Hidradenitis suppurativa (HS), or acne inversa, is a skin condition characterized by painful lesions that form in blocked hair follicles. HS mostly occurs on body parts that come into contact with each other, including the inner thighs.
HS affects hair follicles, typically in locations with sweat glands where body parts come into contact with each other. Other common locations include the armpits and groin.
This article will discuss hidradenitis suppurativa when it occurs on the thighs, including symptoms, treatment, and when to contact a doctor.
HS can occur on the thighs. Friction and pressure contribute to HS, and the inner thigh is a
A small 2016 study found that the thighs, groin, and armpits were the three most common HS sites for people with inflammatory bowel disease (IBD).
HS breakouts often look like pimples or boils. They may go away for a while but then reappear.
Other symptoms of HS include:
- lumps that are tender and deep
- breakouts that reappear in the same spot
- skin swelling
- discomfort, such as itching, burning, or excessive sweat, that occurs before a breakout
- lumps that grow and join together
- painful abscesses that break open and leak pus or blood
- unpleasant odor
- spots that look like blackheads, often in pairs
- skin tunnels, known as sinus tracts
- itching and pain
A person may also experience anxiety or depression as a result of the condition.
People with arthritis may notice increased joint pain when they develop HS.
People with skin lesions on their thighs may also have lesions in primary HS locations such as the armpits or groin area.
While there is no cure for HS, treatment can prevent the condition from worsening.
Treatment benefits can include:
- reduction in flare-ups
- pain relief
- wound healing
A dermatologist can customize a person’s treatment according to the severity of the condition and how it affects their life.
Learn more about HS treatment at home.
Areas of skin with HS may become irritated if a person uses certain skin care products or soaps.
A dermatologist can create a skin care plan that may include a benzoyl peroxide wash. Switching deodorants or antiperspirants can also help.
People with more advanced HS may need wound care, including:
- regular dressing changes
- antiseptic wash or diluted white vinegar compress
Hyperbaric oxygen therapy (HBOT) might be an option for wounds that do not heal. This procedure can increase blood oxygen levels to aid in wound healing.
Learn more about open wound care.
The American Academy of Dermatology Association (AAD) lists several types of medications to treat HS. They include:
- Antibiotics: Examples include dapsone or clindamycin to treat infection and pus-filled lumps. Sometimes doctors prescribe a combination of antibiotics.
- Resorcinol: This helps to reduce inflammation and unclog hair follicles.
- Acitretin: This oral medication is a retinoid that acts similarly to vitamin A.
- Hormonal medications: Examples include finasteride, birth control pills, and spironolactone.
- Biologics: This type of medication can affect the immune system and reduce inflammation and pus.
- Metformin: This is a drug typically used to treat type 2 diabetes, which can also reduce inflammation.
Hidradenitis suppurativa can be painful, so managing pain is part of HS treatment. A doctor may suggest:
- topical treatments, such as lidocaine, ice packs, or prescription medication
- pain relief medication, such as over-the-counter or prescription
- complementary therapies, such as medical cannabis and acupuncture
A dermatologist can refer someone to a pain specialist if the usual pain relief treatments are ineffective.
A dermatologist can perform in-office procedures to help treat HS. These include:
- laser hair reduction to reduce the number of sites where HS lumps can form
- laser surgery to vaporize HS lesions
- corticosteroid injections to reduce inflammation
- botulinum toxin (Botox) to reduce excessive sweating
- abscess draining to relieve pain and pressure
- deroofing to remove the skin covering a sinus tract so that it can heal without returning
- wide excision to remove lesions, such as tunnels beneath the skin
If a person develops an unusual lesion or abscess on their skin, a healthcare professional can refer them to a dermatologist who can determine whether they have HS. A correct diagnosis can lead to helpful treatment.
For people with HS, it is important to closely monitor the skin and advise a healthcare professional of any changes. For example, if one of the sores starts to leak fluid, they can take a swab test for infection.
HS can cause skin infections such as
- an increase in pain, redness, swelling, or warmth
- red streaks extending from the area
- a pitted appearance to the skin, like an orange peel
Sepsis is a chain reaction that occurs throughout the body in response to an existing infection. It requires urgent medical care. Sepsis symptoms
- shivering and chills
- weak pulse or high heart rate
- extreme discomfort or pain
- pale, sweaty, or clammy skin
- shortness of breath
- cognitive changes such as confusion or disorientation
Sepsis is a life threatening condition requiring immediate medical assistance.
People who have had HS for a long time should also monitor the affected areas for other skin changes. This is because some individuals have a higher risk of developing squamous cell carcinoma (SCC).
HS is a painful and chronic skin condition that can occur on the thighs. HS sites are often those with sweat glands and hair follicles and where body parts come into contact, so the inner thigh is a common location.
There is no cure for HS, but treatment is available to ease symptoms. Continuous condition monitoring is important since HS can lead to complications such as skin infections and sepsis.