Learn what hidradenitis suppurativa is, how it is diagnosed, common symptoms, causes, stages, and treatment options.
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Medical Review: General Surgery / Proctology Team | Published: May 1, 2026 | Last Updated: May 1, 2026
Important Medical Notice: This article is for educational purposes only and does not replace a medical examination. If you have rapidly growing painful lumps, fever or spreading redness, seek medical care promptly.
Quick Answer
Hidradenitis suppurativa, also known as acne inversa, is a chronic inflammatory skin disease that usually affects areas where skin rubs together, such as the armpits, groin, buttocks, under the breasts, and around the anus. It may cause pain, drainage and scarring. HS is not contagious and is not caused by poor hygiene. Diagnosis is usually clinical and is based on typical lesion type, typical body areas, and recurrence. Treatment depends on severity and may include lifestyle changes, topical or oral medications, antibiotics, biologic treatments, laser-based approaches, drainage procedures, and surgery in selected cases.
️ Medical Disclaimer: This content is intended for patient education. Diagnosis and treatment must be planned by a qualified physician after examination.
Table of Contents
Hidradenitis suppurativa, often shortened as HS, is a chronic inflammatory skin disease.HS, is a chronic inflammatory disease of the hair follicles. It is also called acne inversa. The condition usually appears in areas with friction, sweating, and hair follicles — such as the armpits, groin and buttocks.
HS is not a simple pimple, ordinary boil, or hygiene problem. It can begin as a painful, deep-seated nodule. Because the early lesions can resemble boils or ingrown hairs, the diagnosis is often delayed.
The ICD-10-CM code for hidradenitis suppurativa is L73.2.L73.2. This classification reflects HS as a recognized chronic skin condition rather than a temporary superficial infection.
️ Clinical Note: A recurring “boil” in the same area should not be ignored, especially if it drains and refills repeatedly. Repetition is one of the key clues that separates HS from an ordinary skin infection.
If you are looking for a treatment-focused overview, see our main service page: Hidradenitis Suppurativa: Laser Treatment and New Methods.
The symptoms of hidradenitis suppurativa vary according to disease severity. Early HS may cause small painful nodules. More advanced disease may include abscesses, draining sinus tracts, and scarring.
Area | Typical Complaint | Why It Matters |
|---|---|---|
Armpits | Painful lumps, movement-related pain | Friction, shaving, and sweating can worsen irritation. |
Groin | Drainage, odor, pain | Tight clothing and moisture may increase flare-ups. |
Buttocks / perianal area | Abscess, drainage, pain when sitting | May be confused with pilonidal disease or anal fistula. |
Under breasts | Tender swelling, moisture, friction | Can be confused with irritation or fungal rash. |
HS is not caused by poor hygiene and it is not contagious. Current understanding suggests that HS begins around the hair follicles. The disease usually develops through a combination of genetic, immune, hormonal, metabolic, and environmental factors.
For a deeper look at causes and risk factors, see: Is Hidradenitis Suppurativa Genetic? Causes and Risk Factors.
Hidradenitis suppurativa is usually diagnosed clinically. This means that diagnosis is made by a physician based on the appearance, location, recurrence pattern, and history of the lesions. There is no single blood test that confirms HS in every patient.
In some cases, the doctor may request imaging, culture tests, or additional evaluation to distinguish HS from pilonidal disease, anal fistula, infected cysts, Crohn-related perianal disease, or other skin conditions.
HS severity is commonly described using the Hurley staging system. Hurley staging system. Staging helps physicians plan treatment and estimate the need for medications, laser-based approaches, biologic therapy, or surgery.
Stage | Clinical Picture | General Treatment Direction |
|---|---|---|
Hurley Stage I | Nodules or abscesses without obvious tunnels or widespread scars. | Lifestyle care, topical treatment, early medical follow-up. |
Hurley Stage II | Recurrent abscesses, tunnels, and scarring in separated areas. | Oral medications, antibiotics, laser, local procedures, combined treatment. |
Hurley Stage III | Widespread interconnected tunnels, chronic drainage, and extensive scarring. | Biologic therapy, surgery, wound care, multidisciplinary management. |
HS treatment should be individualized. The best plan depends on disease stage, affected areas, pain level, and impact on daily life. Modern guidelines describe HS management as multimodal, meaning that different treatments may be combined over time.
For antibiotic-focused information, see our article on antibiotics for HS. The Best Antibiotics for Hidradenitis Suppurativa. For lifestyle and diet, see Could Diet Affect Hidradenitis Suppurativa?.
Laser and surgical treatments are considered according to HS stage and lesion type. Laser hair removal may reduce follicular triggers in selected patients. Surgery is usually individualized and should not be seen as a one-size-fits-all solution. Surgical literature emphasizes that HS surgery is often part of a broader treatment plan rather than a stand-alone cure.
For surgery-specific guidance, see: Surgical Treatment for Hidradenitis Suppurativa: When and How Is It Performed?.
Incorrect self-treatment may worsen HS, increase irritation, or delay proper care. This is especially important when lesions are draining or infected.
Emergency Warning: Fever, chills, rapidly spreading redness, severe pain or feeling systemically unwell require urgent care.
You should see a doctor if painful lumps keep returning in the same areas.
Early diagnosis can reduce delays, prevent unnecessary home experiments, and help build a long-term treatment plan.
If you have recurrent painful lumps in the armpits, groin, or buttocks, seek specialist evaluation.
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