6 Health Issues to Watch for if You Have Hidradenitis Suppurativa
Hidradenitis SuppurativaYour Guide to Managing HS

6 Health Issues You Could Be At Risk For if You Have Hidradenitis Suppurativa

6 Health Issues You Could Be At Risk For if You Have Hidradenitis Suppurativa
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Updated on January 16, 2025
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Hidradenitis suppurativa, or HS, is a skin condition in which people develop painful nodules or abscesses under the skin in specific areas of the body. While these lesions may slowly heal on their own, they often recur and can lead to tunnels forming under the skin and scarring.

 HS can be debilitating and devastating for those who have it.

“’[The] painful nodules, bumps, and boils typically [occur] in the armpit, breast, or groin areas,” explains Honolulu-based Aaron Fong, MD, of Dawson Dermatology. “These can be painful and seep foul-smelling fluid. Unfortunately, since HS isn’t widely known and is often misdiagnosed, people may not seek appropriate treatment for years.”

In fact, because the condition is often mistaken for something else, some people live with HS for years before getting diagnosed.

Why Does Hidradenitis Suppurativa Develop?

It’s unclear what causes HS, but there appear to be risk factors ranging from hormones and family history to environment. Individuals in their teens or twenties are more likely to develop HS than other age groups, as are smokers and women compared to men.

 HS occurs most often among Black people, so experts speculate that race or ethnicity may also affect a person’s chances of developing it.

One thing experts do know is that the condition is linked to other serious health issues. “We don’t fully understand why, but HS is associated with other conditions, such as obesity, metabolic syndrome, and Crohn’s disease,” Dr. Fong says. “In addition, since HS is a disorder of the hair follicle, it often occurs with similar related disorders, such as acne conglobata and dissecting cellulitis of the scalp.”

8 Things That Can Make Hidradenitis Suppurativa Worse

Discover some factors that can exacerbate hidradenitis suppurativa and learn how to manage them for a healthier life.
8 Things That Can Make Hidradenitis Suppurativa Worse

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6 Health Conditions Related to Hidradenitis Suppurativa

While there is still a lot to learn about HS, it is known that it can increase your risk of other potentially serious health issues. Here are six major ones to be aware of:

1. Metabolic Syndrome

HS appears to be linked to a higher risk of metabolic syndrome, a cluster of conditions — high blood pressure, excess body fat around the waist, high blood sugar, abnormal cholesterol or triglycerides — that often occur together.

 According to an analysis of studies, there is a strong association between HS and metabolic syndrome.

Left unmanaged, metabolic syndrome can increase your risk of heart attack and stroke. While there are many ways to address metabolic syndrome, making lifestyle changes, such as eating a healthy diet and increasing exercise, may help reduce the risk of serious complications.

2. Axial Spondyloarthritis

This type of arthritis mainly affects the axial skeleton — the chest, spine, and pelvis — though for some it can affect the digestive system, skin, and eyes.

 Research has indicated that HS may be more common in those who also experience this condition. One study of axial spondyloarthritis patients found that HS was more prevalent in that group compared with the general population.

The main symptom of axial spondyloarthritis is pain in the lower back.

 Treatment for the condition varies but may include medication, physical therapy, exercise, and lifestyle modifications.

3. Inflammatory Bowel Disease

Otherwise known as IBD, inflammatory bowel disease is an umbrella term used for disorders that involve chronic inflammation of the digestive tract. The two main types are ulcerative colitis and Crohn’s disease.

People with IBD may experience diarrhea, rectal bleeding, abdominal pain, weight loss, and fatigue, and treatment may require medications, nutritional support, and, in some cases, surgery.

A comprehensive review of large-scale studies found a significant association between HS and the risk of IBD in patients. Based on their findings, the study authors suggested that people with HS who experience recurrent symptoms like diarrhea, bloody stool, and abdominal pain see a gastroenterologist.

4. Cardiovascular Disease

Heart disease is the leading cause of death in the United States: One person dies every 33 seconds from it, according to the Centers for Disease Control and Prevention (CDC).

