Hidradenitis suppurativa (HS) is an inflammatory skin disorder in which a mix of keratin, sweat, and bacteria builds up in the hair follicles. This creates bumps under the skin. As they get inflamed and expand, abscesses can form. Sometimes these abscesses burst or form tunnels under the skin.

HS is often misdiagnosed. It has a similar appearance to acne or boils, especially in the early stages. It can take time to get a proper diagnosis.

Continue reading to learn more about HS symptoms, treatment, complications, and more.

People with HS are more likely to experience other inflammatory conditions. Inflammation in the joints can cause pain and mobility challenges.

A 2020 cohort study showed that there were higher rates of three types of arthritis in people with HS. The three types identified are:

  • ankylosing spondylosis (AS)
  • rheumatoid arthritis (RA)
  • psoriatic arthritis (PsA)

Spondyloarthritis is a group of inflammatory conditions affecting the spine and larger joints. AS is the most common type of spondyloarthritis.

One study showed higher rates of spondyloarthritis in people with HS. In many cases, symptoms of both conditions started within a short time period. This made the authors wonder whether HS and spondyloarthritis may even be part of the same condition.

If you live with HS, it’s important to watch for changes in your health. If you notice pain, swelling, and joint stiffness, talk to your doctor. Early detection is always best.

There’s a higher risk for inflammatory arthritis when you have HS. There’s also a greater chance of having other conditions, including:

  • Metabolic syndrome. Metabolic syndrome is a cluster of factors that increase the risk of heart disease. This includes high blood pressure, high triglycerides, low HDL, and high blood sugar. One study showed that 50.6 percent of people with HS had metabolic syndrome, compared to 30.2 percent of the control group.
  • Polycystic ovarian syndrome (PCOS). This condition occurs when there is an increase in androgen hormone production. It causes ovarian cysts and irregular periods. A large analysis showed that 9 percent of people with HS have PCOS. In the group without HS, 2.9 percent had PCOS.
  • Crohn’s disease. Crohn’s disease is a form of inflammatory bowel disease (IBD). It can affect any area of the digestive tract. A large Danish study showed 0.8 percent of people with HS had Crohn’s disease. In the study, Crohn’s disease affected 0.3 percent of the general population.
  • Lymphoma. Lymphoma is a type of cancer that targets immune system cells. A 2019 cohort showed that people with HS have up to 4 times the risk of developing lymphoma than people without the condition.
  • Mental health. A 2018 review showed that people with HS are more likely to have anxiety and depression. If you’re experiencing changes in your mood, talk with your doctor. There are effective ways to feel better.

Treatments to manage HS will help to reduce pain. Therapy for HS is often based on healing any lesions and reducing inflammation. Some of these treatments will also be helpful for joint pain if inflammation is the source of the pain.

  • Antibiotics. Oral or topical antibiotics can be used if there’s an infection.
  • Oral retinoid medications. These medications are often used for acne. For some people, they can be helpful to manage HS, too.
  • Corticosteroids. These medications reduce the immune response and lower inflammation in the body.
  • Anti-inflammatories. These oral medications reduce pain by lowering inflammation in the body.
  • Tumor necrosis factor alpha inhibitors (TNF-alpha inhibitors). With HS, too much inflammatory protein called TNF- alpha is created. This is the same protein released in some other inflammatory conditions. TNF-alpha inhibitors block the action of those proteins. This lowers the immune response and reduces pain from inflammation.
  • Carbon dioxide laser therapy. This surgical intervention may be used in more severe cases. Lasers target and remove sections of skin that are damaged by HS.
  • Laser hair removal. This treatment may be used in milder cases of HS. The lasers damage the hair follicle. This can reduce inflammation in the area and may help to prevent or slow the recurrence of HS.

Yes, HS is an inflammatory disease. Inflammation happens as part of an immune response. When the immune system is triggered, blood flow increases to the target area. An army of white blood cells and other proteins are sent out.

This response is perfect if you cut your finger. It also works to target invaders such as bacteria or viruses. Problems happen when the immune system response doesn’t turn off, and the continued inflammation causes damage and pain.

Hidradenitis suppurativa (HS) is an inflammatory skin condition. There are many different inflammatory diseases. It’s recognized that many share similar traits and may be related.

Having HS increases the chance of developing another inflammatory condition. Several types of arthritis are more common in people with HS. Other inflammatory conditions include metabolic syndrome and Crohn’s disease.

If you notice any changes in your health, talk with your healthcare team. Early detection is important.