Painful Lumps? Why It's Hidradenitis Suppurativa & Medical Steps to Heal

If you're dealing with painful, recurring lumps under the skin, especially in areas like the armpits or groin, you may be wondering what's going on. Many people assume these bumps are simple boils or ingrown hairs. But when they keep coming back, worsen over time, or leave scars, the cause may be hidradenitis suppurativa (HS).

Hidradenitis suppurativa is a chronic inflammatory skin condition that requires medical care. It's not caused by poor hygiene, and it's not contagious. Understanding what it is—and how it's treated—can help you take control of your health and prevent long-term complications.

---

What Is Hidradenitis Suppurativa?

Hidradenitis suppurativa (HS) is a long-term inflammatory condition that affects areas of the body where skin rubs together and where there are sweat glands and hair follicles.

Common areas include:

• Armpits
• Groin
• Buttocks
• Inner thighs
• Under the breasts

HS begins when hair follicles become blocked. This leads to inflammation deep under the skin, forming painful lumps or nodules. Over time, these can rupture, leak fluid, and create tunnels under the skin (called sinus tracts). Repeated flare-ups can cause thick scarring.

HS is considered a medical disease, not a cosmetic problem.

---

What Do Hidradenitis Suppurativa Lumps Feel Like?

People with hidradenitis suppurativa often describe:

• Deep, painful bumps under the skin
• Tender areas that feel warm
• Lumps that grow over days
• Drainage with an unpleasant odor
• Recurring lesions in the same spots
• Scars that thicken or form rope-like bands

Early on, HS may look like a simple boil. But unlike a regular boil, HS often:

• Comes back in the same area
• Involves multiple lumps at once
• Gets worse over time without treatment

If this sounds familiar, you can take a free, AI-powered Hidradenitis Suppurativa symptom checker to help determine whether your symptoms align with this condition and guide your next steps toward getting a proper diagnosis.

---

Why Does Hidradenitis Suppurativa Happen?

The exact cause of hidradenitis suppurativa isn't fully understood, but research shows it involves:

• Blocked hair follicles
• Immune system overactivity
• Chronic inflammation
• Genetic factors

HS is not caused by:

• Poor hygiene
• Infection (though infections can happen secondarily)
• Using deodorant
• Shaving

Risk factors include:

• Family history of HS
• Smoking
• Obesity
• Onset after puberty (most common in people aged 20–40)

HS affects women more often than men and can significantly impact quality of life.

---

Stages of Hidradenitis Suppurativa

Doctors often classify hidradenitis suppurativa into three stages (Hurley stages):

Stage 1

• Single or few abscesses
• No tunnels or scarring

Stage 2

• Recurrent abscesses
• Tunnels under the skin
• Some scarring

Stage 3

• Widespread involvement
• Multiple interconnected tunnels
• Significant scarring

Early diagnosis and treatment can prevent progression from Stage 1 to more advanced disease.

---

Medical Steps to Heal and Manage Hidradenitis Suppurativa

There is currently no complete cure for hidradenitis suppurativa, but many effective treatments can reduce flares, control pain, and limit scarring.

Treatment depends on severity.

1. Topical Medications (Mild HS)

For early or mild disease, doctors may prescribe:

• Topical clindamycin (an antibiotic gel or lotion)
• Antiseptic washes

These help reduce inflammation and bacterial overgrowth.

---

2. Oral Medications

For more persistent hidradenitis suppurativa:

• Oral antibiotics (such as doxycycline or clindamycin + rifampin)
• Hormonal therapy (in some women)
• Anti-inflammatory medications

These treatments help calm the immune response driving HS.

---

3. Biologic Therapy

For moderate to severe hidradenitis suppurativa, biologic medications may be recommended.

• Adalimumab is FDA-approved for HS
• These medications target specific immune pathways

Biologics can significantly reduce flare frequency and improve quality of life, but they require monitoring by a healthcare provider.

---

4. Steroid Injections

Doctors may inject corticosteroids directly into painful nodules to:

• Reduce swelling
• Decrease pain
• Prevent progression

This can provide relatively quick relief.

---

5. Surgical Options

In advanced hidradenitis suppurativa, surgery may be necessary.

Options include:

• Drainage of painful abscesses
• Removal of tunnels
• Wide excision of severely affected areas

Surgery can dramatically improve severe disease but is typically reserved for later stages.

---

Daily Self-Care That Supports Healing

While medical treatment is essential, certain lifestyle steps may help reduce flares:

• Stop smoking (if applicable)
• Maintain a healthy weight
• Wear loose-fitting clothing
• Avoid friction in affected areas
• Use gentle skin cleansers

Do not squeeze or pop lesions. This can worsen inflammation and scarring.

---

When Should You See a Doctor?

You should speak to a healthcare professional if you have:

• Recurrent painful lumps
• Lesions that don't heal
• Drainage with odor
• Increasing scarring
• Fever or spreading redness

HS can sometimes become complicated by serious infection. If you experience:

• High fever
• Rapidly spreading redness
• Severe, worsening pain

Seek urgent medical attention.

Even if symptoms feel manageable, early medical care can prevent long-term damage. Always speak to a doctor about any symptoms that could be serious or life-threatening.

---

The Emotional Impact of Hidradenitis Suppurativa

Hidradenitis suppurativa doesn't just affect the skin. Chronic pain, drainage, and scarring can lead to:

• Embarrassment
• Social withdrawal
• Anxiety or depression

These reactions are understandable. HS is a medical condition, not a personal failing. If emotional distress is affecting your daily life, speak to your doctor about support options.

---

Why Early Diagnosis Matters

Many people with hidradenitis suppurativa wait years before receiving a diagnosis. It's often mistaken for:

• Recurrent boils
• Acne
• Ingrown hairs

The earlier HS is diagnosed, the better the chance of:

• Slowing disease progression
• Reducing scarring
• Improving quality of life
• Avoiding major surgery

If you suspect your painful lumps may be related to this condition, using a trusted Hidradenitis Suppurativa symptom assessment tool can provide valuable insights before your doctor's appointment.

---

The Bottom Line

Painful, recurring lumps in the armpits, groin, or other skin-fold areas may be more than simple boils. Hidradenitis suppurativa is a chronic inflammatory condition that requires medical evaluation and long-term management.

While there is no cure, effective treatments can:

• Reduce flare-ups
• Control pain
• Prevent scarring
• Improve daily life

The key is early recognition and partnership with a healthcare provider.

If you are experiencing symptoms that match hidradenitis suppurativa, don't ignore them. Use a reliable symptom tool, then speak to a doctor to confirm a diagnosis and create a personalized treatment plan—especially if your symptoms are worsening or could indicate something serious.

You are not alone, and effective medical help is available.