Hidradenitis suppurativa (HS) — also called acne inversa — is a chronic (long-term), inflammatory skin condition. People living with HS develop acne-like bumps and lesions in areas of the body that have many sweat glands and hair follicles. It often affects places where skin rubs together, including the breast area.

For many people, HS affects the skin on or under the breasts, leading to painful nodules or tunnels (also called sinus tracts) that can drain fluid and cause scarring over time. In this article, we’ll explore why HS symptoms develop on and around the breast area, along with ways to find relief from this uncomfortable symptom and when to contact your doctor.

What Does Breast HS Feel and Look Like?

Many people develop HS on or under their breasts. For some, this is where their HS journey started. As one myHSteam member shared, “Under my breasts is where mine started as a kid.”

Some people with HS on their breasts also have it on other areas: “My problem areas are under my arms, breasts, and groin area,” wrote one member.

Still others find that HS develops on their breasts later, after appearing elsewhere. “This spot so far is the worst and the first time I’ve had it under my breast,” shared one member.

HS on the breasts may be worse than in other locations. “I’ve had four [lesions] removed from my breasts,” wrote one member. “It was awful.”

Another added, “I’ve been dealing with an outbreak on my breast all week. I’ve had so much pain. Haven’t been feeling the best.”

Symptoms of HS on and Under the Breasts

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Symptoms of HS vary from person to person. The Hurley staging system is commonly used to describe how severe the condition is:

• Stage 1 — One or more lesions with minor scarring
• Stage 2 — One or more lesions with some tunneling and scarring
• Stage 3 — Multiple lesions across larger areas of the body, with widespread tunneling and scarring

If you have a family history of HS, your chances of developing it may be higher. Certain factors may trigger symptoms or cause flares, including:

• Smoking
• Hormones
• Stress
• Sweating
• Weight gain

Early signs and symptoms of HS on or around the breasts include pain, burning, itching, and hyperhidrosis (excessive sweating). These symptoms may start a day or two before a lesion appears.

Lesions that form on or under the breasts — or in other parts of the body — can last anywhere from a few days to several months. The lesions may look like deep, pea-size bumps, similar to acne cysts or boils. Larger lesions may burst and drain foul-smelling pus. Eventually, the lesions may leave scars and form interconnecting tunnels under the skin. Sometimes, lesions disappear but then come back.

Treatment for HS on and Under the Breasts

While there’s no known cure for HS, several treatments can help manage symptoms and reduce the chances of future flares. Your dermatologist will work with you to create a personalized treatment plan, based on the type, location, and severity of your HS lesions.

For mild to moderate HS (Hurley stages 1 and 2), commonly used treatments include:

• Hormonal medications, such as birth control pills
• Topical agents, such as lidocaine (for pain relief) and anti-inflammatory medications
• Topical or oral antibiotics, such as clindamycin, dapsone, or tetracycline
• Metformin, a medication sometimes used off-label to reduce inflammation
• Over-the-counter pain relievers, such as acetaminophen
• Retinoids, such as acitretin
• Spironolactone, a hormone-blocking medication

If your HS doesn’t improve after a few months of treatment — or if it’s more severe (Hurley stage 3) — your doctor may recommend:

• Laser hair removal
• Corticosteroid injections (to reduce swelling)
• Botulinum toxin (Botox) injections (to reduce sweating and inflammation)

In some cases, surgery may be the best option to clear HS on or around the breasts. “I had a recurring abscess on my breast cut open today,” wrote one member, “and they cleaned out the sinus tracts, as well as removing dead scar tissue and skin.”

How To Manage HS on and Under the Breasts

Along with medical treatments, some at-home strategies can help manage symptoms of HS on or under the breasts. While there’s no guaranteed way to prevent HS, making small lifestyle changes may reduce flares and improve quality of life. These include quitting smoking, eating a balanced diet, and getting regular physical activity.

Successfully managing your HS can help you feel better — both physically and emotionally.

Bandage Your Wounds With Care

Learning how to bandage HS lesions around your breasts can help ease discomfort associated with HS in this sensitive area. Your doctor or wound care specialist can show you safe and effective techniques. A few tips to consider:

• Wear a bra with removable padding so you can place dressings inside — or try HS-specific clothing like HidraWear, which is designed to hold dressings in place.
• Use self-adhesive dressings — or repurpose items like menstrual pads or nursing pads for coverage and absorption.
• Choose gentle wound tape, such as paper tape or dressing retention tape, to avoid irritating the skin.
• Ask your doctor about insurance coverage for specialty wound care supplies.

Quit Smoking

Research shows that around 70 percent to 90 percent of people who develop HS also smoke cigarettes. Quitting smoking may help reduce inflammation and lower the risk of future flare-ups. If you smoke, talk to your doctor about tools and programs that can support your quit plan.

Consider a Skin-Friendly Diet

What you eat may impact your HS. While there’s no single “HS diet,” some people find that avoiding certain foods can reduce symptoms. Small studies suggest that limiting the following may help:

• Dairy products (cheese, butter, and cow’s milk)
• Sugary foods and drinks (soda and candy)
• Brewer’s yeast, found in products like soy sauce, beer, and wine
• Eating a balanced diet can support hormone and blood sugar balance and lower inflammation. Consider:
• Cutting back on sugar and processed foods
• Adding more high-fiber foods, like fruits, vegetables, and whole grains
• Including omega-3 fatty acids, found in salmon, sardines, olive oil, and walnuts

Some people benefit from following a Mediterranean-style or plant-based diet. Before making major changes, ask your doctor or a registered dietitian for guidance.

Ask Your Doctor About Weight Loss

Some people notice improvements in their HS symptoms after weight loss. Research suggests that losing 15 percent of body weight may help if you have a body mass index (BMI) in the overweight or obesity category. Weight loss may make the most difference in the early stages of HS, before tunnels form under the skin.

It’s important to note that not everyone with HS has a high body weight, and not everyone sees symptom improvement with weight loss. If you’re curious whether weight may be playing a role in your HS, talk to your doctor about a safe and supportive plan.

Practice Self-Care

In the early stages of HS — or between flares — gentle at-home care may help reduce irritation:

• Avoid harsh products, such as antiseptics or scrubbing tools like loofahs or brushes. (HS is not caused by poor hygiene.)
• Shave carefully, especially near the breasts and armpits, to avoid irritating the skin.
• Clean the area daily using a gentle antibacterial soap or cleanser.
• Wear loose, breathable clothing and bras made from soft fabrics to reduce friction.
• Apply a warm compress or heating pad to the area for 10 minutes at a time to help relieve pain.
• Keep the area cool and dry to reduce sweat and moisture buildup.

Some members have offered their recommendations for managing HS around the breasts. “Keep a bandage in your bra,” one wrote. “Use Hibiclens to keep it germ-free.”

HS symptoms in the breast area can be especially painful and frustrating — but you’re not alone, and help is available. Talk to your dermatologist about treatment options, and connect with others who understand what you’re going through on myHSteam.

Find Your Team

On myHSteam, the social network for people and their loved ones living with hidradenitis suppurativa, more than 46,000 members come together to ask questions, offer support and advice, and connect with others who understand life with the skin condition hidradenitis suppurativa.

Have you ever faced a severe case of HS on the breasts? If so, how did it affect you, and what did you do to treat it? Share your story and tips in the comments below, posting on your Activities page, or connect with like-minded members in Groups.