Hidradenitis Suppurativa: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 2, 2026.
What kind of doctor treats Hidradenitis Suppurativa?
A dermatologist usually treats hidradenitis suppurativa. Many patients start with a primary care doctor, who can confirm the diagnosis and begin basic treatment. If the condition is moderate to severe or needs surgery, they will refer the patient to a dermatologist.
What it is
Hidradenitis suppurativa, often called HS, is a long-term skin condition that causes painful lumps where skin rubs together, such as the armpits, groin, and under the breasts. The lumps can break open, drain fluid, and heal slowly. Poor hygiene does not cause HS, and it is not contagious.
Symptoms
The most common sign is a tender bump under the skin that may look like a deep pimple or a boil. Bumps can fill with pus, and some burst and drain blood or fluid. Repeated flare-ups can leave tunnels under the skin called sinus tracts, along with scars.
Causes and who gets it
Doctors believe HS starts when hair follicles become blocked, causing swelling and breakage. Hormones, family history, and the immune system all seem to be involved. Smoking and extra body weight are linked to worse symptoms. It usually begins after puberty, and women are diagnosed more often.
How doctors diagnose it
There is no single test for HS. A doctor usually looks at the skin and asks about the history of the lumps. Because HS has a typical look and location, most cases are diagnosed during a skin exam, though swabs or blood tests may rule out other problems.
Treatment
Treatment depends on severity. Mild cases may improve with warm compresses, gentle skin care, and prescription washes. Doctors often prescribe antibiotics, and hormone treatments, steroid injections, and immune-system pills are options for some people. Severe cases may need surgery. Treatment usually reduces flares and pain, but many people need more than one type over time.
When to see a doctor
Anyone who gets repeated painful lumps in the armpits, groin, or other skin folds should see a doctor. Early treatment can help control flares before scars and tunnels form. Seek care sooner if a sore drains for a long time, causes fever, or makes daily activities hard.
How a direct primary care or concierge doctor fits in
A direct primary care doctor is paid through a flat monthly fee instead of insurance billing, while a concierge doctor usually charges more and often works alongside a patient's insurance. These doctors can prescribe medicines, check flares during longer visits, and coordinate care with a dermatologist when needed. Severe cases are referred to a skin specialist.
Common questions
Is hidradenitis suppurativa the same as acne?
No. It is sometimes called acne inversa, but it is a separate condition. HS forms deeper under the skin and shows up in skin folds, not on the face like typical acne.
Can HS go away on its own?
It usually does not go away without treatment. Most people have flare-ups over many years, though the severity varies a lot from person to person. Treatment often makes flares less frequent and less painful.
Is HS caused by being unclean?
No. HS is not caused by poor hygiene and it is not contagious. It happens because of blocked hair follicles, inflammation, and other factors inside the body.
Can lifestyle changes help?
Some people have fewer flares when they stop smoking or manage their weight. These steps do not replace medical treatment, but they may make symptoms easier to live with.
Sources
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
