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Hidradenitis Suppurativa Myths And Misconceptions

By Editorial Team · September 10, 2020

Misconceptions about hidradenitis suppurativa (HS) start with its name. The name comes from Greek (hidros, sweat; aden, gland; -itis, inflammation) and Latin (suppurare, to form or discharge pus).1-3

A French doctor named the disease in 1854. He thought inflammation of the sweat glands caused pus and scarring. Doctors now say that HS comes from problems with hair follicles, which are near sweat glands.1

What is HS?

HS is a painful, chronic inflammatory skin disease. The disease begins when clogged hair follicles cause bumps. The process leads to:4

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

The most common locations are:5

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

HS is not as widespread or well-known as some other skin diseases. As a result, myths and misconceptions are common.

Myth 1: Using deodorants causes it

The use of various deodorants has been a theory for the cause of HS. However, studies have not shown that the use of deodorants and antiperspirants to be a major factor in the development of HS.6

While deodorant does not cause HS, it can aggravate the tender skin of people with HS. It is important to choose a deodorant that is non-irritating and will not worsen the inflammation of HS sores in and around the armpits. Deodorant use can also help control sweat and heat in the armpits, which can lead to friction that can cause or worsen HS sores. Talk to your doctor about what deodorant might be right for you.7

Myth 2: It is related to poor hygiene

The odor and appearance of HS most likely led to the idea that poor hygiene causes the disease.

Researchers are not sure how or why HS develops in the body. They believe that genetic, anatomical, immunological, and environmental factors are involved.4

Doctors reassure people with HS that poor hygiene is not a cause.5,8

Myth 3: It is contagious

Bacteria often invade HS bumps and tunnels connecting the bumps under the skin, which can worsen the disease. However, researchers generally agree that infection is not the primary cause of HS.4,5

No evidence has been found that HS is transmitted from one person to another. Doctors do not consider it contagious.5

Myth 4: It is an STD

The first doctors that many people with HS usually see are not dermatologists (skin specialists). HS is not very common, and these doctors may not be familiar with its appearance. They may misdiagnose a lesion for evidence of a sexually transmitted disease (STD). HS cannot be sexually transmitted since it is not contagious.9

Myth 5: It is challenging to build close relationships

The pain, odor, pus, and appearance of HS often cause social and mental health problems. Effects often include:10,11

  • Embarrassment
  • Social isolation
  • Sexual distress
  • Depression
  • Anxiety

Studies show that people with HS have the same comfort level with body contact that people without HS do. Researchers had assumed that people with HS would not want to be touched by others, though studies have proven this wrong. Studies also show that people with HS have many close relationships, with many often bringing their partner, family members, or close friends with them to medical checkups.10

Written by: Ina Fried | Last reviewed: December 2020
  1. Menderes A, Sunay O, Vayvada H, Yilmaz M. Surgical management of hidradenitis suppurativa. Int J Med Sci. 2010;7(4):240–247. Published online 2010 Jul 19. doi:10.7150/ijms.7.240.Accessed 7/2/2020.
  2. Harper D. -itis. Online Etymology Dictionary. Available at https://www.etymonline.com/word/-itis. Accessed 7/2/2020.
  3. Harper D. Suppuration. Online Etymology Dictionary. Available at https://www.etymonline.com/word/suppuration. Accessed 7/2/2020.
  4. 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.
  5. 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. Accessed 6/20/2020.
  6. Alikhan A, Sayed C, Alavi A, et al. North American clinical management guidelines for hidradenitis suppurativa: a publication from the United States and Canadian Hidradenitis Suppurativa Foundations: Part I: Diagnosis, evaluation, and the use of complementary and procedural management. J Am Acad Dermatol. 2019;81(1):76‐90.
  7. No BS about HS. AbbVie. Available at https://www.nobsabouths.com/hs-patient-stories/hidradenitis-suppurativa-tips. Accessed 9/7/2020.
  8. Slade DEM, Powell BW, Mortimer PS. Hidradenitis suppurativa: pathogenesis and management. British Association of Plastic Surgeons. 2003;56:451-461. doi:https://doi.org/10.1016/S0007-1226(03)00177-2. Accessed 7/16/2020.
  9. Nesbitt E, Clements S, Driscoll M. A concise clinician’s guide to therapy for hidradenitis suppurativa. Int J Womens Dermatol. 2020 Mar;6(2):80-84. Epub 2019 Dec 27. doi:10.1016/j.ijwd.2019.11.004. Accessed 7/16/2020.
  10. Schneider-Burrus S, Jost A, Peters EMJ, et al. Association of hidradenitis suppurativa with body image. JAMA Dermatol. 2018 Apr;154:447-451. Epub 2018 Feb 21. doi:10.1001/jamadermatol.2017.6058. Accessed 6/19/2020.
  11. Machado MO, Stergiopoulos V, Maes M, et al. Depression and anxiety in adults with hidradenitis suppurativa: a systematic review and meta-analysis. JAMA Dermatol. 2019 Jun 5. https://doi.org/10.1001/jamadermatol.2019.0759. Accessed 6/19/2020.

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