Can Hidradenitis Suppurativa Kill You? Risks, Causes & Treatment

You know, there’s a question that lingers for a lot of people when they first hear the diagnosis: Can hidradenitis suppurativa kill you? And honestly? It’s a fair thing to wonder. When you’re dealing with something that causes deep, painful nodules, wounds that won’t heal, and months — sometimes years — of flare-ups… You start thinking in bigger terms. Not just “how do I fix this?” but “what is this doing to my body long-term?”

So let’s start simple. Hidradenitis suppurativa (HS) is a chronic skin condition. Technically, it’s considered a disorder of the sweat glands and inflammation of hair follicles, mostly in areas like your underarms, groin, buttocks, or breasts. But putting it that clinically feels… hollow. Because if you’re living with it, you know it’s more than some dermatology blurb. It hurts. It lingers. It can change how you move, how you dress, and how you even talk to people.

This article will break that down — not just the risks, but why they happen, how you can lower them, and how people are treating HS today in real-life, real-body ways. You’ll find insights on causes, stages, treatments, and even mental health, because — let’s be real — chronic illnesses like this don’t just affect your skin.

1. What Is Hidradenitis Suppurativa?

So, what is hidradenitis suppurativa? The name sounds clinical — and it is — but at its core, HS (also called acne inversa) is a chronic skin condition marked by deep inflammation under the skin. Painful lumps, draining tunnels (sinus tracts), and thick, rope-like scars tend to form in sensitive areas and often come back.

It’s more than skin-deep — classified as an inflammatory disease, HS involves immune system responses and possibly your microbiome. The exact cause isn’t clear, but a mix of genetics, hormones, and factors like obesity, smoking, and environment likely play a role.

2. Who Gets Hidradenitis Suppurativa?

Statistically? It tends to show up after puberty, often between the ages of 18 and 40, and it’s more common in women. There’s also some data pointing to higher prevalence in Black and Hispanic populations, though underdiagnosis and diagnostic delay make this tricky to pin down.

Risk factors include:

• A family history of HS (genetics does seem to matter)
  
• Metabolic syndrome (which is linked to things like type 2 diabetes, liver dysfunction, and non-alcoholic fatty liver disease)
  
• Autoimmune or inflammatory diseases like inflammatory bowel disease
  
• Smoking (huge one)
  
• Obesity or rapid weight gain
  

And while it’s not officially contagious or caused by poor hygiene (let’s clear that up right away), it still carries social stigma. Probably because the symptoms look… raw. Angry. And the smell from persistent drainage during HS flares doesn’t help. It’s one of those conditions that impacts quality of life in deeply personal, often invisible ways.

3. Where Does Hidradenitis Suppurativa Usually Happen?

Here’s a table to make this a bit easier:

Commonly Affected Areas	Why These Areas?
Underarms	Lots of apocrine sweat glands
Groin and inner thighs	Friction, moisture, and hair follicles
Buttocks	Sitting pressure, sweat glands
Under breasts	Heat, weight, and skin folds
Around the anus	Friction + moisture combo

Some people only get mild outbreaks in one or two spots. Others, especially in more severe cases, see it spread to multiple areas, sometimes with interconnected lesions and fibrotic tissue that never quite heals.

1. Wait — Is HS the Same as Acne?

Good question. They’re related but not the same. HS isn’t typical acne — it’s not caused by clogged pores or excess sebum. That’s why standard acne treatments don’t usually work. Instead, HS involves deep skin inflammation.

plus those sinus tracts and chronic abscesses. So while it’s sometimes called acne inversa, that label is misleading — HS behaves more like a chronic inflammatory disease than a teenage skin issue.

2. How Is It Diagnosed?

In clinical practice, HS is often diagnosed by:

• Visual examination of lesions
  
• Medical history and pattern of flares
  
• Rule-outs for infections or other skin diseases
  

There’s no blood test or definitive scan — which leads to lots of misdiagnoses, especially early on. Some people go years before they hear the actual name for what they’re dealing with.

