Hidradenitis suppurativa

No, hidradenitis suppurativa (HS) is not an infection, and it cannot be transmitted to your baby during pregnancy or childbirth. However, HS may have a genetic component. If you have HS, your child might have a slightly increased likelihood of developing it later in life, but this is not guaranteed. HS is influenced by a combination of genetics, hormones, and lifestyle factors, rather than being directly passed on to your baby.

Pregnancy does not cause hidradenitis suppurativa (HS), but it can influence how the condition behaves. Hormonal changes during pregnancy may worsen or, in some cases, improve HS symptoms. Painful lesions, particularly in areas such as the groin or under the breasts, may become more uncomfortable as your body changes.

Due to limited medication options, your treatment plan may need to be adjusted. It is crucial to review your medications early—ideally before conception or as soon as you discover you are pregnant. A specialist can help you manage HS safely during pregnancy by adjusting medications and monitoring for any complications.

There is no precise data on how often hidradenitis suppurativa (HS) becomes active or worsens during pregnancy. However, many individuals with HS notice changes in their symptoms due to hormonal fluctuations. Some may experience an improvement, particularly during the second trimester, while others may have worsening flare-ups, especially in the groin or underarm areas. Since everyone’s experience is unique, it is essential to closely monitor symptoms and have a proactive treatment plan in place during this time.

Treatment must be adjusted during pregnancy to ensure safety for both parent and baby. Your Specialist may recommend:

Safe treatment options may include:

• Topical antibiotics (e.g., clindamycin cream)
• Antiseptic washes (e.g., chlorhexidine)
• Warm compresses for pain relief
• Simple surgical drainage if abscesses occur
• Paracetamol for pain (always check with your midwife or GP)

Avoid during pregnancy:

• Oral retinoids (e.g., isotretinoin)
• Immunosuppressants
• Biologics like adalimumab (may be used with caution in some cases, but should be reviewed on a case-by-case basis)

Your care team—including dermatology, GP, and obstetrics—will create a treatment plan that manages HS while keeping your pregnancy safe.

While it may not be possible to completely prevent hidradenitis suppurativa (HS) during pregnancy, you can take steps to reduce the risk of flare-ups by:

• Wearing loose, breathable clothing.
• Avoiding shaving or causing trauma to areas prone to HS.
• Gently washing with non-irritating cleansers.
• Steering clear of known personal triggers, if any (some individuals report food triggers).
• Maintaining healthy weight gain with support from your antenatal team.
• Reviewing your medications with your specialist.

Effective communication with both your specialist and obstetric team is crucial in preventing complications.

Yes, while hidradenitis suppurativa (HS) does not directly affect fertility or postpartum recovery, it can create physical and emotional challenges after giving birth. Here are some considerations to keep in mind:

• Pain from lesions, particularly in areas like the groin or breasts, can make it difficult to sit, walk, or hold the baby.
• If HS affects the breasts or underarms, breastfeeding may be painful.
• Open lesions can increase the risk of skin infections, so maintaining good hygiene is essential.
• It's important to review medication safety during breastfeeding, as some antibiotics and painkillers may be restricted.

Working with your healthcare team early on can help you manage these challenges with:

• Safe pain relief options
• Support for wound care
• Alternatives or adaptations for breastfeeding if needed

With a well-designed plan, many people with HS are able to successfully navigate the postpartum period and breastfeeding.

Yes, hidradenitis suppurativa (HS) can be treated—though it is a long-term condition and there is currently no known cure. Treatment focuses on controlling flare-ups, relieving symptoms, preventing scarring, and improving quality of life.

