Hidradenitis suppurativa care in NY, NJ, & CT

Hidradenitis Suppurativa (HS) is a chronic and often painful skin condition that can significantly impact quality of life.

Characterized by recurring bumps, abscesses, and scarring in sensitive areas, HS often goes undiagnosed or misdiagnosed for years, leading many to suffer in silence.

At Advanced Dermatology, P.C., we understand the physical discomfort and emotional frustration HS can bring. Our board-certified dermatologists specialize in diagnosing and treating HS with compassion, clarity, and evidence-based solutions tailored to your needs.

Keep reading to learn more about hidradenitis suppurativa, or schedule an appointment today to start a personalized care plan.

What is Hidradenitis suppurativa?

Hidradenitis suppurativa is a chronic inflammatory skin condition that affects hair follicles, most commonly in areas with friction, sweat, or apocrine glands such as the underarms, groin, buttocks, and breasts.

It causes painful, swollen nodules that may rupture and drain, leading to sinus tracts and scarring.         

How common is hidradenitis suppurativa?

HS affects between 1% and 4% of the U.S. population, according to federal data. However, the actual number may be higher because the condition is often mistaken for boils or infections. Many people live with HS for years before receiving an accurate diagnosis.

Who is most likely to develop hidradenitis suppurativa?

HS most commonly develops after puberty and is more frequent in:

• Women.
• Individuals with a family history of HS.
• People with metabolic conditions like obesity or insulin resistance.
• Smokers.

Is Hidradenitis suppurativa an autoimmune or inflammatory condition?

Hidradenitis suppurativa is an inflammatory skin condition, not an autoimmune disease. It causes painful bumps and is linked to inflammation, not the immune system attacking itself.

Understanding HS as a chronic inflammatory skin disease

HS is a long-lasting, inflammatory skin disease. Unlike autoimmune conditions, Hidradenitis suppurativa is primarily caused by inflammation — not by the immune system attacking healthy tissue.

How HS affects hair follicles and sweat glands

HS typically begins with inflammation around hair follicles, mainly in body areas where skin rubs together, such as the underarms, groin, buttocks, and under the breasts.

The disease affects apocrine sweat glands, causing blockages and swelling. This inflammation can lead to tender lumps, tunnels under the skin (sinus tracts), and even scarring.

Does hidradenitis suppurativa spread over time?

HS usually starts in one area, but without treatment, it can spread to other regions of the body. The disease may progress from mild to moderate or severe forms, making early intervention and ongoing care crucial.

Hidradenitis suppurativa symptoms

The symptoms of hidradenitis suppurativa typically appear in skin folds and progress over time. Key symptoms include:

• Painful, red bumps under the skin.
• Blackheads in clusters.
• Abscesses that break open and leak pus.
• Tunnels (sinus tracts) under the skin.
• Thick, rope-like scarring.

Early signs of HS skin condition

The earliest signs of HS include small, painful bumps or nodules. These lumps may look like pimples or boils and often occur in areas prone to friction. Over time, they can become larger, break open, and leak pus, sometimes causing a foul odor.

Stages of hidradenitis suppurativa symptoms

HS is often described using the Hurley staging system:

• Stage I: Isolated boils or nodules without scarring.
• Stage II: Recurrent abscesses with limited tunneling and scarring.
• Stage III: Extensive interconnected tracts, chronic inflammation, and significant scarring.

How to differentiate hidradenitis suppurativa from other skin conditions

HS may be mistaken for:

• Ingrown hairs.
• Folliculitis.
• Acne.
• Cysts.

What sets HS apart is the pattern, persistence, and recurrence of painful bumps in specific areas and their tendency to heal with scarring.

If you’ve experienced recurring boils or abscesses in the same places, it’s time to speak with a dermatologist.

Hidradenitis suppurativa causes

The exact cause of hidradenitis suppurativa is still not fully understood. However, it’s believed to result from follicular occlusion (blocked hair follicles), followed by inflammation and infection.

Factors that may contribute include:

• Genetics.
• Hormonal changes.
• Smoking.
• Obesity.
• Immune system dysregulation.

HS is not contagious and is not caused by poor hygiene.

What triggers hidradenitis suppurativa flare-ups?

HS flare-ups can be triggered by heat, sweating, friction, tight-fitting clothes, stress, and hormonal changes (such as during menstruation). Lifestyle factors like obesity and smoking can also increase flare frequency and severity.

