While healthcare professionals do not know the exact cause of hidradenitis suppurativa (HS), evidence notes that genetic factors can play a role in developing the condition.

HS is a condition involving nodules and abscesses across the skin. It often occurs near hair follicles where sweat glands are present, such as the groin, bottom, breasts, and armpits. In many cases, certain genetic changes may have a link with this condition.

The specific cause of HS is not clear. But some individuals are more likely to develop this disease than others. Females, people who smoke, and people with obesity are at higher risk.

Around 1 in 3 people with HS have family members with this condition. Although genetics can play a role, other factors contribute to developing HS.

This article discusses the genetic factors of HS, other causes and risk factors, and seeking medical advice.

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Some evidence suggests that 30–40% of people with HS have one or more family members with the condition. A 2020 study indicates that as many as 77% of participants have family members with HS. This suggests that the number of cases associated with genetics may be higher than previously thought.

This implies that inheriting certain gene alterations may play a role in developing the condition. However, while genetic predisposition may be involved, environmental and lifestyle factors, such as smoking and obesity, can also contribute to the condition.

Researchers have noted certain genetic alterations in individuals with HS. Some affected genes may include:

  • PSEN1

These genes control an enzyme complex called the γ-secretase complex. This complex helps break down proteins inside cells.

The PSENEN protein activates certain elements of the γ-secretase complex. This protein also plays a part in pigmentation. Mutations in the PSENEN gene may lead to HS in certain cases.

About 39 of 57 gene variations in individuals with HS occur in the NCSTN gene. This gene codes for a protein that helps assemble the γ-secretase complex. Mutations in NCSTN can prevent this complex from properly breaking down proteins.

The PSEN1 gene also controls the structure of the γ-secretase complex. Alterations in this gene affect the function of this complex. These gene variations can also contribute to Alzheimer’s disease.

Researchers believe that these alterations can negatively affect immune function. They may also lead to increased inflammation. As such, they may manifest as the painful skin growths and immune issues associated with HS.

Although genetic factors may contribute to HS, there are numerous other causes and risk factors. For example, most people with this condition are more likely to experience overweight or obesity.

Obesity can contribute to increased skin friction. It can also lead to greater sweat production or a hormonal imbalance. All of these factors may worsen HS symptoms.

Smoking is also a major risk factor for this condition. Evidence suggests this may be due to tobacco- and nicotine-promoting proteins that are present in HS lesions. Nicotine can also affect skin bacteria. Changing the skin’s bacterial makeup may be associated with the development or worsening of HS in some cases.

People with HS are also more likely to have other health conditions. These may include:

There is no single known cause for HS. But genetics, lifestyle factors, and other health conditions may contribute to this condition.

It is advisable for those experiencing symptoms of HS to consult a doctor. These symptoms may include:

  • indented areas of skin that contain blackheads
  • painful lumps that grow and burst over time
  • abscesses full of fluid or leaking pus
  • scarring as these abscesses heal

These growths and abscesses can be extremely painful. If left untreated, they can become infected.

The symptoms of HS can also lead to anxiety and depression. Additionally, evidence notes a potential association between HS and the development of skin cancer.

Receiving a diagnosis and treatment as early as possible can increase the chance of responding to treatment. Treatment may include medications, lifestyle changes, and specialized skin care. As such, it is advisable for people to contact a doctor to help manage symptoms and slow disease progression.

Learn how to manage symptoms of HS.

HS is a chronic skin condition that causes nodules and abscesses. Over time, these abscesses may burst and lead to advanced scarring.

In many cases, people with HS have relatives with this condition. Certain genetic changes may increase the risk of developing HS. However, lifestyle and environmental factors also contribute.

With early diagnosis and prompt treatment, individuals with HS can manage their symptoms. Getting the right support is crucial for managing pain and slowing progression.