Hidradenitis suppurativa is a chronic condition that causes abscesses and nodules on the skin. Although it is more common in areas like the groin or buttocks, it can also occur on the face. With proper treatment, people can manage their symptoms effectively.

Most people with hidradenitis suppurativa develop this condition between 21–29 years old. It is a rare disorder, affecting only around 1–4% of people.

Abscesses from hidradenitis suppurativa can be very painful and generally cause scarring. Individuals with hidradenitis suppurativa on the face may also experience mental health complications. This condition can also make daily activities, like work or school, challenging.

Read on to learn about symptoms, complications, causes and risk factors, treatment, frequently asked questions, and the outlook for a person with hidradenitis suppurativa.

Hidradenitis suppurativa may look like pimples or boils at first. However, over time, these growths worsen and become more painful. Abscesses begin to form and fill with fluid. They eventually burst and lead to scarring.

The symptoms of hidradenitis suppurativa vary between individuals and affected areas. But common symptoms may include:

  • painful nodules or abscesses
  • skin pores filled with oil or debris
  • firm lesions full of fluid
  • small lesions filled with pus

Facial hidradenitis suppurativa is uncommon, so it can be difficult to recognize the signs. Researchers have found that the type of facial scarring can indicate the presence of this condition.

Scars that resemble ropes on the skin’s surface are typical of hidradenitis suppurativa. Cribriform scarring may also be a sign of hidradenitis suppurativa. This type of scarring involves multiple small holes in the skin.

Learn about hidradenitis suppurativa on the neck.

The most common complication of hidradenitis suppurativa is scarring. Severe scarring can make it hard for the body to drain fluids.

If left untreated, these scars can cause permanent disfiguration. However, severe facial scarring from hidradenitis suppurativa is extremely rare.

In rare cases, this may lead to swelling of affected regions. Other complications may include:

Learn more about hidradenitis suppurativa scarring.

Facial hidradenitis suppurativa can also negatively affect social experiences. One study found that nearly 30% of participants with hidradenitis suppurativa experienced depression or anxiety.

In another study, 100% of participants reported that active lesions from this condition affected psychological or physical well-being. Over 80% of these individuals noted that scarring and other skin damage caused psychological distress.

Hidradenitis suppurativa on the face may cause more psychological complications than in other locations. The visibility of this condition is likely behind these negative outcomes.

Certain treatment options may also cause complications. 2022 literature examined the rate of these complications. Researchers estimated this rate to be around 11%. Certain surgical techniques may carry higher risks than others. Over 16% of people who undergo surgery experience a relapse of hidradenitis suppurativa.

The cause of hidradenitis suppurativa remains poorly understood, but researchers believe that most cases originate in hair follicles.

When hair follicles become clogged, bacteria can grow within them. This can gradually lead to painful nodules or abscesses. After abscesses burst, the pus they contain may affect other body parts.

Risk factors

Certain risk factors also make someone more likely to develop this condition. These factors can include the following:

  • having a relative with hidradenitis suppurativa
  • being overweight or obese
  • smoking
  • having psoriasis

Hidradenitis suppurativa is generally more common in women, but researchers have found that facial hidradenitis suppurativa is more common in men.

Individuals with weakened immune systems may also be at higher risk of developing this condition. A 2021 study examined a case of facial hidradenitis suppurativa in a man with human immunodeficiency virus (HIV). Researchers noted that having HIV increased the risk of also developing hidradenitis suppurativa.

People with a family history of this condition may consider speaking with a doctor to learn more. Individuals at risk for hidradenitis suppurativa should visit a medical professional if they begin experiencing symptoms.

As facial hidradenitis suppurativa is so rare, the triggers of this condition remain poorly understood.

However, one of these triggers may be smoking. Between 70–90% of people with hidradenitis suppurativa smoke cigarettes.

Smoking a cigarette may cause or worsen facial hidradenitis suppurativa in certain cases. Gaining weight can also increase the chance of developing this condition.

Hidradenitis suppurativa originates in hair follicles. As a result, clogged follicles on the face’s surface may also trigger facial hidradenitis suppurativa.

There is currently no single cure for facial hidradenitis suppurativa. However, lifestyle changes may improve or eliminate hidradenitis suppurativa symptoms on the face.

Treatment options may include:

  • weight loss
  • following a balanced diet
  • quitting smoking
  • using antibacterial soap
  • topical treatments
  • antibiotics
  • surgery

Many people with this condition can benefit from surgical treatment. This can also help reduce the appearance of facial scarring. Other options for treating facial scars can include the following:

As facial hidradenitis suppurativa is uncommon, the research on treatment remains limited. Individuals living with this condition should work with their doctor to determine the most appropriate treatment and prevention options.

Individuals living with hidradenitis suppurativa may have additional questions about their condition. We will review a few of these below.

Is hidradenitis suppurativa similar to any other conditions?

Hidradenitis suppurativa can mimic other conditions. This often leads to delays in diagnosis. In the early stages, individuals may mistake their symptoms for those of a typical acne breakout.

These symptoms may also resemble those of:

What other areas of the body does hidradenitis suppurativa affect?

This condition can affect the following:

  • groin
  • genitals
  • buttocks
  • breasts
  • armpits
  • the skin around the anus

It may also occur near the ears or around the belly button.

Can hidradenitis suppurativa be prevented?

Certain lifestyle changes may reduce the chance of developing hidradenitis suppurativa.

However, researchers do not fully understand the reasons behind this condition. Future studies may shed more light on effective prevention strategies.

Does hidradenitis suppurativa affect work?

The severity of hidradenitis suppurativa can vary widely. Due to this, its effect on work eligibility differs between individuals. In severe cases, individuals may face social stigma because of their appearance. This can affect their ability to participate in work or school activities.

Abscesses and nodules can also be very painful. This discomfort may limit a person’s ability to perform work duties.

Is hidradenitis suppurativa considered a disability?

Some individuals with hidradenitis suppurativa may qualify for disability benefits. To qualify, these individuals must experience symptoms for at least 3 months.

These symptoms must persist even after treatment. Also, individuals who qualify for disability must have extensive lesions across their skin.

The outlook for hidradenitis suppurativa varies between individuals. Although there is no cure, treatment can help individuals manage their symptoms. An early diagnosis increases the chance of responding well to treatment.

The effects of this condition can interfere with daily activities. Discomfort can make it hard to carry out certain tasks. Individuals with hidradenitis suppurativa are at a higher risk of developing mental health conditions.

Hidradenitis suppurativa is a skin condition involving painful lesions or abscesses. In rare cases, this condition can affect the skin on the face.

When hidradenitis suppurativa occurs on the face, it can lead to infections and permanent scarring. The presence of abscesses or scars on the face can also increase the chance of developing mental health conditions.

Although there is no cure for facial hidradenitis suppurativa, many treatment options are available. Lifestyle changes, medication, or surgery may also help manage this condition.