Genetic, hormonal, and lifestyle risk factors

While the exact cause of HS is not fully understood, there is evidence that genetics plays a role, as HS sometimes runs in families. Hormonal changes, particularly during puberty, can influence the onset. Obesity and smoking are significant risk factors, and making healthy lifestyle choices can be part of effective management.

How is hidradenitis suppurativa diagnosed?

There is no specific test for HS. Diagnosis is based on:

• Physical exam of the affected areas.
• History of recurring abscesses in the same location.
• Assessment of disease stage and symptoms.

Early diagnosis is key to managing the condition effectively and preventing progression.

Physical exam and clinical evaluation

A dermatologist will examine affected skin areas, review your symptoms, and ask about your medical history. The physician may look for classic signs such as recurrent, painful bumps in typical body locations, as well as scarring or drainage.

When imaging or additional testing is needed

In some cases, additional testing, such as ultrasound or MRI, may be recommended to assess the depth and extent of the disease, especially if tunnels or sinus tracts are suspected. Lab tests may be used to rule out infections or other conditions.

Treatment options for hidradenitis suppurativa

While there is no permanent cure for HS, effective treatments are available to manage symptoms, reduce flares, and improve quality of life.

At Advanced Dermatology, P.C., we create personalized treatment plans based on your symptoms, stage, and skin type.

Biologic therapy and advanced anti-inflammatory care

For moderate to severe HS, advanced therapies such as biologic medications are available. These drugs target specific pathways in the inflammatory process and can be given by injection. The Advanced Dermatology, P.C. team stays up to date on the latest biologic and anti-inflammatory treatments to provide cutting-edge care for HS.

Laser and procedural therapies

Laser hair removal and other procedural treatments can help reduce flare-ups and scarring. In some cases, surgical removal of persistent or severe nodules and draining abscesses may be necessary. Our clinics offer a range of in-office procedures tailored to your needs.

Medical treatments for hidradenitis suppurativa

Medical dermatology treatments may include:

• Antibiotics: Oral or topical, to treat and prevent infection.
• Biologics: Such as adalimumab (Humira®) to reduce inflammation.
• Hormonal therapy: For patients with hormone-related triggers.
• Steroid injections: To reduce swelling and pain in active lesions.

Surgical options for severe cases

• Incision and drainage: For painful abscesses (not a long-term solution).
• Laser therapy: To destroy hair follicles and reduce recurrence.
• Excision surgery: To remove chronic or scarred tissue in advanced HS.

Topical and oral medications

• Antibacterial washes (e.g., chlorhexidine).
• Retinoids (vitamin A-based medications).
• Oral anti-inflammatories.

Lifestyle modifications to manage hidradenitis suppurativa

• Quit smoking to reduce inflammation.
• Weight management to minimize skin friction.
• Wear loose-fitting, breathable clothing.
• Avoid shaving the affected areas.

Can hidradenitis suppurativa be permanently cured?

While there is currently no permanent cure for HS, many patients achieve significant improvement and prolonged symptom-free periods through a combination of medical and lifestyle interventions. The goal is long-term management and improved quality of life.

Long-term HS management vs. cure expectations

HS requires ongoing management. Our team at Advanced Dermatology, P.C., partners with you to create a personalized long-term care plan. We help set realistic expectations, focusing on symptom control, minimizing flare-ups, and preserving skin health.

When should you see a hidradenitis suppurativa specialist?

You should consult a dermatologist experienced in hidradenitis suppurativa if:

• You have recurring boils, cysts, or painful nodules in skin folds.
• Over-the-counter or general treatments haven’t helped.
• You’re starting to develop scars, tunnels, or skin changes.
• HS is affecting your ability to work, exercise, or socialize.

Prompt evaluation and proper diagnosis can significantly improve outcomes.

Choosing a dermatologist for HS treatment

Choosing a dermatologist with experience in HS is vital. Our board-certified dermatologists in NY, NJ, and CT have expertise in diagnosing and treating HS, providing compassionate, evidence-based care tailored to each patient.

Our approach to hidradenitis suppurativa care

At Advanced Dermatology, P.C., we recognize that HS affects more than just your skin. It can also affect your emotional well-being and confidence.

Our team of board-certified dermatologists takes a compassionate, multidisciplinary approach that includes:

• Thorough evaluation and diagnosis.
• Customized treatment planning.
• Long-term symptom management and monitoring.
• Coordination with other specialists when needed.

We’re here to help you regain control and live more comfortably with HS.

Frequently asked questions about hidradenitis suppurativa

The Advanced Dermatology, P.C. team is committed to ongoing patient education and support. Here are answers to some common questions: