Hidradenitis suppurativa vs. folliculitis: A comparison

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Researchers are not exactly sure whether there is a relationship between folliculitis and HS. While both diseases can present with similar skin lesions, HS and folliculitis are two different skin conditions.

A 2019 study found that people with disseminate recurrent folliculitis (DRF) — a subtype of folliculitis — had a higher risk of developing HS later on in life. However, beyond that, the researchers did not find any specific connection between the two.

Further research is necessary to determine whether there is any clear relationship with the onset of these skin conditions.

While both HS and folliculitis may cause acne-like skin manifestations, some differences in symptoms help determine whether a person has one condition or the other.

Folliculitis

Folliculitis may cause:

• discolored bumpy rush
• pruritus (itchy skin)
• blisters around the follicles containing pus

HS

HS symptoms may include:

• purple, red, or discolored bumps or deeper nodules
• pain and skin irritation
• cysts or boils that contain pus
• formation of tunnels under the skin between the skin lesions

Location of lesions for both

The location of the rash may also help differentiate the two.

HS is more common in certain areas where the skin rubs together, such as:

• armpits
• inner thighs
• under the breasts
• groin
• anus
• between the buttocks

However, HS is not limited to these areas only.

Folliculitis tends to involve the hair follicles, so it is more likely to develop in areas such as:

• scalp
• arms
• back
• face
• neck
• breasts
• buttocks

There are some differences in the causes and risk factors for both.

Folliculitis

The most common cause of folliculitis is infection with a bacteria called Staphylococcus, also known as Staph. However, other types of fungi and bacteria can also cause it.

People can acquire bacterial folliculitis through skin-to-skin contact or sharing certain items, such as razors or towels, with someone who has folliculitis.

Limited skin hygiene can also increase the risk of folliculitis and trigger its recurrence.

HS

The exact cause of HS is unknown, but experts think it has something to do with genetics and the immune system. HS does not have a link to hygiene and is usually not transmissible.

Some risk factors associated with HS include smoking and obesity. These factors can significantly increase the risk of developing HS symptoms.

HS can occur at any age but usually starts during puberty. This suggests that sex hormones may have a role in the onset of disease. Other factors that may play a part in HS include:

• acne
• excessive hair growth, known as hirsutism
• Crohn’s disease

There are some differences in the treatment of folliculitis and HS.

Folliculitis

Folliculitis tends to be mild and may resolve on its own in a couple of weeks. Doctors may sometimes recommend topical treatments, such as antibiotics, to speed up recovery and fight off the infection.

Other measures can also help, such as applying diluted white vinegar to the area.

If the topical medications do not help with folliculitis, doctors may prescribe other treatments, such as:

• nonsteroidal anti-inflammatory drugs
• antihistamines to help ease itching
• oral antibiotics
• antifungal medication for fungal folliculitis

Once a person recovers from folliculitis, maintaining proper skin hygiene can significantly help prevent its recurrence.

Learn more about folliculitis management.

HS

HS is a chronic condition and usually requires more extensive medical management than folliculitis. In some cases, people with HS may require surgery.

While there is no cure for HS, several medications may help manage it. These include:

• zinc
• topical medications
• pain relief medications
• hormone therapy
• steroids
• antibiotics
• acne washes
• retinoids or vitamin A derivatives
• biologics or medications that alter how the body’s immune system works

Doctors may also recommend undergoing surgery to remove the painful lesions that some people experience with HS. The surgical treatment options may include:

• partial or total excision to remove atypical lesions
• electrosurgical peeling to remove the upper layers of the skin
• deroofing to remove the top layer of the lesion and create a wound

Learn more about HS management.

If a person develops any skin lesions or has concerns about their skin, they should seek medical advice. Healthcare professionals such as dermatologists can diagnose skin conditions and recommend the most appropriate treatment.

HS and folliculitis can both present similar acne-like symptoms. However, they are two distinct skin conditions. Folliculitis occurs due to a fungal or bacterial infection involving the hair follicles. HS is a chronic condition linked to genetics and atypical functioning of the immune system.

Usually, folliculitis tends to be mild and often goes away on its own. Doctors may prescribe antibiotics and other medications to help folliculitis resolve quicker in some more severe cases.

HS has no cure, but several medications can help people manage their condition. Surgery may also be an option to remove painful lesions that may develop on the skin.

A person should always consult a healthcare professional if there are any concerns about skin symptoms, as they can recommend suitable treatment options.