Emerg Infect Dis.2014;20(12):1990–1998. doi:10.3201/eid2012.140064
Fabbrocini G, Ruocco E, De Vita V, Monfrecola G.Squamous cell carcinoma arising in long-standing hidradenitis suppurativa: An overlooked facet of the immunocompromised district.Clin Dermatol. 2017;35(2):225-227. doi:10.1016/j.clindermatol.2016.10.019
Jung JM, Lee KH, Kim YJ, et al.Assessment of overall and specific cancer risks in patients with hidradenitis suppurativa.JAMA Dermatol. 2020;156(8):844-853. doi:10.1001/jamadermatol.2020.1422
American Academy of Dermatology Association.Hidradenitis suppurativa: Diagnosis and treatment.
Saunte DML, Jemec GBE.Hidradenitis suppurativa: Advances in diagnosis and treatment. JAMA.2017 Nov 28;318(20):2019-2032. doi:10.1001/jama.2017.16691
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