Can You Get Hidradenitis Suppurativa (HS) in Your Vagina?

There’s no cure for HS, but treatments can help ease symptoms. Here’s everything you should know about how condition affects the groin and pubic area and how you can get the best care possible.

“The vaginal tissue is different [from skin] so [HS] is not found in this area, but can be commonly seen in women along the vulva, as well as under the breasts and buttocks,” says Pooja R. Shah, MD, director of dermatology at the Katz Institute for Women’s Health at Northwell Health in New Hyde Park, New York.

• General skin discomfort, such as itching, burning, and excessive sweating.
• Painful nodules, which may resemble a deep pimple, cyst, or boil, that persist for weeks or months. Over time, more nodules may form and enlarge, filling up with fluid and forming painful abscesses.
• Leaking abscesses, which can break open and release pus and blood with a foul-smelling odor.
• Black-head like spots that appear in later stages.
• Tunnels, which form over time with repetitive healing and reopening and connect the nodules under the skin. These tunnels, also called sinus tracts, can lead to permanent scarring.

Symptoms of hidradenitis suppurativa can resemble other conditions, says Christine Greves, MD, an ob-gyn with Orlando Health in Florida, including Bartholin’s cyst, a bacterial infection, or sexually transmitted infections. “It can also be as simple as a hair follicle that is inflamed, called folliculitis,” she says, so it's important to see your doctor if you notice symptoms and they aren’t going away.

“We do not know exactly what causes hidradenitis suppurativa, but the prevailing theory is that hair follicles become clogged with a protein called keratin, which causes bacteria to breed,” says Shari Lipner, MD, PhD, a dermatologist at NewYork-Presbyterian and Weill Cornell Medicine in New York City. “The hair follicle eventually bursts and the process continues.”

Hormonal Influences

Genetic Predispositions

Lifestyle Factors

Everyone gets pimples and harmless bumps from time to time on their skin, but if they don’t go away or if they’re painful, you should get it checked out.

Dr. Shah recommends making appointments with both your gynecologist and dermatologist simultaneously to make sure nothing gets missed.

“Hidradenitis is often misdiagnosed during the initial stages when it is key to intervene and get under control,” she says. “Alternatively, my recommendation would be that if there is only vulvar skin involvement, women should seek an appointment with their dermatologist first. Whereas if there is involvement of the vagina (different anatomical part than the vulvar skin) and associated discharge, then they should seek an appointment with their gynecologist first.”

There isn’t a cure for HS, but treatments including medications and surgery, as well as lifestyle changes, can help you manage the condition.

Topical and Oral Medications

• Antibiotics, which can be taken orally or applied as a cream or gel directly to the abscesses. Be sure to closely follow directions when applying and avoid getting it in the vagina.
• Steroid injections to reduce swelling and inflammation.
• Hormonal therapy, such as estrogen-containing combined oral contraceptives, if hormonal imbalance is believed to be a cause.
• Biologics, which alter the body’s immune response to fight the disease.
• Pain medication to alleviate discomfort if over-the-counter varieties aren’t working.

Surgical Interventions

• Deroofing, which involves removing the top part, or the “roof,” of the tunnels under the skin and cleaning out any pus to allow them to heal. This is an outpatient procedure done under local anesthesia.

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• Laser hair removal, which can help improve HS by destroying the hair follicles that are involved in the disease process. “If you are considering laser hair removal, it is important to be treated by a board-certified dermatologist who is trained in operating these lasers,” Dr. Lipner says. “Being treated by a non-dermatologist could result in permanent side effects, including scarring.”
• Surgical removal, for severe cases that haven’t responded to more conservative treatments, this involves removing all of the affected skin and fat. Wound healing can take weeks up to months in some cases, and risks include pain, scarring, and infection.

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Lifestyle Changes

If you’re dealing with HS in the groin area, consider some lifestyle changes that can help.

“Lifestyle changes, such as weight loss, if you are overweight, and stopping smoking, if you smoke, can improve hidradenitis suppurativa,” Lipner says. “Helpful self care tips include wearing loose clothing and using antimicrobial washes if recommended by your dermatologist. Avoid getting it inside the vagina.”

Lipner also advises against waxing the genital area. “If you develop a painful lump, warm water or black tea compresses can help,” she says.

• Hidradenitis suppurativa can cause painful lumps in the genital and groin regions, as well the underarms, breasts, and buttocks.
• If you experience uncomfortable bumps in these areas that don’t go away, see your dermatologist and gynecologist right away so you can get proper diagnosis and care.
• Treatments include medications, surgical intervention, and lifestyle changes like quitting smoking and losing weight.