A Specialist Healthcare Professional will usually recommend a combination of treatments, tailored to the severity of your condition:

• Topical treatments: Such as antibiotic creams (e.g. clindamycin) for mild HS.
• Oral medications: Including long-term antibiotics, hormonal treatments (like the combined contraceptive pill or spironolactone), and sometimes short courses of oral steroids for inflammation.
• Injections into lesions: Steroid injections (e.g. triamcinolone) can reduce swelling and pain in inflamed lumps. These are often used for targeted flare control.
• Injectable antibiotics: In more severe or widespread flare-ups, a short course of injectable antibiotics like ceftriaxone may be used to treat secondary infection—especially when oral antibiotics have not worked or cannot be tolerated.
• Biologic therapies: In more severe, long-standing HS, medications like adalimumab (a TNF-alpha inhibitor given by injection) can help reduce inflammation and prevent flare-ups.
• Surgery: In cases where scarring, tunnels, or repeated abscesses occur, surgery may be needed. Options include draining abscesses, removing tunnels or scarred areas (a procedure called deroofing), or wider skin excision.

Lifestyle changes can also make a big difference:

- Quitting smoking
- Maintaining a healthy weight
- Wearing loose-fitting clothing
- Managing stress and triggers
Because HS varies widely from person to person, it's essential to speak with a Specialist for an individualised treatment plan.

Effective treatment of HS can:

• Reduce pain, swelling, and drainage
• Lessen frequency and severity of flare-ups
• Prevent or reduce scarring and tunnel formation
• Improve mobility and comfort
• Enhance self-confidence and intimacy
• Improve mental health and quality of life

Although treatment often takes time to work, sticking with it can make a significant difference.

Not always. Surgery is not first-line but can be helpful for people with persistent, severe, or scarring HS that doesn't respond to medical treatment.

Surgical options may include:

• Incision and drainage – for temporary relief of abscesses (though this doesn’t prevent recurrence)
• Deroofing – removing the “roof” of tunnels while preserving surrounding skin
• Excision – removal of affected areas, especially in Hurley stage III
• Skin grafting or reconstruction – in more advanced cases

Your Specialist will explain whether surgery is appropriate, and what benefits or risks it might involve.

While home care cannot cure HS, it can help reduce flare-ups and support your medical treatment. Strategies include:

• Gentle hygiene: Wash with mild, fragrance-free cleansers. Avoid scrubbing.
• Loose, breathable clothing: Reduces skin friction and irritation.
• Avoid shaving: Especially in sensitive areas; consider trimming instead.
• Warm compresses: Can ease discomfort and promote drainage of small lumps.
• Antiseptic washes: Like chlorhexidine may reduce bacterial load on the skin.
• Pain relief: Paracetamol or ibuprofen may help with pain and inflammation.
• Healthy lifestyle:
• Quit smoking
• Maintain a healthy weight
• Manage stress and sleep

Some people find dietary changes helpful (e.g., reducing sugar, dairy, or processed foods), though the evidence for this is still evolving.

These steps are supportive, not substitutes for medical treatment. Persistent symptoms should be reviewed by a Specialist.

Most people with HS can be treated, but some treatments may not be suitable depending on your health status or life circumstances.

Examples include:

• Pregnancy or breastfeeding – limits use of certain antibiotics, hormonal therapies, or biologics.
• Underlying conditions – liver, kidney, or immune system issues may affect medication choices.
• Allergies or side effects – can restrict what treatments are safe for you.
• Access to care – biologics and specialist surgeries may require NHS funding approval or hospital referral.

That’s why it’s essential to discuss your full medical history with your Specialist Healthcare Professional—they will help create a safe and effective plan tailored to your needs.

Hidradenitis Suppurativa (HS) is usually diagnosed during a physical examination by a Specialist Healthcare Professional. There is no single test for HS. Diagnosis is based on:

• The appearance of characteristic lesions: painful lumps, abscesses, blackheads, scarring, and sinus tracts.
• The location of these lesions: typically in areas with skin friction or apocrine sweat glands (e.g. armpits, groin, buttocks).
• A pattern of recurrence: symptoms that come and go over time.
• Your medical and family history.

Occasionally, your specialist may take a skin swab to rule out bacterial infections or a biopsy if the diagnosis is uncertain. However, these are not routine for HS.
Many people experience delays in diagnosis—sometimes for years—because HS can be mistaken for other skin conditions. If you have persistent, painful lumps in typical areas, ask your healthcare provider about HS.

A correct diagnosis of HS relies on recognising certain key features. A Specialist will typically consider:

• Typical symptoms: Recurrent, painful lumps or abscesses, often starting after puberty.
• Specific types of lesions: Such as double comedones (blackheads with two heads), inflamed nodules, draining sinuses, and scarring.
• Location: HS typically affects the armpits, groin, under the breasts, buttocks, and inner thighs.
• Course over time: Chronic or relapsing pattern is a hallmark.
• Exclusion of other conditions: The Specialist may need to rule out boils, pilonidal cysts, acne, Crohn’s disease, or infections.
• Family history: Around 30–40% of people with HS have a close relative with the condition.

There are diagnostic criteria used by specialists, including Hurley staging to assess severity (Stage I to III). While you don’t need to know these in detail, your specialist will use them to help plan treatment.

Yes. Several skin conditions can mimic HS, especially in the early stages. These include:

• Boils (furuncles)
• Folliculitis – infection or inflammation of hair follicles
• Cutaneous abscesses from bacteria like Staphylococcus aureus
• Pilonidal cysts – especially near the tailbone
• Crohn’s disease – can cause similar lesions in the groin/perianal area

This is why it’s important to be seen by a Specialist Healthcare Professional who can assess the full clinical picture. Getting the correct diagnosis means better, more targeted treatment.

There is no blood test or scan that can directly diagnose HS. The mainstay of diagnosis is a thorough clinical assessment—looking at your symptoms, lesion types, locations, and how long you’ve had them.

In some cases, your specialist may:

• Take swabs to check for bacterial infection
• Perform a biopsy if there’s uncertainty about the diagnosis
• Use ultrasound imaging (in specialist settings) to assess tunnel formation beneath the skin

These tests are not routinely required, but they may help in complex cases or when other conditions need to be ruled out.

No, there is no legal or medical obligation to tell your partner, as HS is not contagious and not sexually transmitted.

However, many people find that sharing their diagnosis:

• Improves understanding and emotional support
• Helps explain any discomfort, dressings, or scarring
• Reduces embarrassment or anxiety during intimacy

If HS is affecting your confidence or relationships, it can help to involve your partner in your care. If you're unsure about how or whether to tell them, consider discussing it with your Specialist or a support group—they can help you find the right words.

The long-term outlook for hidradenitis suppurativa (HS) varies from person to person. For some, HS remains mild, with occasional flare-ups that can be managed with lifestyle changes and medication. For others, it can become a chronic and progressive condition, with repeated painful lumps, scarring, and restricted movement.
HS can have a significant emotional and social impact, particularly when it affects mobility, body image, or intimate relationships.

While there is currently no cure, early diagnosis and effective treatment can:

• Slow disease progression
• Reduce flare-ups
• Prevent complications like tunnelling and scarring

Treatment may involve medication, surgery, and targeted lifestyle changes. With the right management and specialist support, many people can live well with HS, even if it remains a long-term condition.

You are not required to disclose your diagnosis to your partner, as Hidradenitis Suppurativa (HS) is neither sexually transmitted nor contagious. However, maintaining open communication can be beneficial for your partner in several ways:

• It helps them understand what you’re experiencing.
• It allows them to support you if HS impacts your intimacy, mobility, or daily life.
• It helps avoid misunderstandings regarding any visible lesions or dressings.

Ultimately, the decision to share your diagnosis is a personal one. If you feel uncertain about what to do, consider discussing it with a specialist or counselor who can assist you in determining the best course of action for you.

Hidradenitis Suppurativa (HS) does not prevent pregnancy but can affect symptom severity during and after. Some people experience improvement, while others may have flare-ups.

If HS is present in the groin or perineal area, vaginal delivery may be uncomfortable and could increase the risk of infection. In severe cases, a cesarean delivery may be recommended.

