In some cases, secondary infections, rare complications, and painful, severe symptoms may warrant an emergency visit.

Painful bumps, cysts, abscesses, and tunnels of infection under the skin (sinus tracts) are features of hidradenitis suppurativa (HS), a chronic inflammatory skin condition also known as acne inversa.

While HS isn’t usually life threatening, it can occasionally be the cause of hospital visits. Severe symptoms, pain, and secondary complications may all require urgent medical attention.

Here’s what to know.

You can visit your hospital’s urgent care or emergency room for any medical concern, including skin conditions like HS.

There are plenty of circumstances that warrant a visit to the hospital for HS. Just because HS isn’t considered life threatening doesn’t mean you have to wait to see a doctor. If you feel you need immediate care, it’s always acceptable to go to the hospital.

HS symptoms can be extremely painful. It’s also possible to experience secondary infections or rare complications like squamous cell carcinoma. Timely treatment of symptoms can also reduce pain levels and limit tissue damage and scarring.

However, if you can wait to visit your primary doctor or dermatologist, that may be preferable. When you go to an urgent care center or emergency room for non-urgent conditions, you may be prolonging the wait for someone who does need immediate medical attention. And it can take a long time to be seen by a doctor.

Symptoms of HS (and their severity) can vary from person to person. But generally speaking, visiting the hospital for HS may be a good idea if you:

  • are unable to visit your regular dermatologist or doctor within a reasonable time frame
  • have a severe flare despite following your treatment plan
  • experience intense pain
  • notice symptoms are rapidly worsening or spreading
  • develop deep or large abscesses
  • notice significant pus drainage
  • are concerned there may be a secondary infection
  • notice unusual skin changes to areas affected by HS, such as discoloration, non-healing sores, or irregular skin growth

According to a review from 2022, approximately half of people diagnosed with HS notice systemic symptoms like fever, chills, or nausea, right before a flare-up.

While these symptoms may be part of your typical HS experience and aren’t always a reason to visit the hospital, they can also be indicators of potentially serious complications, like secondary infection.

If you’re heading to the hospital for HS, bring important documents with you, like your identification, health insurance card, and a printed medical history. Having these items on hand can expedite the check-in process.

Your wait time will depend on how many people checked in before you and whether or not anyone needs immediate medical attention. While emergency rooms and urgent care centers are generally first-come, first-served, they do prioritize people in critical condition.

It’s not uncommon to have to wait several hours to be seen if the hospital is busy.

Once you’re seen by a doctor, they’ll assess your skin condition, pain level, and any other symptoms you’re experiencing. Let your doctor know about your HS diagnosis. HS can resemble a number of other skin conditions, especially soft tissue infection, and not all emergency care doctors are as familiar with HS as your dermatologist.

Treatment for HS in the hospital depends on your pain level and the severity of any abscesses, draining, or sinus tracts.

According to a cross-sectional study from 2020 on HS-related hospital visits:

  • 58.3% of people were prescribed opioid pain medications
  • 66.6% of people were prescribed antibiotics
  • 28.9% of people underwent excision and drainage

Less severe cases without significant drainage may be managed with topical numbing agents, injections, and oral nonsteroidal anti-inflammatory (NSAID) medications.

If you need to have abscesses drained, how long you remain in the hospital can vary. Smaller nodules can be incised (opened) using a biopsy tool, while larger or recurrent lesions may require wider incisions.

Plan on adding a few hours to your visit if you need to have a procedure done.

In the hospital, your emergency doctor’s goal is to manage your pain and make HS tolerable. They’ll refer you to a dermatologist for chronic issues that could involve major surgeries and significant tissue removal or skin grafts.

Being proactive about managing HS is the best way to avoid a trip to the hospital. Working closely with a dermatologist can help reduce the frequency and severity of HS flares, which may also lessen how often you visit the hospital.

Tips for managing HS include:

  • following your treatment plan consistently and taking medications exactly as directed
  • washing your skin with an antimicrobial wash
  • avoiding scrubbing or rubbing your skin
  • skipping out on hair removal (waxing and shaving) when possible (however, shaving is preferred to waxing)
  • considering laser hair removal to reduce your hair follicles, sebaceous gland activity, and bacteria on your skin
  • treating painful nodules at home with warm compresses
  • avoiding sweating and overheating
  • wearing loose-fitting clothing
  • switching to a mild deodorant without dyes, fragrances, baking soda, or parabens
  • managing overweight and obesity
  • quitting smoking

But even if you take all the right steps to stay on top of HS, you may still need to seek urgent medical care from time to time.

The 2020 cross-sectional study found more than 40% of people visiting the hospital for HS reported 10/10 pain, which typically requires prescription-strength medications to manage. If you can’t get in touch with your regular doctor when severe pain strikes, the emergency room or urgent care center may be your best option.

HS is a chronic skin condition that can be extremely painful and distressing enough to send you to the hospital.

In an urgent care setting, doctors will work to manage your pain and any emerging symptoms contributing to your discomfort. For chronic management, you’ll be referred to a dermatologist who can provide more advanced surgical care for sinus tracts and scarring.