Hidradenitis suppurativa (HS) can sometimes affect the vulva region. Since it may be linked to anogenital cancer, prompt diagnosis and treatment are recommended.

HS is a chronic and inflammatory skin condition characterized by inflamed lesions and tunneling under the skin. It affects hair follicles where sweat glands exist, such as the armpits, under the breasts, or the anal region.

It also commonly affects the groin area, including the vulva, which consists of the outer labia (labia majora), the inner labia (labia minora), and the clitoris.

Here’s what to know to treat the condition and prevent further complications.

Though experts do not know the exact cause of hidradenitis suppurativa (HS), they believe family history, an overactive immune system, and inflammation in the body are contributing factors.

In a small 2021 study, about 11% of 230 females with HS reported experiencing outbreaks in the vulvar region. But unlike some other types of the condition, vulvar HS has been associated with issues like miscarriages during pregnancy and cancer.

Since it usually develops in the hair follicles where sweat glands are prevalent, experts think it occurs when these follicles clog with sweat, bacteria, keratin, or other debris. When these lesions fill with pus and rupture, it can worsen the inflammatory response and cause issues like boils and tunnels.

It also tends to manifest where skin rubs together, creating friction.

About one-third of people with HS have another family member with the condition, suggesting a genetic link.

HS is also three times more common in females than males, which could signal a hormonal connection. Puberty, menstruation, and taking hormones (including oral contraceptives) all seem to affect symptoms.

Common HS triggers include smoking tobacco and obesity.

However, 2021 research suggests that vulvar HS, in particular, is associated with patients with a lower BMI. Those with vulvar HS are also more likely to report a later onset of HS. While HS typically onsets in the early 20s, vulvar HS may occur much later in life.

HS, whether vulvar or otherwise, is not contagious. Although vulvar HS may be mistaken as a sexually transmitted infection (STI), it cannot be transmitted to others.

Despite another common myth, poor hygiene does not cause HS.

HS on the vulva looks the same as it does on the armpits and other commonly affected areas of the body.

Flares on the vulva may present as:

  • clusters of reddish or purplish pustules typically less than 1 cm in diameter
  • pustules that leak pus or blood
  • red, darkened, discolored, or inflamed skin surrounding lesions
  • outbreaks where skin rubs together (i.e., vulva, thighs, buttocks, and anus)
  • scarring where previous outbreaks occurred

When to see a doctor

If you think you have HS, it’s always a good idea to schedule an appointment with a medical professional for a prompt diagnosis and treatment. Supportive treatments can greatly improve your symptoms and daily quality of life.

Since HS is also commonly mistaken for STIs like herpes or genital warts, a prompt diagnosis is necessary to help avoid transmitting an STI to someone else.

Although HS is not contagious, if you have it, 2018 research suggests that you’re more likely to have another condition that affects the hair follicles, such as acne or herpes. Though experts do not know for certain, having HS may mean that you are more vulnerable to contracting an STI.

Even though there’s currently no cure for HS, there are ways to effectively manage it, including:

  • cleansing the impacted areas with an antibacterial wash like Hibiclens
  • applying a topical or oral antibiotic to treat any underlying infection
  • taking prescription or OTC pain medication
  • undergoing steroid injections to reduce inflammation
  • taking a biologic to target an overactive immune response
  • sometimes, surgical removal or deroofing of lesions

Quitting or reducing smoking if you smoke and maintaining a healthy weight are also linked to a reduction in HS symptoms.

What happens if hidradenitis suppurativa goes untreated?

Without treatment, HS can become more severe, leading to infections, pain, scarring, and a serious impact on your day-to-day quality of life.

Research from 2019 has also linked groin HS to anogenital cancer. While this doesn’t necessarily mean that HS causes cancer, scientists hypothesize that chronic inflammation from HS could contribute to cancer-causing mutations.

While this research is not conclusive, treating HS and its underlying inflammation as soon as possible may help prevent more serious health complications.

There’s also some very limited research from 2020 to suggest that vulvar HS may increase the risk of miscarriage during pregnancy. For that reason, talking with a healthcare professional and developing a treatment plan for managing HS before becoming pregnant is recommended.

Though there’s currently no cure for HS, treating the condition as soon as possible is recommended to help improve symptoms and live well. Since vulvar HS has been linked to miscarriage and cancer, prompt management can be especially important.

Treatments may include antibacterial cleansers, antibiotics, biologics, or surgery. Quitting smoking if you smoke and maintaining a moderate weight can also help improve symptoms.