4. Can Hidradenitis Suppurativa Kill You? Understanding the Mortality Risk

Okay, so let’s just go ahead and tackle it. Can hidradenitis suppurativa kill you? Like, literally — is this a condition that could cost you your life?

It’s not the easiest question to ask. Or answer. But it matters.

HS is rarely fatal on its own. The skin condition itself — the abscesses, sinus tracts, the scarring — doesn’t directly cause death. However… and this is where nuance comes in… the secondary complications and chronic inflammation associated with HS can raise your mortality risk over time.

There has been data — limited, but growing, suggesting that people with long-term, untreated HS may have higher chances of developing other health issues. Particularly those tied to systemic inflammation, like:

• Cardiovascular disease (including myocardial infarction or heart attack)
  
• Cerebrovascular accidents (aka strokes)
  
• Severe infections (think: bacterial infections turning into sepsis)
  
• Metabolic syndrome
  
• Liver dysfunction, including non-alcoholic fatty liver disease
  
• And — very rarely — a type of skin cancer known as squamous cell carcinoma
  

So, technically? Yes — there’s a path, albeit a long and unusual one, where untreated HS could eventually lead to something life-threatening. But it’s often a complex web of indirect causes.

Let’s Break That Down

Type of Risk	Connection to HS	Fatal Potential
Infection	Open wounds + sinus tracts can get infected, especially in deep tissue	Yes, if it leads to sepsis or other life-threatening infections
Cancer	Chronic inflammation over decades can rarely lead to squamous cell carcinoma	Yes, but very rare
Heart Disease	Chronic systemic inflammation = higher risk of cardiovascular death	Indirect but real risk
Liver Disease	Associated with metabolic issues and inflammation	Potentially fatal in late stages
Suicidal Ideation	Tied to chronic pain, social isolation, and mental health decline	Non-physical but critical mortality factor

Now — and this really matters — these complications don’t affect everyone with HS. In fact, many people manage the condition for life without ever facing these extreme outcomes. But the risk increases when severe HS goes untreated, especially in Stage III cases with persistent drainage, thick scarring, and chronic abscesses.

5. So… How Often Does HS Actually Lead to Death?

Honestly? There’s no giant pile of statistics to point to. HS is underreported, and it’s usually not listed as a direct cause of death even when it contributes.

But studies like those from Olmsted County and large-scale reviews in clinical practice suggest that HS does correlate with higher overall mortality rates, particularly in individuals with comorbidities like diabetes, obesity, or autoimmune conditions.

So again, the answer isn’t a hard yes or no. It’s more like: “Probably not… but maybe, if it’s complicated and ignored for too long.”

And that “maybe” is enough to make proactive care worth it.

6. Complications That May Increase Health Risks

Alright, let’s get into the gritty stuff. You might wonder, “If HS itself doesn’t usually kill you, what exactly makes it dangerous?”

The truth is — the danger lives in the complications. Some are physical, some emotional, and others… well, a mix of both. Let’s talk about the ones that matter most.

1. Infections & Sepsis: When Wounds Go From Painful to Perilous

You probably already know this if you’ve had an HS flare that didn’t heal right — these aren’t ordinary skin bumps. They can go deep. And if bacteria get trapped in those sinus tracts, it can spiral fast into a bacterial infection or worse, cellulitis or sepsis.

🔸 Pro Tip: If a wound becomes hot, swollen, red, and you feel feverish or dizzy, don’t wait. Seek medical attention right away. That’s your body screaming that something’s off.

2. Squamous Cell Carcinoma: A Rare But Real Threat

This one’s scary, but rare enough that you don’t need to panic. Still — it’s worth knowing: long-standing, severe HS, especially in the anogenital area, can in rare cases lead to squamous cell carcinoma — a type of skin cancer.

Why? Chronic inflammation over decades can alter how cells divide and repair. Think of it like the body getting so used to being inflamed, it forgets how to respond correctly.

