By Hope Mitchell, MD, FAAD
The Truth Contributor
Have painful bumps that keep coming back in the same area – like your armpits, groin, buttocks, or under your breasts? These bumps may swell, drain, heal and then return again and again. Many people think they’re dealing with acne or boils, but for some, these recurring flare-ups are actually a condition called Hidradenitis Suppurativa (HS).
You know how frustrating these bumps can be and I know new treatment options are now available for this condition – advocate for yourself the next time you see your doctor.
HS is a chronic auto inflammatory condition (the immune system overreacts) that begins deep in the hair follicles as blockages that trigger inflammation leading to painful bumps, tunnels or sinus tracts under the skin. It is NOT contagious or due to poor hygiene but can lead to pigmentation, scarring and even skin cancer in chronic HS lesions, especially in men.
Black people carry a disproportionate burden of HS.
While we don’t know the exact cause of HS, genetics, hormones, smoking and weight can play a role. Although anyone can develop HS regardless of race or gender, it is more common in women, U.S. studies show that Black women are three times more likely to develop HS than white women.
Psychosocial burden including depression, anxiety, social isolation and stigma are compounded in communities where HS is misunderstood. Wearing certain clothes, exercising comfortably, or even intimacy can be challenging.
Social Determinants of Health Drive HS Disparities in the Black Community. Here’s why:
Delayed Diagnosis and Underrecognition – the disease often appears earlier (but is underrecognized, misdiagnosed as boils or dolliculitis, or diagnosed later), is more severe and more likely to cause scarring in Black people, especially men.
Limited Access to Dermatologic Care – insurance barriers, limited access to health care professionals who advocate for new treatments early reduce quality of life for those living with HS.
Structural Racism and Bias – implicit bias can lead to dismissal of pain and disease severity or omission of all treatment options.
Socioeconomic Inequalities – there is a higher rate of job loss and unemployment due to painful lesions, drainage, odor, limited resources for wound care, transportation for doctor visits and ability to take time off from work.
Common & New and Emerging Treatments: Focus on reducing inflammation, pain and scarring.
There’s currently no cure for HS, but there are many ways to manage it. The right treatment plan depends on the severity of the disease and each patient’s individual needs.
A dermatologist may recommend:
Topical or oral medications to reduce inflammation and prevent new lesions.
Biologic therapies newer injectable medications approved since 2015 for moderate to severe HS. Hormonal therapy especially for women with menstrual flares and triggers.
Procedures, like laser hair removal, steroid injections, or surgery, for stubborn or advanced disease.
Lifestyle support, such as quitting smoking, gentle skin care, weight management and food journaling for triggers.
Daily Self-Care Strategies That Make a Difference
Living with HS often means combining medical treatments with thoughtful daily care. Here are a few practical strategies that can help support your skin:
Cleanse gently: Use warm water and a mild antibacterial cleanser. Avoid harsh scrubs that can irritate the skin.
Soothe smartly: Warm compresses and calming ingredients like aloe vera can ease discomfort during flares.
Choose breathable clothing: Loose, soft fabrics reduce friction and irritation.
Hands off: Resist the urge to pop or squeeze HS bumps—they’re deep under the skin, and manipulation can worsen inflammation and scarring.
Be mindful of diet and triggers: Some people notice flare-ups after eating certain foods. Keeping a food journal can help identify patterns.
Prioritize your mental health: HS can impact self-esteem and emotional well-being. Support groups, therapy, or honest conversations with loved ones can make a real difference.
The Bottom Line: Hope and Advocacy for Improved Quality of Life
Raising awareness, promoting early diagnosis, and improving access to new treatments can dramatically improve outcomes for people living with HS With proper care, many people experience fewer flares, less discomfort, and improved quality of life.