Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease. It causes painful, acne-like lesions or cysts under the skin. Usually, HS lumps happen in the armpits, groin area, inner thighs, buttocks, and under the breasts. It’s rare, but some people also get symptoms of hidradenitis suppurativa on the neck.

If you have HS on your neck, you’re not alone. Several members of myHSteam report neck symptoms. “I get an average of three new painful boils on my neck every week,” shared one member.

The good news is that HS is more treatable than ever. New and more effective treatment options are available. Seeking help as soon as you notice symptoms on any part of your body is essential to feeling better faster. Here’s what you can do to stop HS from becoming a literal pain in the neck.

Symptoms of HS on the Neck

HS typically affects parts of the body that have a lot of sweat glands. The neck isn’t commonly affected, but there have been cases of HS on the neck. Another potential cause of painful bumps on your neck is cystic acne. Cystic acne causes pimples to develop under your skin. These pimples are filled with pus and are painful. A dermatologist can take a closer look to determine if HS, cystic acne, or another skin condition is responsible for your neck symptoms.

Early signs and symptoms of HS on the neck include folliculitis (inflamed hair follicles). These can eventually develop into deeper lesions under the skin. Some people also have symptoms like itching, pain, stinging, or burning 12 to 48 hours before they notice a lesion.

HS lesions can last for weeks or months. Lesions can look like a deep, pea-sized bump similar to an acne cyst or boil. Some skin lesions can grow and burst, draining foul-smelling pus. Over time, skin lesions may leave ropelike, raised scars and form tunnels under the skin that connect with each other. The symptoms may go away and come back unexpectedly.

Treating HS on the Neck

There’s no cure for HS and no specific treatment that’s meant just for the neck area. However, there are many ways to improve your symptoms and reduce new lesions.

Treatments for HS can include:

• Topical medications, including antibiotics
• Oral medications, including antibiotics, hormone therapy, and retinoids
• Biologics
• Corticosteroids
• Laser hair removal
• Surgery

“My dermatologist used steroid injections directly into the cysts/boils on my neck, which helped them go away,” shared one myHSteam member.

One case study found that HS on the neck responded well to tumor necrosis factor (TNF-alpha) inhibitors. These are biologic medications that are injected under the skin. “I went on a TNF-alpha inhibitor three months ago, and it put me into nearly full remission,” wrote one myHSteam member who reported HS lesions on their neck.

Lifestyle Tips for Managing HS Symptoms on the Neck

Combining medical treatment with lifestyle habits can help you best manage your HS symptoms on the neck and elsewhere on your body. Here are a few changes that are proven to help.

Quit Smoking

Smoking cigarettes is associated with HS. Quitting smoking can help prevent worsening HS symptoms and reduce your risk of flare-ups.

Diet

What you eat may affect your HS. Some foods may trigger flare-ups, and other foods may help prevent them. A few small studies have found that avoiding certain foods — dairy, carbohydrates, and sugar, among others — may lessen flare-ups and sometimes clear HS.

Some dermatologists have reported improvements in some individuals with HS when they followed a Mediterranean diet or a plant-based diet. It is important to first speak to your dermatologist or primary care provider before changing your diet.

Weight Loss

High body weight may increase the risk of HS and may make the symptoms worse. Obesity affects the body’s hormones and inflammation levels. It can also increase skin folds, sweating, and friction, which can cause irritation. While weight loss may not impact your neck only, maintaining a healthy weight may reduce your overall risk of HS flare-ups.

Ask your healthcare provider if you have questions about weight loss. They may refer you to a registered dietitian. They may also suggest medical interventions like medication.

At-Home Recommendations

You may be able to reduce your flare-ups or improve your symptoms by following these skin care and self-care tips:

• Avoid using harsh products on the skin.
• Avoid using cleaning tools such as loofahs and brushes to scrub the skin.
• Don’t shave near breakouts on the neck.
• Clean your neck daily with an antibacterial soap or cleanser.
• Wear loose-fitting clothing to prevent rubbing or friction against the skin.
• Use a warm compress or heating pad on painful bumps for 10 minutes at a time.
• Keep your skin cool and dry.

Some myHSteam members also shared their at-home tips:

• “Use hot packs and hot baths.”
• “Stop wearing makeup to cover up your abscesses.”
• “Stop using scented bodywashes and lotions, perfumes, and body sprays.”
• “Bleach baths have helped me so much!”
• “Figure out what foods, drinks, or stresses make your skin flare up.”
• “I apply benzoyl peroxide on my lesions at night and wash my face and neck with an antibacterial cleanser.”

Talk to Your Dermatologist

Speak with your dermatologist about any issues with your neck. First, they’ll need to make sure there aren’t any other conditions causing the problem (like cystic acne or an infection). Then, they can recommend a treatment plan that’s best for your situation.

Connect With Others Who Understand

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

Have you ever experienced HS symptoms on your neck? Let others know in the comments below.