Certain medications for HS, like biologics and oral antibiotics, may not be safe during pregnancy or breastfeeding. If you plan to become pregnant or are pregnant, consult your specialist to review your treatment plan and manage symptoms safely.Hidradenitis Suppurativa (HS) does not prevent pregnancy but can affect symptom severity during and after. Some people experience improvement, while others may have flare-ups.

If HS is present in the groin or perineal area, vaginal delivery may be uncomfortable and could increase the risk of infection. In severe cases, a cesarean delivery may be recommended.

Certain medications for HS, like biologics and oral antibiotics, may not be safe during pregnancy or breastfeeding. If you plan to become pregnant or are pregnant, consult your specialist to review your treatment plan and manage symptoms safely.

Hidradenitis suppurativa (HS) is a chronic condition that can flare up repeatedly. Even if your symptoms improve, you are not immune to experiencing further flare-ups. Treatment can help manage symptoms and reduce the frequency and severity of these flare-ups, but most individuals with HS will go through ups and downs over time. Long-term management is essential, and your treatment plan may need adjustments as your condition evolves.

If you've experienced Hidradenitis Suppurativa (HS), it's essential to focus on reducing flare-ups and managing known risk factors. While you may not be able to prevent HS entirely, you can take steps to lessen its severity and frequency:

• Quit smoking: Smoking is strongly linked to the severity of HS.
• Maintain a healthy weight: Obesity increases skin friction and systemic inflammation, which can exacerbate HS.
• Wear loose-fitting clothing: This helps reduce rubbing and irritation in areas that are vulnerable to HS.
• Avoid shaving or skin trauma: This is especially important in areas prone to HS outbreaks.
• Use mild skincare products: Harsh soaps and scrubbing can worsen irritation, so it’s best to opt for gentle products.
• Manage stress: Stress may contribute to flare-ups, so finding ways to relax and de-stress can be beneficial.
• Review your diet: Some people report improvements by avoiding dairy, sugar, or nightshade vegetables (like tomatoes and peppers). While evidence is limited, it might be worth trying under professional guidance.

If you have a family history of HS or are noticing early signs of this condition, consulting a specialist is crucial. Early intervention can help prevent the progression of HS and improve long-term outcomes.

The exact cause of hidradenitis suppurativa (HS) isn't fully understood, but it's believed to result from a combination of genetic, hormonal, immune, and environmental factors. It’s important to know that HS is not caused by poor hygiene, and it is not contagious.
Here's what researchers and clinicians currently understand:
- Follicular blockage: HS begins when hair follicles become blocked, often in areas where skin rubs together, such as the armpits, groin, and buttocks.
- Immune system activation: The body responds with inflammation that leads to painful lumps, abscesses, and sinus tracts.
- Hormonal influence: HS usually starts after puberty and may flare with hormonal changes such as menstruation or pregnancy.
- Genetics: Up to one-third of people with HS have a family history, suggesting a genetic component.
- Lifestyle and metabolic factors:
o Smoking is strongly associated with HS and can worsen its severity.
o Obesity increases risk by promoting skin friction and systemic inflammation.
o Insulin resistance and metabolic syndrome, including conditions like PCOS (polycystic ovary syndrome), are increasingly linked to HS due to their hormonal and inflammatory effects.

If you're concerned about HS, it's best to speak with a Specialist Healthcare Professional. Early diagnosis and tailored treatment can improve long-term outcomes.

Several risk factors are associated with a higher chance of developing hidradenitis suppurativa (HS):

• Genetics – having a close family member with HS
• Smoking
• Being overweight or obese
• Female sex – HS is more common in women
• Hormonal conditions – such as polycystic ovary syndrome (PCOS)
• Insulin resistance or metabolic syndrome
• Chronic inflammatory diseases – like Crohn’s disease or ulcerative colitis

While these factors increase the risk, anyone can develop HS—even those without any clear risk factors

Certain factors can make HS more severe or lead to more frequent flare-ups:

