4 physical signs you have an often misdiagnosed skin condition that increases the risk of depression and scarring, and how to treat it

A close-up of a woman’s blackhead-like bumps caused by hidradenitis suppurativa.Getty Images

  • Hidradenitis suppurativa (HS) is an often misdiagnosed skin condition that appears on the armpits and groin.

  • HS can lead to disability and depression if left untreated.

  • Painful, itchy, pus-filled bumps on the armpits, buttocks, genitals, and breasts are signs of HS.

Hidradenitis suppurativa is a rare but potentially debilitating skin condition that can leave patients permanently scarred or disabled.

Man with hands in front of penis because of pain.

The man had been in “excruciating” penile pain for three days before reporting to doctors.Getty

A skin condition that affects the armpits, genitals, and breasts can have devastating effects on patients, but is often misdiagnosed.

Hidradenitis suppurativa (HS) affects only 1 to 4 percent of the population, according to the Cleveland Clinic, but the condition can be “extremely life-threatening.” The disease can cause painful, itchy, pus-filled bumps to form under the skin, and the size and pain of HS legions can create problems with mobility and flexibility. Patients with extended legions may qualify for federal disability benefits.

Patients with HS are also more likely to suffer from depression and anxiety, according to a 2020 meta-analysis published in the Journal of the American Academy of Dermatology. A 2018 article in the Journal of Investigative Dermatology found that patients with HS have a significantly higher risk of suicide, which the authors considered a “very clear indicator of the depth to which HS can affect patients’ lives.

The condition is often misdiagnosed due to patient embarrassment about seeing a doctor, a doctor not knowing the signs of HS, and misinformation about treatments, Men’s Health reported.

HS begins during puberty and is more common in blacks, smokers, overweight people, and women. If detected early, doctors can manage the condition with antibiotics, prescription ointments, hormonal pills and steroid injections, according to Kaiser Permanente.

Physical signs of this rare but debilitating condition include itchy lumps that coalesce over time and cysts that form on the groin, armpits, or buttocks.

You have lumps the size of marbles or peas under the skin.

the nurse feels patient for the bumps on her chest

LUIS ROBAYO/AFP via Getty Images

The most common signs of hidradenitis suppurativa are painful, pea-sized bumps under the skin, according to the Mayo Clinic. The condition begins as a painful mass that can persist for weeks or months. Often the lumps heal slowly and come back, sometimes splitting open and leaking smelly pus.

HS can also present as multiple blackheads appearing in small pitted areas of the skin.

Your groin, genitals, armpits or buttocks are pimples and itchy.

man reaching and itching his armpit

Getty Images

The skin condition affects areas that rub together and contain sweat glands, such as the armpit, groin, genitals, breasts, and buttocks.

Texas dermatologist Adam Mamelak told Men’s Health that people with hidradenitis suppurativa might feel embarrassed to see a doctor because the areas affected by the condition are tender, delaying diagnosis.

Your skin appears red, tender and swollen in places.

Woman holds her chest in pain with two hands

Getty Images

HS causes clogged and inflamed hair follicles or sweat glands due to abnormal proliferation of cells. A person with the condition may have red, tender, and swollen skin around the armpits, buttocks, and other areas of the body that rub together, which is an early sign of HS, according to the Cleveland Clinic.

Lumps that look like acne or boils start to grow and clump together.

small boil on the skin

Getty Images

The American Academy of Dermatology Association (AADA) has stated that cysts or boils caused by hidradenitis suppurativa heal and reopen repeatedly, causing hollow tunnels called sinus passages to form under the skin.

The tunnels can cause lumps of hidradenitis suppurativa to grow and coalesce as the disease progresses. These could turn into abscesses that fill with fluid, such as pus or blood, and become painful, according to the AADA.

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