To diagnose hidradenitis suppurativa (HS), a doctor will look at the physical appearance and location of painful bumps under your skin.
Hidradenitis suppurativa (HS) is a chronic skin condition that causes painful bumps under the skin in areas where the skin rubs together. While a few skin conditions can appear similar to HS, it has certain characteristics that can help set it apart.
To diagnose HS, a doctor, often a dermatologist, will examine the location and appearance of your bumps and abscesses.
If one of the sores is leaking fluid, a doctor may swab it and take a sample to check for infection. However, this is not necessary to diagnose HS.
Read on to learn more about diagnosing HD and when to speak with a doctor.
To diagnose hidradenitis suppurativa, a doctor will request your health history and ask about the location of any breakouts. The placement of bumps on your body is typically an indicator of HS.
They will examine any bumps or abscesses you currently have. HS has some physical traits that set it apart from boils, acne, or other similar-looking conditions.
A doctor will look for several characteristics before making a diagnosis of HS. These may include:
- deep and tender nodules
- spots that appear similar to blackheads
- large and painful abscesses
- scars from previous HS breakouts
They will also look for a typical pattern of distribution and whether the breakouts are reoccurring.
If one of your bumps leaks fluid, a doctor may take a sample on a swab to test for infection. This is not a test for HS itself; there is currently
If you think you may have hidradenitis suppurativa, you should see a dermatologist. A dermatologist is a type of doctor that can treat and diagnose conditions that affect your skin, hair, and nails.
They will also be able to identify whether it is HS or a skin condition that appears similar.
A few skin conditions can appear similar to HS, this includes:
Infection
HS often begins with 1 or 2 nodules or bumps under the skin, which can resemble a skin infection.
Infection can produce the same type of swollen, tender bump or pus-filled abscess. The difference is that bacteria cause infections, while an overreaction of the body’s immune system causes HS when keratin and sweat build up inside a hair follicle, trapping bacteria.
Acne
Acne and HS can bear a close resemblance. Both begin when hair follicles become blocked by oil, keratin, dead skin cells, and bacteria. However, HS occurs in any place with sweat glands, while acne can occur anywhere on the body.
Unlike in most cases of acne, HS creates ropy tunnels under the skin between nodules called sinus tracts. These channels connect lesions and can scar over time,
Ingrown hair
Ingrown hairs occur when a hair curves and grows back into the skin, causing inflammation and a bump. For people with curly hair, this may be a particular problem in the beard and neck area, where they can occur in clusters.
Although they both appear as bumps on the skin, ingrown hairs differ from HS because hair pierces the skin from the outside and creates inflammation. Keratin, sweat, and bacteria blocking the hair follicle from underneath the skin can cause HS.
Folliculitis
Folliculitis is inflammation of the hair follicle. It commonly happens in follicles when they’re damaged, allowing bacteria to get inside. Less common causes include blockage or irritation of the follicle. Damage occurs due to:
- frequently rubbing or touching the skin
- wearing tight clothing
- rubbing skin on skin
- shaving
The bumps folliculitis causes may resemble HS but tend to be smaller and commonly resolve on their own, especially when triggers are avoided.
HS may begin to scar and can limit mobility, so early diagnosis and treatment are important.
A dermatologist is a specialist trained to recognize skin conditions. A primary care doctor may refer you to a dermatologist for specialized care.
You should speak with a doctor if your breakouts are:
- painful
- infected (look for pus or draining, swelling, pain, or a discolored streak)
- blistering
- spreading
If you think you have HS, you may have some questions. Here are answers to a few commonly asked questions.
Can a blood test detect hidradenitis suppurativa?
A blood test
How is hidradenitis suppurativa treated?
A doctor will work with you to set up a treatment plan to help reduce inflammation and irritation. This may include:
- skin care like washes with benzoyl peroxide and gentle antiperspirants
- oral or topical medications like hormonal or anti-inflammatory medications
- injectable medications like biologics or corticosteroids
- in-office procedures that help drain abscesses and remove lesions or tunnels beneath the skin
- wound care (HS can create very slow-healing sores)
- laser hair removal
- treatment for depression or anxiety
Hidradenitis suppurativa is a chronic skin condition that causes painful, boil-like bumps to develop when hair follicles become blocked. It usually occurs in areas with many sweat glands and where skin rubs together.
A doctor can typically diagnose HS based on an oral history of the outbreaks and a visual inspection of the outbreak areas.
HS treatment includes a variety of methods, including skin care, medications, and surgical procedures. A doctor can discuss a treatment plan after a complete evaluation.