Some cases documented in medical literature have shown fatal outcomes from cancer that was originally rooted in HS lesions.

It’s not common. But it’s not impossible.

3. Fistulas and Tunneling: More Than Skin Deep

HS doesn’t always stay on the surface. In Stage II and III, it can form tunnels under the skin, connecting abscesses through pathways called fistulas. These aren’t just painful — they can also:

• Worsen infections
  
• Trap bacteria
  
• Damage deeper tissue
  
• Require surgical interventions
  

Sometimes they grow so dense that they form fibrotic tissue, which makes healing even harder. It’s like your body is trying to patch things with scar material, but ends up creating a thick maze of pain.

4. Reduced Mobility and Diminished Quality of Life

If you’ve ever had HS under your arms or between your thighs, you know how something as basic as walking can become an ordeal. Over time, scarring to life areas — places where your skin needs to bend, stretch, move — can dramatically reduce your quality of life.

Some patients report:

• Avoiding social situations due to odor or drainage
  
• Missing work during flares
  
• Sexual avoidance or shame
  
• Ongoing chronic pain from scarred areas
  

And all of that? It adds up — slowly eroding the everyday sense of normalcy.

✅ Quick Recap: Common HS Complications Worth Watching

Complication	Risk Level	What to Watch For
Infection/Sepsis	High	Fever, red-hot skin, swelling
Squamous Cell Carcinoma	Rare but severe	Non-healing wounds, growing ulcers
Fistulas/Tunneling	Moderate to high	Painful lumps under the skin, interconnected abscesses
Mobility Issues	Common	Pain during walking or arm movement
Mental Health Decline	High	Isolation, depression, loss of interest in life

7. Mental Health and Emotional Toll of HS

So, we’ve talked about the body — the infections, the scarring, the silent risks. But what about your mind?

It’s almost too easy to overlook how much hidradenitis suppurativa affects your mental health — because most of it doesn’t show up on a scan. There’s no MRI that captures what it feels like to isolate yourself from friends because you’re afraid of leaking or odor. No lab test can detect the dread that builds before a date, a work presentation, or even just a beach day.

But the pain is real. And for many? It’s heavier than the physical part.

In fact, studies — and real people — keep pointing to the same thing: people living with HS are far more likely to experience:

• Depression
  
• Anxiety disorders
  
• Body image struggles
  
• Suicidal ideation
  

1. Why Is HS So Hard Emotionally?

Let’s be honest — the symptoms can be brutal. Chronic abscesses, persistent drainage, thick scarring, and constant discomfort don’t exactly set the stage for components of health.

But beyond that, there’s this ongoing feeling of loss: of normalcy, of spontaneity, of physical comfort. And for many, especially in more severe cases, HS flares disrupt daily life. That uncertainty? It takes a toll.

2. A Personal Note (Fictional but Familiar)

One patient once described it like this:
“It’s like waking up every day and having to negotiate with your own body — where can I go, what can I wear, who can I talk to… based on whether or not I’m leaking through my clothes.”

That level of exhaustion — decision fatigue, shame, anticipation of judgment — isn’t something you bounce back from with just a painkiller.

3. Link Between Pain and Suicidal Thoughts

Unfortunately, chronic pain and suicidal ideation often go hand in hand. HS brings both — the physical sting of flares and the psychological weight of living around them.

A study found that people with hidradenitis suppurativa were twice as likely to have a diagnosed psychiatric disorder, and three times more likely to report suicidal thoughts compared to the general population. These aren’t just numbers — they’re quiet battles playing out every day in real lives.

Pro Tip: 👉 If you ever find yourself thinking it’s too much — please, talk to someone. Your pain is valid. And there’s more help out there than most people realize. Therapy, support groups, antidepressants, mindfulness, peer chats — you don’t have to handle this alone.

