The short answer is nobody knows. But, the long answer is that there are lots of ideas. Doctors believe the primary mechanical problem is follicular occlusion. Which is just a fancy way of saying your hair follicles get blocked. When that happens, the chaos you know as HS ensues.

There are a few theories on why this happens. The first is genetics. Research indicates that HS may be a mutation in a set of genes. A third of patients with HS have a family history of HS. But doctors think that the gene responsible for HS is autosomal. Which means that you don’t need to have a family member with the disease to develop HS. We have an article on the genetic theory of HS, which you can read here.

The second theory is the sex hormones (in women). HS most often begins in one’s teen years. The average age of onset is 20. A 2020 paper has shown that HS symptoms worsen around a woman’s period. The paper also found that menopause may exacerbate HS symptoms contrary to previous studies. So, some doctors believe the cause of HS may have something to do with sex hormones.

The third theory revolves around the immune system and a dysregulation or malfunction of some of the cells that usually keep us safe. This is the focus of a lot of research, but there are no definite answers just yet.

HS can affect any part of your body, but it is mostly found in areas where your skin rubs against itself such as:

Underarms : Under The Breast : Groin : Ears : Back Of The Neck : Inner Thighs : Buttock

If you think you have HS consider the following:

– Have you had a boil that becomes inflamed, heals and comes back at least once in the past six months?
– Or do you have scarring from boils that have healed?
If the answer is yes to these questions, then you may have HS. But, to confirm that you must see a doctor.