Hidradenitis suppurative occurs in areas with hair follicles where skin rubs together, so the armpits are frequently affected.

Hidradenitis suppurative (HS) is a chronic condition that causes painful bumps to develop under the skin. It occurs in areas with hair follicles and sweat glands where skin rubs together.

HS is also called acne inversa, even though it is not acne. It does not result from improper hygiene and cannot pass between people.

Keep reading to learn more about the symptoms, causes, and treatments for hidradenitis suppurativa in your armpits.

A breakout of HS often starts with a pea-size bump that ruptures and leaks pus. You may see boil-like lumps form near that first bump, spreading into the surrounding area. These bumps may also rupture, oozing pus and blood.

As the condition progresses, small bumps like blackheads may form in pairs or clusters.

Narrow passages between the bumps, called sinus tracts, can develop under the skin. They may open on the surface of the skin and ooze pus.

HS commonly scars the skin.

Hidradenitis suppurativa in the armpit is a painful condition that causes boil-like bumps to form and rupture. Scarring may develop, and the lesions are likely to reoccur.

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Hidradenitis suppurativa in an armpit. Seen here are multiple abscesses. Photo by DermNet New Zealand.

Armpits are likely to have HS because they have hair follicles. When follicles get clogged, sweat and keratin build up in them. Blocked hair follicles trap bacteria, become inflamed, and swell. This causes the painful lumps of HS.

Scientists believe that genetics, hormones, and environmental factors all play a part in whether you develop HS. They are also studying whether it is an autoimmune disease.

Some people are more likely to develop HS than others. You have a higher risk if you:

There is no cure for HS, but remedies and medical treatment can help manage pain and reduce the severity of breakouts.

Hidradenitis suppurativa armpit home remedies and over-the-counter treatment

Before or in addition to other treatments, there are several home remedies you can try. The American Academy of Dermatology Association (AAD) recommends:

  • placing a black tea or warm cloth compress over the breakout area
  • avoiding sweating
  • using a deodorant or antiperspirant without:
    • alcohol
    • baking soda
    • parabens
    • dyes
    • fragrance
  • wearing loose-fitting clothing
  • not scrubbing the skin, which causes inflammation
  • not waxing the armpits

Medical treatment

A doctor might prescribe a topical medication or an oral medication that you swallow, according to the AAD.

A few options that a dermatologist might prescribe for you to apply directly to the areas of HS are:

A dermatologist could prescribe one or more oral medications to treat HS systemically. These may include:

A doctor may recommend corticosteroid injections into HS lesions to reduce inflammation, or laser hair removal to prevent lesions from forming. In addition, treatment with Botox can help reduce sweating, which may lessen the chance of infection.

Hidradenitis suppurativa armpit surgery

Dermatologists can perform four types of surgery on hidradenitis suppurativa in the armpits:

  • Incision and drainage: In incision and drainage, a healthcare professional opens a lump and drains the pus. Most lesions will return, however.
  • Deroofing: The doctor removes the top layer of skin covering a lesion or sinus tract. The wound is left open to heal, which reduces the chance that the lesion will return.
  • Wide excision: With a wide excision, the doctor removes a lesion or sinus tract running beneath the skin. The wound is usually large and is left open to heal on its own, which reduces the chance that a lesion will return.
  • Laser surgery: An intense laser can vaporize HS. The doctor may require treatment with medication before surgery to bring your HS under control. Following laser surgery, it can take as long as 6 months for the skin to heal.

Knowing when to contact a doctor for a bump, breakout, or rash can be difficult. The AAD recommends that you contact a doctor when a rash:

  • is painful
  • is infected
  • has open sores
  • spreads rapidly
  • begins to blister

You should also see a doctor if you have a fever with along with a rash or breakout.

Here are the answers to some commonly asked questions about hidradenitis suppurativa in your armpits.

Does hidradenitis suppurativa in the armpit smell?

Hidradenitis suppurativa may have an unpleasant odor when the inflamed lumps break open and ooze pus. The smell is from the pus, which is made up of bacteria and broken-down cells.

Can you shave your armpits if you have hidradenitis suppurativa?

You can shave with HS, but it requires extra care. For example, nicks or abrasions could create a new HS lesion or start an infection.

The AAD recommends using antibacterial soap and a gel-to-foam shaving gel.

Can hidradenitis suppurativa in your armpits be cured?

There is no cure for HS in the armpits. A doctor can create a plan to reduce pain and lessen outbreaks.

HS in the armpits occurs when hair follicles become blocked, trapping keratin, sweat, and bacteria. This causes painful lumps to form. These lumps rupture, oozing pus and sometimes blood.

Small, pitted areas of skin with blackheads may form. Tunnels called sinus tracts can form under the skin between the lesions, which can also rupture and leak pus.

HS occurs in areas of the body with skin folds, so the armpits are particularly likely to be affected. It’s a painful condition that causes scarring.

Scientists aren’t sure why some people develop HS, but they believe genetics, hormones, and environmental factors play a role. Treatments include skin care, medications, and sometimes surgery.