4. How to Manage Mental Health With HS?

There’s no perfect blueprint, but here’s a layered approach that might help:

Mental Health Strategy	How It Helps	Access Point
Cognitive Behavioral Therapy (CBT)	Reframes negative thoughts around body image and pain	Psychologist or online therapy apps
Pain Psychologists	Specializing in chronic pain + mental health interaction	Often via pain clinics
Support Groups (Online/In-Person)	Reduces isolation, normalizes your experience	Reddit, Facebook, HS-specific platforms
Mindfulness/Meditation	Helps manage anxiety spikes during flares	Free apps like Insight Timer, Calm
Psychiatric Medications	Treats depression or anxiety at the chemical level	Through primary care or psychiatry

8. What Causes HS and Who Is at Risk?

Alright — deep breath. Let’s step back and ask: Where does this even come from? Why does hidradenitis suppurativa happen to some people and not others?

Well… it’s complicated. There’s no one-size-fits-all trigger, but we know a mix of genetics, inflammatory pathways, hormones, and lifestyle choices all seem to play a role.

So while it’s frustrating (understatement of the year) to not have a single root cause, let’s break down what researchers do know.

🔸 1. Genetic Predisposition

About 30–40% of people with HS have a family history of it. That’s a big clue. Some research suggests a link to mutations affecting inflammatory cells or skin structure, but it’s still being mapped out.

🔸 2. Hormonal Imbalances

HS often flares during:

• Puberty
  
• Menstrual cycles
  
• Pregnancy
  
• Menopause
  

This points to a hormonal component — possibly tied to androgens or how hair follicles react to hormonal shifts.

🔸 3. Obesity and Weight Management

Adipose tissue (fat) produces pro-inflammatory signals, which may worsen HS. More skin folds also = more friction and sweating, increasing the chance of follicle inflammation and chronic abscesses. Weight management isn’t a cure — but it can help with symptom control.

🔸 4. Smoking

Probably the strongest behavioral link. Smokers are significantly more likely to develop HS, and flares tend to be more severe. The exact reason’s still debated, but may involve nicotine’s impact on sweat glands and immune system regulation.

🔸 5. Environmental and Lifestyle Factors

Things like tight clothing, poor air quality, stress, and even gut health (hello, microbiome-based therapeutics) may influence flares. It’s a surprisingly whole-body disease.

Pro Tip: 👉 If you’re noticing small, recurring lumps or under-skin “pimples” that don’t behave like acne — especially in friction zones — talk to a dermatologist early. Early intervention can prevent years of scarring.

9. How Hidradenitis Suppurativa Progresses Over Time

Doctors like to organize things. And fair enough — when you’re dealing with a complex condition like HS, it helps to have some kind of roadmap. That’s where the Hurley staging system comes in. It splits hidradenitis suppurativa into three main stages, based on how severe it gets and how much of your body it affects.

But here’s the truth: most people don’t feel like they “fit” into just one stage all the time. Some parts of your body might be at Stage I, while others — especially areas with repeated flares — may have escalated to Stage III. It’s not always linear, and it’s definitely not one-size-fits-all.

Still, it’s a useful way to understand the progression of HS and why early treatment matters.

The Hurley Stages of Hidradenitis Suppurativa

Stage	Symptoms	What It Feels Like	Treatment Urgency
Stage I	Single or multiple painful bumps; no tunnels (sinus tracts) or scarring yet	It comes and goes. You hope it’s just acne.	Low to moderate, but early care helps
Stage II	Recurrent lumps, abscesses, tunneling, some fibrotic tissue	Things start to connect under the skin. Pain lingers longer.	Moderate — time to seek consistent care
Stage III	Widespread lesions, persistent drainage, extensive scarring, sinus tracts	Movement hurts. Clothes hurt. Socializing feels impossible.	High — may require surgical interventions

10. When Does HS Become Dangerous?

It’s usually in Stage III, where the skin’s been through repeated flares, where chronic inflammation has had years to dig in. That’s when we start seeing:

• Severe infections
  
• Thickened, rope-like scars
  
• Immobility in affected areas
  
• And rarely — squamous cell carcinoma
  

Also? That’s when many people hit their emotional breaking point. Physical damage is one thing. The constant negotiating with your body and your life is another. That’s why comprehensive treatment plans — involving dermatologists, mental health support, even nutritionists — are vital at this stage.

