One week, a painful lump shows up on the left side. The next flare may appear on the right or a few inches away. If you have hidradenitis suppurativa (HS) near your vulva or groin, it can feel like the lumps keep coming back nearby, but never in the same place.

HS lesions aren’t traveling across your skin the way an infection spreads, but they can seem to move. That’s because HS can flare in nearby hair follicles within the same general area. When people say “vaginal region,” they are usually referring to HS on the skin around the vagina, such as the vulva and nearby groin area.

Here’s what you need to know.

How Does HS Affect the Groin?

Lesions in the genital area are common and can be especially painful and bothersome. As one myHSteam member shared, “Having a flare right now, and it’s in my groin and vaginal area. It’s so painful. I really wish I could get it under control.”

HS shows up in areas of the body where skin rubs against skin, like the armpits, buttocks, groin folds, and vulva. In these spots, friction, heat, and sweat can irritate the skin and make it easier for a flare to start.

HS causes hair follicles and nearby oil and sweat glands to become blocked and inflamed, leading to a deep, painful lump (often called a nodule or boil). Some lumps turn into abscesses that may leak pus. Repeated inflammation in the same area can also lead to sinus tracts (tunnels under the skin) and scarring.

When HS affects an intimate area like the groin, it can affect daily activities like walking, sitting, using the bathroom, and sexual activity. These challenges are common, and it’s understandable to feel frustrated or exhausted.

Do HS Boils Actually Move?

HS boils do not usually move from one spot to another. What feels like movement is often a new flare nearby or inflammation spreading in the same general area.

Here are a few common reasons that can happen.

A New Flare in a Nearby Hair Follicle

HS occurs in the hair follicles, and the groin has a lot of them packed into a small area. So even if one sore calms down, a new inflamed nodule can show up close by. It might show up a little higher, lower, or on the other side of the vulvar area. It can seem like the same boil moved, even though it’s really a new flare nearby.

Inflammation Spreading in the Same Region

During a flare, inflammation can affect more than one follicle in the surrounding tissue. As a result, the pain or swelling may spread, get worse, or appear in a slightly different spot over a few days. This can make the flare seem like it has shifted, even though it is still affecting the same general area.

Recurring Inflammation

HS often comes back in the same general region because the groin is a friction- and sweat-prone area with a lot of hair follicles. Because HS symptoms tend to come back and can affect both sides of the body, it may seem like the condition is switching from one side to the other. In reality, HS is affecting nearby follicles in the same area.

Interconnected Tunnels

In more advanced HS, some people develop sinus tracts, tunnel-like channels under the skin. These tunnels can connect nearby areas, so irritation and swelling may show up at a different opening from where the flare first started. That can make it feel like the boil moved, especially if one spot drains and another spot pops up soon after.

Do Sinus Tracts Cause HS Lesions To Move?

When sinus tracts are present, HS can feel especially confusing. One sore may calm down while another spot close by becomes swollen and painful. It can seem like a boil shifted when the inflammation is actually spreading through connected tissue under the surface.

Scar tissue can also change the way HS shows up over time. As the body heals after repeated inflammation, skin may become thicker, uneven, or more sensitive in certain areas. Scar tissue can affect how fluid drains, how pressure builds, and where new nodules form, which may make outbreaks feel less predictable from one flare to the next.

If the pattern of your HS suddenly seems to change, like more frequent drainage, new openings, or pain that spreads across a wider area, it may be worth checking in with a dermatologist or other HS-experienced clinician.

Can HS Lesions Appear on Both Sides?

HS doesn’t always follow a neat, predictable pattern. It can show up on one side at a time, but it can also affect the body in a more bilateral pattern (affecting both sides at once), especially in areas like the groin where the skin environment is similar on the left and right.

The groin is a high-friction, high-sweat area with lots of hair follicles, so anything that irritates the skin can set off inflammation on either side.

What Triggers HS Flare-Ups in the Groin?

Because HS affects hair follicles in high-friction, high-sweat zones, the groin can be especially sensitive to everyday triggers. Here’s an overview of common triggers relating to the groin.

Friction

Anything that rubs against the skin — tight clothing, rough seams, or skin-against-skin rubbing — can irritate already-sensitive skin. Over time, friction can make follicles more likely to become inflamed, which may lead to new nodules in the same area.

Shaving or Hair Removal

Shaving, waxing, and some hair-removal creams can irritate the skin and hair follicles. Small nicks, ingrown hairs, or inflammation after hair removal in HS-prone areas can sometimes trigger a flare.

Heat and Sweating

Warmth and sweat can increase friction. Sweat can also trap moisture in skin folds, which may worsen irritation and make flares more likely, especially during exercise, hot weather, or long days in tight clothes.

Join the Conversation

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

Have you noticed any patterns in what triggers HS flares in the vulvar area? Let others know in the comments below.