What are the symptoms of hidradenitis suppurativa?

Early lesions may feel like deep, tender pea-sized lumps beneath the skin. They commonly occur in the armpits, groin, inner thighs, under the breasts, or around the buttocks. A lump may become swollen, warm, and painful before opening and releasing blood-stained or foul-smelling fluid.

With repeated episodes, separate lumps can join beneath the skin through narrow channels called tunnels. Healing may leave thick scars, rope-like bands, dark marks, or areas where movement is uncomfortable. Some people have one affected area, while others develop symptoms in several skin folds. Hidradenitis is not simply poor hygiene, and ordinary acne treatments may not address its pattern.

Arrange a dermatology assessment when painful lumps recur in the same fold, drain, or leave scars. Keep affected skin gently clean and dry, choose loose clothing, and avoid squeezing lesions. Note where episodes occur, how long they last, whether drainage is present, and any triggers such as friction or smoking; this helps the clinician assess the pattern.

Treatment depends on the number, depth, and activity of lesions. Plans may include anti-inflammatory injections into a selected lump, medicines that alter immune signalling, antibiotics, hair-reduction strategies, or surgery for persistent tunnels and scarred areas. A tailored plan can also address pain and wound care.

Seek an appointment if lumps recur, drain, restrict movement, or cause ongoing skin pain. Get prompt medical care for rapidly increasing swelling, spreading redness, severe pain, fever, or feeling unwell, as these can signal a significant infection. Urgent assessment is also needed if a lesion makes sitting, walking, or urinating difficult.

Could these recurring lumps fit hidradenitis suppurativa? Are there tunnels or scarring beneath the skin? Which treatment matches my current lesions, and how should I care for a draining area between visits?