Hidradenitis is a chronic inflammatory skin condition in which painful nodules and abscesses form in areas where sweat and sebaceous glands are concentrated.
The main symptoms include firm, painful nodules under the skin, redness, sometimes discharge, and scar formation. The most commonly affected areas are the armpits, groin, buttocks, and under the breasts.
The condition is not contagious and cannot be transmitted through contact. It is associated with dysfunction of hair follicles and the immune system. With proper treatment, the condition can usually be controlled.
What to Do if Suspected
If you notice painful lumps under the skin, especially in the armpits or groin, it is important to consult a dermatologist.
The first step is an examination by a specialist. The doctor will assess the nature of the lesions and distinguish hidradenitis from boils, cysts, or other skin conditions.
The frequency of flare-ups and the presence of scarring may also be considered. In some cases, consultation with a surgeon is required.
Do not attempt to open the nodules yourself or use aggressive treatments. This may worsen inflammation, lead to infection, and aggravate the disease.
The earlier treatment begins, the higher the chance of preventing complications and scarring.
How the Disease Appears
Hidradenitis presents as firm, painful nodules under the skin.
In the early stages, these are small lumps that may increase in size. The skin above them becomes red and sensitive.
Over time, the nodules may rupture, releasing contents. With repeated flare-ups, dense scars and subcutaneous “tunnels” (channels between inflamed areas) may form.
Most often, the armpits, groin folds, under-breast area, and buttocks are affected.
Symptoms can vary greatly in severity — from single lesions to multiple inflamed areas.
Below in the article, you can view real photos to better understand what the condition looks like.
Main Symptoms
The main signs of hidradenitis:
- Painful nodules under the skin
- Redness and swelling
- A feeling of pressure or pulsation in the affected area
- Discharge when nodules rupture
- Scar formation in long-standing cases
The condition often follows a relapsing course — periods of flare-ups alternate with improvement.
Causes of the Disease
The exact cause of hidradenitis is not fully understood, but it is known to be related to dysfunction of hair follicles.
Blockage of the follicles occurs, followed by inflammation.
Factors involved include:
- Internal: immune system особенности, genetic predisposition, hormonal influences
- External: skin friction, excessive sweating, smoking, excess weight
Infection may occur secondarily but is not the primary cause of the disease.
How the Disease Develops
Initially, a hair follicle becomes blocked — the channel through which hair grows.
Then material accumulates inside, inflammation develops, and a painful nodule forms.
If the process continues, the nodule may enlarge, rupture, and connect with nearby lesions. This leads to chronic inflammation and scarring.
The skin in these areas becomes more sensitive and prone to recurrent flare-ups.
Forms and Types
The severity of hidradenitis is usually assessed by extent:
- Mild: isolated nodules without scarring
- Moderate: recurrent inflammation with scar formation
- Severe: multiple lesions, subcutaneous tunnels, and extensive skin involvement
The stage helps determine the optimal treatment approach.
When to See a Doctor
You should consult a specialist if:
- Painful nodules appear in skin folds
- Inflammation recurs
- Scars or hardened areas form
- Lesions increase in size or become more painful
- Discharge appears
Early consultation helps slow disease progression and reduce complications.
Treatment
Hidradenitis is a chronic condition, but it can be managed.
Treatment aims to reduce inflammation, prevent new lesions, and improve skin condition.
Possible treatments include:
- Topical anti-inflammatory agents
- Antibacterial medications (as prescribed)
- Immune-modulating drugs in more severe cases
- Surgical methods for advanced or persistent lesions
Lifestyle also plays an important role:
- Reducing skin friction
- Gentle care of affected areas
- Managing factors that may trigger flare-ups
Treatment is always individualized and requires medical supervision.
Q&A
Is hidradenitis contagious?
No, it is not transmitted from person to person.
Can hidradenitis be completely cured?
Complete cure is not always possible, but proper treatment can significantly reduce symptoms and flare-ups.
How is hidradenitis treated?
Treatment includes topical therapies, systemic medications if needed, and sometimes surgery. The approach is determined by a doctor.
Why do painful nodules appear?
They result from inflammation of hair follicles and surrounding tissues.
Can nodules be squeezed?
No, this can worsen the condition and lead to complications.
Do scars remain?
Scarring may occur in long-standing cases, which is why early treatment is important.
Is hidradenitis related to hygiene?
No, it is not caused by “poor hygiene,” although proper skin care can help reduce symptoms.
Can I exercise?
Yes, but it is important to avoid friction and irritation in affected areas.
Sources
- Clinical guidelines on hidradenitis
- American Academy of Dermatology (AAD)
- European Academy of Dermatology and Venereology (EADV)
- World Health Organization (WHO)
Images of hidradenitis
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