Pro Tip: 👉 If you’re bouncing between flare-ups and never seem to fully heal, that’s a sign you might be transitioning to Stage II or III. Don’t wait. Early interventions can prevent scarring, and sometimes that’s the line between chronic pain and manageable symptoms.

Can You Stop HS From Progressing?

Sometimes, yes. While HS isn’t “curable” in the traditional sense, a lot of patients slow or halt its progression with a combination of:

• Biologics (like Humira)
  
• Weight management
  
• Laser hair reduction in affected zones
  
• Anti-inflammatory treatments (including antibiotics, corticosteroid injections)
  
• Careful tracking of HS flares and triggers
  

And honestly? Just being taken seriously by your doctor early on can make a huge difference.

11. Treatment Options to Prevent Complications

So let’s get practical. When you’re dealing with something that’s painful, recurring, emotionally exhausting, and potentially life-altering, the biggest question becomes: What helps?

Thankfully, hidradenitis suppurativa treatments have evolved. And while no single solution works for everyone (wish it did), there’s a growing list of approaches to help you find relief — and avoid severe complications down the line.

Let’s break them into tiers.

1. Common Treatments for Hidradenitis Suppurativa

Treatment Type	Examples	When It’s Used
Topical Medications	Clindamycin, resorcinol	Mild HS, early flares
Oral Antibiotics	Doxycycline, rifampin + clindamycin combo	Moderate HS, bacterial infections
Hormonal Therapy	Anti-androgens (spironolactone), oral contraceptives	Female patients with hormonal flares
Biologics	Adalimumab (Humira), infliximab	Moderate-to-severe HS with systemic inflammation
Surgical Options	Incision & drainage, wide excision, laser therapy	Refractory or Stage III HS
Emerging Therapies	Botulinum toxin injections, microbiome-based therapeutics	For targeted or resistant cases

2. Which Treatments Work Best?

Honestly, it depends. But here’s what some dermatologists and real patients say:

• Biologics have been game changers for many, especially in slowing down new HS flares
  
• Laser hair reduction (especially diode laser) reduces follicular inflammation in common HS zones
  
• Surgical interventions, while intimidating, often offer long-term relief when medications fail
  
• Combining meds with lifestyle modifications (like a healthy diet, stress reduction, smoking cessation) improves outcomes significantly

3. How Long Until You See Results?

Fair question — and a frustrating one. Because with HS, progress often feels slow.

• Antibiotics may help flares within a few weeks
  
• Biologics can take 2–3 months to show consistent improvement
  
• Surgical recovery depends on depth and location — could be weeks to months
  

The key is ongoing management. HS isn’t a “try one thing” situation. It’s about building a comprehensive treatment plan that adapts over time. And sticking with it, even when it’s tedious.

Pro Tip: 👉 Keep a flare journal. Track symptoms, food, stress levels, and cycle timing. It sounds basic, but it gives your care team data to fine-tune your plan. Plus, it helps you feel a little more in control.

12. Managing Daily Life With Hidradenitis Suppurativa

Let’s get something out of the way: Lifestyle modifications won’t “fix” HS. This isn’t one of those “just eat kale and meditate” situations. But they can reduce flare-ups, make symptoms more manageable, and help you feel a little more in control of your body again.

Because when you’re living with something that doesn’t always respond predictably to meds or surgery, even the small stuff — what you eat, what you wear, how you move — starts to matter.

And honestly? Lifestyle changes are often the missing layer in a lot of comprehensive treatment plans.

