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If you have hidradenitis suppurativa (HS), you may have come to expect bumps and irritation in places like your inner thighs, groin, and armpits. These are areas where apocrine glands, a type of sweat gland, are most active. Apocrine glands release a thick and oily sweat, often triggered by strong emotions or stress.
Even though your feet can get sweaty, the sweat glands on your soles are different. They’re called eccrine glands, and they release a watery sweat that helps regulate body temperature. Because the feet don’t have apocrine glands, HS bumps or sores on the feet are very rare.
If you notice itchy or pus-filled bumps on your feet, another skin condition — not hidradenitis suppurativa — may be the cause. Read on to learn how HS and other conditions can lead to symptoms on the feet.
So far, there’s only one published case of HS appearing on the top of the foot. A similar condition, called idiopathic plantar hidradenitis, mainly affects children and young adults and is somewhat more common. This condition can cause painful, discolored bumps on the soles of the feet, and in some cases, on the palms of the hands.
A few situations that might trigger pus-filled bumps on the feet in people with HS include:
Children with idiopathic plantar hidradenitis are more likely to develop these painful bumps when their feet become overheated or very sweaty. The condition may develop when sweat glands in the feet become clogged.
If you notice sores or pus-filled bumps on your feet, they may be caused by another skin condition occurring alongside HS. Here are some skin conditions that could lead to similar symptoms.
People living with HS are more likely to develop psoriasis, a chronic (long-term) condition that causes skin inflammation. One form, called pustular psoriasis, leads to inflamed pus-filled bumps called pustules. These pustules often appear white or yellow, surrounded by red, brown, or purple skin, depending on a person’s skin tone.
When these bumps occur on the palms of the hands or the soles of the feet, the condition is called palmoplantar pustulosis.
Research suggests that people with HS are more likely to develop psoriasis — and vice versa — than people in the general population. In one Korean study, HS was linked to palmoplantar pustulosis and other forms of psoriasis in about 10 percent of people with HS.
Health experts believe these conditions may overlap because they both involve:
Together, these factors can damage hair follicles and sweat glands, making it more likely for someone to develop both HS and psoriasis.
In rare cases, treatment for HS with biologic drugs called tumor necrosis factor (TNF) alpha inhibitors can actually trigger pustular psoriasis.
If you’re experiencing itchy, pus-filled bumps on your feet, your doctor can help determine whether pustular psoriasis is present along with HS. While oral antibiotics are often used to treat active HS, palmoplantar pustulosis may require a different treatment approach, such as:
Palmoplantar pustulosis can be tough to treat. The fluid-filled blisters on the bottom of the feet may not respond to typical HS or psoriasis medications. Practicing good skin care — like keeping your feet clean, dry, and protected — may help you manage symptoms more comfortably.
Read more about the relationship between psoriasis and HS.
Hidradenitis suppurativa may also be linked to eczema, including atopic dermatitis, the most common form. However, this connection isn’t as well understood. Like psoriasis and hidradenitis, eczema is a chronic inflammatory skin condition. It often goes through cycles of flares (when symptoms worsen) and remission (when symptoms calm down). Eczema also shares some of the same risk factors as hidradenitis, such as smoking.
Dyshidrotic eczema is a specific type that causes itchy, fluid-filled blisters on the hands and feet. While these blisters may not contain pus, they can feel firm, painful, and may appear during times of excessive sweating. If a blister becomes filled with pus, it could be a sign of a secondary skin infection. It’s important to see a dermatologist for evaluation and treatment if this happens.
Small blisters from dyshidrotic eczema typically begin on the soles of the feet but may spread to the tops of the feet in more severe cases. As the blisters heal, they often dry out, which can lead to fissuring — painful cracks in the skin — and scaling on the feet.
Health experts are studying whether people who have both HS and eczema respond to treatment differently than people with HS alone. If you’re diagnosed with dyshidrotic eczema, treatment can involve:
If you’re taking certain HS treatments — such as interleukin (IL)-17 inhibitors or antibiotics — you may be at a higher risk of developing fungal skin infections. That’s because these medications can weaken your body’s ability to fight off fungi that naturally live on the skin. One common fungal infection is tinea pedis, also known as athlete’s foot.
Members of MyHSTeam have talked about getting fungal infections as a side effect of HS treatment. “I have contracted a fungal infection from some of my medication. It’s very sore and just as weepy and stinky as HS,” shared one member.
Another wrote, “After a month on antibiotics, I frequently get a fungal infection because the body can’t fight that due to being on antibiotics for so long.”
Typical symptoms of athlete’s foot include cracked, itchy, and dry skin, especially between the toes. If the infection becomes severe, it may cause fluid-filled blisters or painful sores on the soles of the feet or between the toes. For some people with HS, this could be the source of unexpected foot symptoms.
Talk to your dermatologist or podiatrist about athlete’s foot symptoms, especially before it worsens or becomes infected. Athlete’s foot won’t go away on its own, so getting medical care early is important.
Severe athlete’s foot may be treated with oral antifungal medications or topical antifungal products like ointments or creams. These treatments help control fungal growth, but it’s important to complete the full course of your prescription.
To help prevent future infections:
If you get fungal infections often, your doctor may consider adjusting your HS treatment or changing the dosage.
If you have pus-filled blisters or itchy bumps on your feet along with HS, talk to your primary care provider or a dermatologist.
Foot symptoms in HS are unusual, but that doesn’t mean they should be ignored. Other skin conditions — including fungal infections or eczema — can cause similar symptoms. Getting a professional diagnosis is important so you can receive the right treatment.
Your doctor may:
They may also help by adjusting your HS treatment plan, addressing any underlying conditions, or recommending ways to relieve itching and pain from foot symptoms.
On MyHSTeam people share their experiences with hidradenitis suppurativa, get advice, and find support from others who understand.
Have you dealt with HS symptoms on your feet? Let others know in the comments below.
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