Many of us have had ingrown hairs at some point. These bumps can look like pimples and cause itching and irritation. But if they don’t go away, get bigger, or spread, they could point to something more serious, including hidradenitis suppurativa (HS).

HS is a chronic inflammatory skin condition, so it may never fully go away. It causes painful lesions (bumps) and abscesses. HS typically shows up in areas where skin rubs together, such as the armpits, groin, inner thighs, buttocks, and breasts.

Because HS can look like ingrown hairs and other skin problems, it is often mistaken for something else. This makes it hard to find effective treatment early.

So, how can you tell the difference before symptoms get worse? Below are five differences that can help you figure out whether you have ingrown hairs or HS.

1. HS and Ingrown Hairs Have Different Causes

New hairs grow from hair follicles under your skin. Sometimes, these hairs grow back into the skin instead of growing outward, causing ingrown hairs.

You’re more likely to notice ingrown hairs after hair removal, like shaving, waxing, or tweezing. People with thick, coarse, or curly hair are more likely to get them.

HS starts with blocked hair follicles, but researchers are not sure what causes the blockage. Several factors may play a role, including hormones, genetics, smoking, and weight.

HS is an ongoing health problem, and flare-ups can happen unexpectedly. According to Cedars-Sinai, women may notice their symptoms getting worse before their period.

Some myHSteam members notice flare-ups at night. “I just want to have one night where I can sleep without pain,” one member shared.

“I just want to have one night where I can sleep without pain.”

— A myHSteam member

2. HS and Ingrown Hair Have Distinct Features

Ingrown hairs are small bumps that look like pimples. They are often purple, red, or brown. You may see hair or pus inside.

At first, HS may look like pimples and acne cysts. However, these lumps can grow much deeper than ingrown hairs. Over time, they fill with fluid to form painful abscesses, which eventually break open.

This repeated swelling, draining, and healing cycle forms sinus tracts. These tunnels under the skin connect the lumps. HS abscesses can have an unpleasant odor when they break open and leak.

3. HS Is More Painful Than Ingrown Hairs

Most ingrown hairs cause mild burning, stinging, or itchiness. They may feel sore when touched, but the discomfort usually does not last long.

HS can be much more painful. Lesions often begin with mild itchiness but can quickly progress to severe pressure and discomfort.

You may feel some relief when the bumps drain. But in later stages of HS, the pain can become severe and make daily life harder. “The pain never gets any easier — even walking is a pain,” one myHSteam member shared.

Ingrown hairs may feel sore when touched, but the discomfort usually does not last long.

4. HS and Ingrown Hairs Have Different Treatments

Ingrown hairs typically heal on their own within a few days or weeks when the hair grows and releases from your skin. You can help loosen the hair by applying a warm compress to the area. Sometimes, healing takes longer if the ingrown hair becomes infected.

Avoid picking or squeezing the affected area. Ingrown hair bumps may grow, become more painful, and lead to scarring.

If your symptoms become worse, talk to your healthcare provider or dermatologist. They can recommend medications to reduce inflammation and treat the infection.

HS is a chronic condition, so home care is important, but you will likely need prescribed treatments to manage your symptoms. There are many treatment options, including antibiotics, biologic drugs, and sometimes surgical procedures. You may also need to talk to your doctor about pain management.

5. Ingrown Hairs Are Easier To Prevent Than HS Flares

The best way to prevent ingrown hairs is by not shaving, but this isn’t an option for everyone. If you need to shave, there are a few important practices you can follow:

• Wet your skin with warm water, then apply shaving cream.
• Shave in the same direction the hairs are growing.
• Don’t shave too close or hard against the skin.
• Rinse the razor off after each stroke.
• Apply a cool, wet cloth after shaving.
• Use an exfoliating scrub to release any trapped hairs.
• Avoid shaving every day, if possible.
• Consider laser hair removal or hair removal cream.

Because HS is a chronic condition, you may not be able to prevent it entirely. However, you can take steps to reduce flare-ups:

• Quit smoking if you smoke.
• Avoid hot, humid environments.
• Opt for loose-fitting, breathable clothing.
• Care for your skin at home.
• Follow your treatment plan correctly.

Join the Conversation

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

Have you confused HS with ingrown hairs? Let others know in the comments below.