1. Skincare Habits That Actually Help

You might already feel like your skin is under attack, so the last thing you want is irritation from your routine. Here’s a gentler approach:

Tip	Why It Helps
Use antibacterial washes like chlorhexidine or benzoyl peroxide	Keeps sweat glands and hair follicles clean
Avoid scrubbing or using loofahs on active lesions	Reduces irritation and the risk of spreading bacteria
Stick to loose, breathable fabrics	Reduces friction and sweat buildup in vulnerable areas
Shave with care (or consider laser)	Shaving can trigger inflammation of hair follicles — laser hair reduction is often safer for HS

2. Food, Triggers, and the Whole “Healthy Diet” Thing

Here’s where it gets frustrating: there’s no one HS diet that works for everyone. But a lot of patients — and emerging research — suggest that diet recipes plays a role in symptom control, especially in reducing inflammatory pathways.

Common triggers people report:

• Dairy
  
• High glycemic foods (white bread, sugar, soda)
  
• Brewer’s yeast (found in beer, bread, and soy sauce)
  
• Red meat or processed meats
  

Now, that doesn’t mean you have to go full vegan keto tomorrow. Just… observe. Try an elimination diet for a few weeks. Keep a journal. Your skin will tell you what it loves and hates, eventually.

3. Movement, Exercise, and Body Confidence

When you’re dealing with chronic abscesses and thickened, rope-like scars, exercise can feel like a cruel joke. But movement helps reduce inflammation, manage metabolic syndrome, and even improve mental health.

Try low-friction options like:

• Swimming
  
• Stationary cycling
  
• Walking with moisture-wicking gear
  
• Yoga (just maybe skip hot yoga if sweat is a major trigger)
  

Also, if you avoid the gym because of HS symptoms, you’re not alone. Many people with HS experience social isolation due to the fear of odor or visible lesions. But comfort can come from routine and clothing choices that help you feel more covered and secure.

4. Support Matters More Than You Think

There are entire online communities built around HS support — Reddit threads, Facebook groups, private forums. You’ll find tips, venting, and just people who get it. Sometimes you don’t need advice. Just validation.

Pro Tip: 👉 Try moisture-absorbing powders (like zinc oxide blends) for friction areas. Especially between thighs or under the breasts. It’s not a cure, but it can seriously reduce flare triggers.

13. Warning Signs That Require Urgent Attention

Here’s the thing no one likes to think about — but should: sometimes, hidradenitis suppurativa flares aren’t just inconvenient. They’re actually dangerous.

And that’s where the original question — Can hidradenitis suppurativa kill you? — circles back in again. Not directly, not often. But life-threatening infections, uncontrolled bleeding, or signs of systemic inflammation can put you in real danger if ignored.

So let’s break it down clearly.

1. Emergency Symptoms of HS

If you’re living with HS, you already know the day-to-day discomfort. But these signs go beyond the usual:

Symptom	Why It’s Dangerous
Rapid swelling and spreading redness	May indicate cellulitis or deep skin infection
Fever, chills, or confusion	Could mean sepsis, a medical emergency
Severe, uncontrolled pain	Could signal an abscess has ruptured internally
Bleeding that won’t stop	Especially in surgical or high-pressure areas
Sudden fatigue or shortness of breath	Rare, but may indicate a systemic infection or cardiovascular issue

2. Flare-Up vs. Emergency: How to Tell

Situation	Likely a Flare	Time to Go to ER
Painful lump that returns every month	✅	❌
Drainage, but no fever or swelling	✅	❌
Abscess that doubles in size overnight, red-hot to touch	❌	✅
General fatigue during your period	✅	❌
Fever + chills + draining wound	❌	✅

Sometimes, especially if you’re used to pain, it’s easy to ignore these signs. But infections tied to HS have, in rare cases, led to hospitalization and even death if left untreated.

This is where HS edges into truly serious territory. And it’s why you should never feel guilty about “overreacting” — because when it comes to signs of life-threatening infections, there’s no such thing.

