Hidradenitis suppurativa (HS, also called acne inversa) occurs when your immune system attacks your hair follicles. While there is currently no way to completely prevent HS, there are steps you can take to manage symptoms and reduce how often flare-ups happen.

If you’re living with HS, or you’re concerned you might develop it, here’s what to know. Understanding HS can help you make informed choices about your care and support your quality of life and overall well-being.

What Causes Hidradenitis Suppurativa?

No one knows exactly what causes hidradenitis suppurativa. Researchers are looking into this question. Gaining more understanding about what causes HS may help people living with this chronic skin disease.

What experts do know is that HS involves an overactive immune response and inflammation around hair follicles. This inflammation can lead to painful nodules (lumps) and abscesses (pus-filled bumps), especially in areas where skin rubs together and sweat glands are common, such as the armpits and groin.

Even when there’s no outside threat, the immune system stays switched “on,” causing skin lesions that may look like infections but are actually driven by inflammation. Learning more about how this process works is an important step toward finding better treatments and, one day, a cure.

Risk Factors for HS

Though researchers don’t know exactly what causes HS, they do know that some people have a higher risk of developing it than others do. Some of these risk factors are:

• Having a family history of HS — About 1 in every 3 people with HS has family members with the condition, pointing to a possible genetic connection.
• Being female, according to Cleveland Clinic
• Living with obesity
• Having sex hormones that are in flux, for instance, during the adolescent years and right before menopause
• Having hirsutism, a condition that causes excess body hair
• Smoking regularly
• Having the skin condition psoriasis
• Being somewhere between puberty and 40 years old
• Being African American, Hispanic, or biracial, according to the American Academy of Dermatology

It’s also important to remember that these are just risk factors. You could have all of these and never develop HS, or you could have none of them and end up with the diagnosis. These are simply things that seem to put people at a higher risk of developing the condition.

What Doesn’t Cause HS?

It’s important to note what isn’t on this list. HS is not a result of poor hygiene. You can shower or bathe regularly and keep your skin clean and still develop HS. It does not mean you’re dirty or that you caused the condition.

HS is also not caused by a sexually transmitted infection (STI), even though it often appears in the groin area. In fact, HS is not contagious at all — you cannot “catch” it from someone else, and you cannot pass it to others.

Can You Reduce Your Risk of Developing HS?

If you have risk factors for HS but haven’t developed symptoms, you might be wondering, “Is there a way to prevent hidradenitis suppurativa?” While researchers don’t know the answer to this, it makes sense to look at what you can and can’t control.

Control the Risk Factors You Can Control

Some of the factors listed above aren’t things you can control. For instance, you don’t control your biological sex, what your sex hormones do, or what genes get passed to you from your family members. Even obesity has a significant genetic component.

Controlling the factors you can may lower your risk of developing HS. You can work with a healthcare provider to quit smoking, for instance. Finding an effective treatment for obesity may help, too.

No one knows how much changing these factors might influence whether or not you develop HS. However, if you’re concerned about ending up with HS, getting these things under control lowers your number of risk factors and may improve your overall health.

Lowering Your Risk for HS Flares

For those who are already diagnosed with HS, there may be ways to limit the number of flares you experience. When hidradenitis suppurativa suddenly goes from dormant or being in remission to getting bad again, it’s called an HS flare or an HS flare-up.

Some steps that might help avoid triggers for HS flares include:

• Not using scented products on your skin, including deodorants and skin care options
• Wearing loose-fitting clothes, rather than tighter ones
• Limiting how much you sweat, which may influence the kind of exercise you do or when you choose to go outside
• Washing your skin with something that kills bacteria
• Avoiding skin irritation, i.e., not scrubbing, shaving, or waxing your skin

Understanding Your Triggers

Some people find that specific situations trigger their HS or make it worse when it’s already flaring. If you can figure out what these are for you, avoiding them may help you experience fewer flares and less severe disease.

Some things that may trigger HS are:

• Stress
• Dietary factors, like eating a lot of simple sugars and dairy products, fat, and yeast
• Not getting enough of certain vitamins and minerals, like zinc, vitamin D, and possibly vitamin B12

You may need to keep a diary or a journal to figure out what triggers HS for you. Write down how you’re feeling emotionally and what you eat, then track how those things correlate with your HS symptoms. You may find that avoiding certain things keeps most of your HS flares at bay. If you’re concerned you may have nutrient deficiencies, talk to your doctor about getting tested and ask whether taking a multivitamin might help.

Some members at myHSteam discuss what triggers their HS flares. “If I’m in remission, I could mainly attribute it to stopping smoking,” one shared.

Another said, “Flare was possibly caused by too much stress at work.”

Someone else added, “I’ve been trying to avoid dairy, as that seems to trigger my HS.”

Can Hidradenitis Go Away?

No one has ever cured HS. It’s a chronic skin condition, meaning that it usually lasts long term, and may even be lifelong. However, HS can, in some people, go away. In fact, 2 or 3 out of every 10 people who get diagnosed with HS eventually see their symptoms go into remission. Remission is a period of time with no HS symptoms.

HS Treatments

There are a lot of treatment options for hidradenitis suppurativa. Some are topical (applied to the skin), while others may be taken orally or by injection. Work with your dermatologist to choose a treatment regimen that’s right for you based on whether you have mild, moderate, or severe hidradenitis suppurativa, how many areas of your body are affected, and what your body responds to. Finding the right treatment plan may help you enter remission and avoid future flare-ups.

Talk to Your Doctor About an Effective Treatment Plan

Whether you’re concerned about developing hidradenitis suppurativa or you’ve already been diagnosed and want to prevent future flares, your dermatology team should be your first stop. Talk to them about your concerns, your goals, and what you’re trying to do to help the situation.

They may be able to give you new ideas about what you can do to lower your risk of developing HS or limit the number of HS flares you experience. They can also help you when HS becomes active, helping you figure out how to treat HS lumps at home, when you need to call a doctor, and what to do if HS has caused wounds on your body.

Join the Conversation

On myHSteam, people share their experiences with hidradenitis suppurativa, get advice, and find support from others who understand.

Have you taken any steps to lower your risk for developing HS, or to reduce triggers that cause your HS to flare? Let others know in the comments below.