• Smoking – one of the strongest aggravating factors
• Obesity – increases skin friction and systemic inflammation
• Hormonal fluctuations – including menstruation and pregnancy
• Family history of severe HS
• Insulin resistance and metabolic syndrome
• Stress – may trigger or worsen flares
• Mechanical irritation – from shaving or tight clothing
• Some medications – such as lithium or certain biologics
• Poorly controlled chronic conditions – like IBD or PCOS

Yes. Condoms protect against sexually transmitted infections (STIs), but hidradenitis suppurativa (HS) is not an STI. HS is a chronic skin condition caused by inflammation of blocked hair follicles and sweat glands—most often in the groin, buttocks, and armpits. It cannot be transmitted through sexual contact.

You cannot “catch” HS from someone else. It is not an infection and not contagious. HS is caused by internal factors—such as genetics, hormones, inflammation—not by physical contact with another person.

There’s no guaranteed way to prevent HS, but several measures may help reduce your risk or lower the chances of flare-ups if you’re predisposed:

• Stop smoking – quitting can significantly reduce flare-ups.
• Maintain a healthy weight – to reduce skin friction and inflammation.
• Avoid skin trauma – wear loose-fitting clothes and avoid harsh shaving.
• Manage insulin resistance – especially if you have PCOS or metabolic syndrome.
• Gentle skin care – use mild cleansers and avoid irritating soaps.
• Consider dietary adjustments – some people find reducing sugar or dairy helpful, although scientific evidence is still evolving.
• Reduce stress – which may play a role in flare frequency.

If you suspect early symptoms or have a family history of HS, seek advice from a healthcare professional. Early treatment may prevent progression.

Hidradenitis suppurativa (HS) is a long-term skin condition with recurring symptoms that often begin after puberty. Key features include:

• Painful lumps: Deep, tender swellings under the skin, usually in areas where skin rubs together (armpits, groin, buttocks, under the breasts).
• Blackheads: Small pitted spots or “double-ended” blackheads may be seen near the lumps.
• Boil-like bumps or abscesses: These may fill with pus and rupture, causing discharge and a foul smell.
• Tunnels (sinus tracts): In severe or long-standing cases, channels may form under the skin, linking multiple lumps. These can repeatedly drain.
• Scarring: The healing process may leave thick, rope-like scars or puckered skin.
• Recurrent flares: Symptoms tend to come and go in cycles and can worsen over time without treatment.
• HS symptoms vary widely. Some people may only develop a few isolated lumps, while others may experience extensive, painful areas over time.

HS often looks like painful lumps or swollen spots under the skin, sometimes mistaken for boils, cysts, or acne. These may become red, swollen, and eventually drain pus. Over time, repeated flare-ups can cause thick scars, skin changes, and tunnel-like tracts connecting the lesions.
The most commonly affected areas are the armpits, groin, inner thighs, buttocks, and under the breasts.
It’s important not to self-diagnose. A Specialist Healthcare Professional can assess and diagnose the condition accurately.

HS usually begins after puberty, most commonly between the ages of 18 and 29. In some cases, it can start later in adulthood. It is rare in children and not typically seen before puberty, which supports a suspected hormonal influence.

If left unmanaged, HS can lead to several medical and psychological complications:

• Chronic scarring and skin damage: Thick scars and puckering that may limit movement, especially near joints.
• Sinus tracts and abscesses: Deep, connected tunnels that can repeatedly get infected and drain.
• Recurrent bacterial infections: Open wounds are vulnerable to infection, sometimes requiring antibiotics.
• Lymphoedema: Inflammation or scarring in areas like the groin or armpits can impair lymph drainage, causing persistent swelling.
• Squamous cell carcinoma: Rarely, long-standing, severe HS lesions (especially in the perineal area) may develop into aggressive skin cancer.
• Anaemia: Chronic inflammation and slow-healing wounds can lead to iron-deficiency anaemia.
• Mental health burden: HS is linked to increased rates of depression, anxiety, social withdrawal, and reduced quality of life.
• Regular follow-up and treatment can significantly reduce the risk of these complications.