3. Urgent Care vs. Emergency Room?

If you’re unsure where to go, here’s a quick guide:

Symptom	Go to Urgent Care	Go to ER
Mild flare-up with drainage	✅	❌
High fever + swelling	❌	✅
Wound won’t close after a week	✅	❌
Sudden spreading rash or dizziness	❌	✅

Pro Tip: 👉 If you’ve been prescribed antibiotics before and you notice they suddenly stop working during a flare, that’s a red flag. You may be dealing with a resistant infection. Don’t wait — call your provider or head to urgent care.

14. Strategies for Reducing Long-Term Risks

Untreated HS doesn’t just stop at the skin. It can sneak below the surface — literally and figuratively — into places you wouldn’t expect. That’s why, even if the condition isn’t directly fatal, the potential consequences of letting it spiral are serious.

Things like:

• Chronic pain that interferes with work, relationships, and daily living
  
• Thickened, rope-like scars and fibrotic tissue that limit mobility
  
• Sinus tracts that become tunnels of ongoing infection
  
• Delayed diagnosis leading to non-alcoholic fatty liver diseases, peripheral vascular disease, or even squamous cell carcinoma (a rare type of skin cancer linked to HS in some severe cases)
  

1. Why Early Diagnosis Changes Everything?

Many people with HS wait years — sometimes a decade or more — before getting properly diagnosed. It’s often misread as acne, boils, or just recurring skin infections. That diagnostic delay? It’s dangerous.

The sooner it’s recognized, the sooner a comprehensive treatment plan can begin. That includes:

• Keeping inflammatory cells in check
  
• Preventing tunneling and scarring
  
• Avoiding dangerous infections
  
• Monitoring for any signs of skin cancer in long-term wounds
  

2. Regular Screenings & Checkups Matter

Living with HS often means juggling more than one health issue. Studies have shown links between hidradenitis suppurativa and:

• Liver dysfunction
  
• Inflammatory bowel disease
  
• Metabolic syndrome
  
• Increased risk of myocardial infarction (heart attack) or cerebrovascular accident (stroke)
  

So don’t just treat the skin. Keep up with:

• Dermatology visits (every 3–6 months for moderate/severe HS)
  
• Blood panels to watch for inflammation, liver issues, and cholesterol
  
• Screenings for squamous cell carcinoma, especially in long-term, non-healing wounds
  

3. Here’s What a Long-Term HS Management Plan Might Include:

Element	Why It Matters
Weight management	Reduces friction, sweat, and systemic inflammation
Healthy diet	Helps modulate inflammation and metabolic risk
Psychiatric support	Prevents isolation, anxiety, and psychiatric disorders linked to chronic illness
Dermatologic therapy	Controls flares, prevents sinus tracts
Surgical interventions (if needed)	Can eliminate chronic problem areas and reduce persistent drainage
Microbiome-based therapeutics (emerging)	Targets bacterial imbalance in the skin environment

It’s not just about symptom relief. It’s about slowing progression and preserving your quality of life — even as your body changes.

Pro Tip: 👉 If you’ve had the same inflamed area for over a year with little healing, ask your doctor for a biopsy. Chronic lesions in HS can (rarely) transform into squamous cell carcinoma, a type of skin cancer. Early detection could save your life.

Final Thoughts

What is hidradenitis suppurativa? The name sounds clinical — and it is — but at its core, HS (also called acne inversa) is a chronic skin condition marked by deep inflammation under the skin. Painful lumps, draining tunnels (sinus tracts), and thick, rope-like scars tend to form in sensitive areas and often come back. It’s more than skin-deep — classified as an inflammatory disease, HS involves immune system responses and possibly your microbiome. 

The exact cause isn’t clear, but a mix of genetics, hormones, and factors like obesity, smoking, and environment likely play a role. While it’s not contagious or caused by poor hygiene, its impact on daily life can be profound. Early diagnosis and proper treatment can help manage symptoms and reduce flare-ups.

Frequently Asked Questions