What is hidradenitis suppurative?

Hidradenitis suppuritiva is a chronic inflammatory condition affecting areas of skin that bear apocrine grands ie. axillae (armpits), groins and under the breasts.


Boil-like nodules and abscesses appear. They discharge pus and form sinuses, eventually leading to scarring 

What are the risk factors for HS?

A family history of HS (40% of patients have a family history)


Insulin resistance

Cigarette smoking

Follicular occlusion syndrome (acne, dissecting cellulitis, pilonidal sinus)

Inflammatory bowel disease eg Crohn's disease

Drugs: lithium

What is the cause of HS?

There is infllammation of the hair follicle wall, destroying sebaceous and apocrine glands and their ducts.

What are the clinical features of HS?

Comedones (blackheads)

Painful papules and nodules (red bumps)



Draining sinuses

Hypertophic (thickened) and atopic (thin) scars

Classification of HS by severity

Stage I: Solitary or several isolated abscesses. No sinus tracts or scarring

Stage II: Recurrent abscesses, single or multiple, widely spaced with sinus tract formation

Stage iii:  Diffuse involvement, recurrent abscesses

This page is under construction.

Photos to arrive soon

Treatment details to follow


Further reading: https://dermnetnz.org/topics/hidradenitis-suppurativa/
South African support group: