Hidradenitis suppurativa (HS) is more likely to affect your underarms or groin area, but there are confirmed cases of HS on the neck. HS anywhere on your body may also contribute to joint pain that can affect your neck.

Hidradenitis suppurativa (HS) is an inflammatory skin condition. HS is known for causing chronic flare-ups of red, inflamed nodules that may also be tender and painful. These eventually form pus and may drain before forming scars.

HS is most common in the armpit and groin areas of the body. But this condition can affect other areas, such as your neck.

While a dermatologist can help you determine whether you have HS on your neck, here are some important things to know before your appointment.

HS develops in the apocrine glands, which are sweat glands located within your hair follicles.

Apocrine glands and associated HS are mostly in the underarms, groin, inner thighs, and underneath the breasts. The most common signs of HS include acne-like pimples, sores, or cysts that develop in the armpits, thighs, or groin.

But HS can occur anywhere on your body, including your neck. While not as common, there’s clinical confirmation of HS developing on the neck.

Still, HS is much more common in areas where skin rubs against skin, such as your armpits. A dermatologist can determine whether you’re experiencing HS or another skin condition, such as cystic acne or folliculitis.

HS is known for causing lesions that can become quite painful. This is true regardless of where these lumps occur.

If you develop HS on your neck, you may notice lesions that are painful and tender to the touch. The pain may affect the surrounding area and deep beneath the skin under any lesions. Any widespread neck pain is more likely if you have multiple HS lesions in the area.

People with HS are also more likely to experience inflammation elsewhere, including the joints. A 2020 study notes that HS can increase your risk of certain types of arthritis. These can cause neck pain, particularly affecting the first and second vertebrae of your cervical spine.

The goals of HS treatment are to:

  • reduce inflammation that can lead to flare-ups
  • alleviate pain and discomfort
  • help prevent future flares

This can involve a combination of skin care techniques and medications.

For HS on your neck, a dermatologist may recommend a gentle, non-irritating cleanser. You may also use an antimicrobial wash to help with flare-ups. Benzoyl peroxide cleansers or spot treatments may also help treat flares.

Treatment for HS can also involve medications that can help reduce pain and inflammation while also decreasing the number of nodules. Options may include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs): These include over-the-counter options, such as ibuprofen (Advil, Aleve), and stronger prescription versions, such as celecoxib (Celebrex), and may help reduce inflammation and treat pain.
  • Biologics: One example is adalimumab (Humira), which may reduce moderate to severe HS nodules and abscesses by half within 3 months, according to the American Osteopathic College of Dermatology.
  • Oral retinoids: Prescription medications, such as isotretinoin (Absorica and Claravis), may help reduce inflammation associated with moderate cases of HS.
  • Oral or topical antibiotics: A doctor may prescribe these as initial treatments to help clear nodules or if HS nodules become infected.
  • Birth control pills: Some people assigned female at birth with HS may also treat the condition with estrogen-containing oral contraceptives.

Severe HS may require an in-person doctor’s visit. Procedures a healthcare professional may perform include:

  • Corticosteroid injections: When applied directly into an HS lesion, these injections may reduce pain and inflammation. But you can only use them in cases where there’s no skin infection.
  • Drainage: As the name suggests, this procedure involves draining a painful HS lesion to reduce its size.
  • Surgery: This is also a treatment option for severe and recurring nodules. But keep in mind that surgery also carries a risk of scarring.

Care tips for managing HS

Aside from medical treatments, you might also consider lifestyle changes. While the following do not cause HS, these tips may help you manage this condition, regardless of where you’re experiencing a flare-up:

  • Avoid shaving your neck, chin, or any other area where you’re experiencing flares.
  • Avoid picking at any nodules or abscesses, as this may increase the risk of scarring.
  • Stay in a cool space whenever possible to prevent overheating.
  • Maintain a moderate weight.
  • Manage stress as best as you can.
  • If you smoke, consider quitting.
  • Try to avoid foods that can cause inflammation.
  • Avoid tight clothing in affected areas.
  • Wear underwear made with absorbable material like cotton.

You can also help treat painful neck lumps by applying warm compresses or brewed tea bags to the affected area.

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Is hidradenitis suppurativa permanent?

While there’s currently no cure for HS, medications can help reduce the number and severity of associated nodules. Without treatment, HS may continue to flare. You may also experience periods of flare-ups and remission over several years.

Do HS flares always occur in the same area?

HS flares are most common in the underarm and groin areas. People with breasts may also develop this condition under the breast area. While flares can recur, it’s also possible for new lumps to occur in different parts of the body.

How large do HS lumps get?

HS lumps may vary in size. Some appear like small pimples, while others look like large cysts or boils. They typically range in size from 0.5 to 2 cm (0.2 to 0.8 inches).

When left untreated, HS lesions can scar and thicken, with severe cases becoming so large that they might interfere with mobility. This is more common in areas where skin rubs against itself, such as the armpit or inner-thigh areas.

HS is not as common in the neck area as it is in other areas of the body, such as your underarms, thighs, and groin. But you can develop these painful lesions in other areas of the body.

If you have HS, you may also be more likely to develop certain types of arthritis. These can cause neck pain, even if you do not have HS lumps on your neck.

If you’re experiencing possible symptoms of HS on the neck, it’s also important to see a dermatologist for a proper diagnosis. They can also rule out other possible causes of lesions and bumps on your neck, such as cystic acne, boils, or skin cancer.