There are many forms of heart disease and causes of cardiovascular-related death, but research has shown that HS is associated with significantly increased risks of adverse cardiovascular-related outcomes, such as stroke, heart attack, and death.

 In a study, researchers found that having HS significantly increased the risk of heart attack or stroke.

Heart disease treatment varies widely from case to case, but lifestyle modifications and medications may be necessary, as well as medical procedures or surgeries in some cases.

5. Depression, Anxiety, and Suicide Risk

Skin disorders that cause visible symptoms can take an emotional toll and contribute to low self-worth, embarrassment, and social isolation. This, in turn, may increase risk for anxiety, depression, and suicidal thoughts and generally affect quality of life.

One research analysis found that depression and anxiety are common in people with HS. Given this link, the researchers recommend that clinicians watch for symptoms of mental health conditions that can accompany HS and refer patients for appropriate care.

6. Sexual Dysfunction

There are many forms of sexual dysfunction, but the term generally applies to any problem that prevents a person or couple from experiencing satisfaction from sexual activity.

According to one study, about half of people with HS experience sexual dysfunction. The research indicated that being in a stable relationship seemed to protect women with HS from developing sexual dysfunction and suggested that the issue may be partially related to extreme pain, active lesions, and other symptoms.

Treatment for sexual dysfunction depends on the cause and circumstances because both physical and psychological factors may be at play, but medications and psychotherapy may be helpful.

How Seeing a Dermatologist Can Help

Even though HS can affect much more than your skin, a good place to start is by seeing a dermatologist who specializes in the condition. “Dermatologists are trained to recognize, appropriately diagnose, and treat hidradenitis suppurativa,” Fong says. “With the correct diagnosis, we can manage HS appropriately to prevent progression and worsening, relieve pain, and reduce scarring.”

From there you can work to develop a more comprehensive treatment plan, which may incorporate other healthcare specialists to help you manage related conditions.

And while HS itself is still not fully understood, experts say emerging research may offer relief to people with HS in the future. “While there is still much we do not know about HS, there has been a lot of research in the past several years,” Fong says. “We have made several breakthroughs that have lead to many different treatment options for this condition. We hope that more of the general public can be made aware of this condition so they can seek treatment earlier and reduce its impact on their quality of life.”

The Takeaway

  • Hidradenitis suppurativa, or HS, is a skin condition in which painful lesions form under the skin in specific areas of the body.
  • Research shows that HS often occurs along with other serious health conditions, so your treatment plan may incorporate additional specialty care as well as seeing your dermatologist.
  • Commonly co-occurring conditions can be serious and even life-threatening, so experts recommend confirming your diagnosis with a dermatologist early to manage your illness effectively.

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Jacquelyn Dosal

Jacquelyn Dosal, MD

Medical Reviewer
Castle Connolly Top Doctor

Jacquelyn Dosal, MD, is a board-certified dermatologist practicing at The Dermatology House in Park City, Utah. Her areas of expertise include acne, rosacea, integrative treatments of inflammatory skin diseases, as well as laser treatment of the skin and injectables.

Dr. Dosal writes cosmetic questions for the certifying exams for the American Board of Dermatology. She is also the deputy editor for the American Academy of Dermatology's podcast, Dialogues in Dermatology.

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Michelle Konstantinovsky

Michelle Konstantinovsky

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Michelle Konstantinovsky is a Bay Area–based freelance journalist, marketing specialist, and ghostwriter. An alumnus of the University of California in Berkeley Graduate School of Journalism, she’s written extensively on health, body image, entertainment, lifestyle, design, and technology for outlets such as Vogue, Vanity Fair, Glamour, Shape, Self, Scientific American, Wired, and more. She served as a senior content writer at One Medical, the health and wellness editor at Fitbit, a contributing editor and the social media director at California Home + Design, and a content marketing consultant at Carrot Fertility. She is an avid admirer of shiny objects and early 2000s pop culture.
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Resources
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