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Your Healthcare Team: Doctors Who Diagnose and Treat Hidradenitis Suppurativa

By Editorial Team · November 9, 2020

Seeing a couple of bumps on your skin is typically not cause for alarm. However, if bumps recur, worsen, or occur in locations such as your armpits, groin, buttocks, and other places on your body, you may have hidradenitis suppurativa (HS). Understanding HS can help you find the right doctor so you can get a diagnosis and treatment faster.

What is HS?

HS is a painful, chronic inflammatory skin disease. The disease begins when clogged hair follicles cause bumps. The process leads:1

  • Abscesses
  • Pus
  • Odor
  • Inflammation
  • Tunnels under the skin
  • Scars

The most common locations are:2

  • Armpit
  • Groin
  • Buttocks
  • Under the breasts
  • In the anal and genital areas

Early treatment is important

Getting an accurate diagnosis and starting treatment quickly can:3-5

  • Prevent disease from getting worse
  • Avoid pain and emotional distress
  • Reduce the number of days lost through sickness
  • Decrease healthcare expenses

Delays in diagnosis of HS

Almost 75 percent of people with HS have reported that it took more than 2 years to get a diagnosis. The average delay in getting a diagnosis is 7 years from when symptoms first occurred.5

People with a family history of HS are more likely to delay seeing a doctor. Researchers think that the families might see the disease as a “condition of life.”5

Who do you see for HS?

The first doctor you see may be your primary care physician. Because of the location of lesions, flares, or sores, women often see a gynecologist first. People with HS also may seek care from:6,7

  • General surgeons
  • Plastic surgeons
  • Immunologists
  • Infection control specialists

Because HS is not very common, the doctors may not recognize it right away. No test identifies the disease.6,7

Your best bet for a correct diagnosis is a dermatologist who is experienced in treating HS. A dermatologist, a doctor specializing in the skin, can diagnose HS by its typical appearance, locations, and recurrence.2

Managing pain

People with HS often consider pain as one of the worst effects of the disease. Acute pain comes from inflamed lesions. It may send patients to the emergency room for relief. Chronic pain is an ongoing aching and throbbing. Both types of pain can interfere with sleep and activities of daily life.4

Drugs prescribed by your dermatologist can help relieve moderate pain. For severe pain, your dermatologist can create a treatment plan with a pain management specialist.4

What about your mental health?

More than half of people with HS say the disease has a very large negative effect on how they live. Their quality of life is more impaired than in psoriasis, acne, stroke, or even heart transplant candidates.8

Nearly half of people with HS say they currently have depression or have experienced depression in the past. A study found that people with HS had more than twice the risk of suicide than people without HS.4

To deal with the mental health aspects of the condition, HS experts recommend a care team that includes mental health professionals, such as psychologists or psychiatrists.4

Written by: Ina Fried | Last reviewed: December 2020
  1. Seyed Jafari SM, Hunger RE, Schlapbach C. Hidradenitis suppurativa: current understanding of pathogenic mechanisms and suggestion for treatment algorithm. Front Med (Lausanne). 2020 Mar 4;7:68. doi:10.3389/fmed.2020.00068.
  2. Margesson LJ, Danby FW. Hidradenitis suppurativa. Best Pract Res Clin Obstet Gynaecol. 2014 Oct;28:1013–1027. https://doi.org/10.1016/j.bpobgyn.2014.07.012.
  3. Napolitano M, Megna M, Timoshchuk EA, et al. Hidradenitis suppurativa: from pathogenesis to diagnosis and treatment. Clin Cosmet Investig Dermatol. 2017;10:105‐115. doi:10.2147/CCID.S111019.eCollection 2017.
  4. Patel ZS, Hoffman LK, Buse DC, et al. Pain, psychological comorbidities, disability, and impaired quality of life in hidradenitis suppurativa. Curr Pain Headache Rep. 2017;21(12):49.
  5. Saunte DM, Boer J, Stratigos A, et al. Diagnostic delay in hidradenitis suppurativa is a global problem. Br J Dermatol. 2015 Dec;173:1546-1549. doi:10.1111/bjd.14038.
  6. Kiss N, Plázár D, Lőrincz K, et al. Gynecological aspects of hidradenitis suppurativa. Orv Hetil. 2019 Feb;160(8):291-299. doi:10.1556/650.2019.31319.
  7. Menderes A, Sunay O, Vayvada H, Yilmaz M. Surgical management of hidradenitis suppurativa. 2010 July 19;7(4):240-247.
  8. Tzellos T, Zouboulis CC. Review of comorbidities of hidradenitis suppurativa: implications for daily clinical practice. Dermatol Ther (Heidelb). 2020;10(1):63‐71.

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