The symptoms of HS can vary quite a bit. Some people experience very mild symptoms, and some people experience very severe symptoms.  We will try to describe as many as possible in this article:

Mild symptoms and early warning signs

The most common areas that are affected by HS are the armpits, the groin, the thigh, buttocks, and genitals. But it can affect almost any area of the body, like the neck, back and chest, the ears, arms, and legs. So, the following applies to all areas of the body, but pay attention in particular to the common areas.

Blackheads

You might notice an area of skin that has little groups of blackheads, and some of these blackheads might appear in pairs, or there might be a tiny tunnel in your skin, with a blackhead in each end.  These in particular can be a sign of HS, and you should see a dermatologist who will recognise this.

Painful lumps under the skin

HS often begins with a single or several small, innocent looking lumps under the skin. The lumps may be red and hard, or they might be soft and feel like there is fluid inside them. Often, they do not go away, but will sit there under the skin for weeks and months.

Sometimes they will burst open, drain pus, or blood, and eventually heal, leaving a scar. If you notice an area of your skin that has lots of small scars from these lumps, it could be a sign of HS. Scarring is a signature of HS and should not be ignored.  You or your doctor might think it is just a boil, or an ingrown hair. But if this occurs more than once in the same area, it could be HS.

There are many words used to describe these lumps and bumps. Words such as:

  • Boils
  • Abscess
  • Lesion
  • Nodule
  • Cyst

More severe symptoms of HS

Swelling

The lumps can become very swollen and fill up with pus. These can become extremely large and painful. They can restrict movement and you might find it difficult to walk or to move your arms.  Sometimes these lumps will eventually come to a head and drain a foul smelling pus. It can drain for days, or even weeks.

Sometimes they get so painful and swollen that you may need to get medical attention and have a procedure called an incision and drainage. If you find yourself having a procedure like this, make sure to tell the doctor that you suspect it is HS and ask to be referred to a dermatologist.

The lumps may keep filling up and draining for several days or weeks. And when they eventually close over, there may be scarring.

Tunnels

As the disease progresses, it can get worse and cause more damage to the skin.

The lumps can begin to form tunnels underneath the skin. These can become swollen and drain pus constantly. These tunnels are also called sinus tracts. Sometimes you will be able to feel them under the skin, or if you press one part of it, you might see pus coming out from another part of it. It might cause some holes to open up in your skin. It can be very painful and worrying.

Scarring

The cycle of the lesions appearing, draining, and healing, along with the formation of tunnels can cause the skin to contract and form scars that look like knots or are rope like in appearance. It can cause the skin to become tight and restrict movement.

Other symptoms of HS

HS is often underestimated as a skin condition. But it can affect us in so many ways. HS is an inflammatory disease and can wreak havoc on our bodies.  A lot of people with HS experience other symptoms, either before or during a flare up. These include:

  • Fatigue – This is more than just feeling sleepy. Fatigue is a complete lack of energy. It makes it difficult to concentrate or muster up the motivation to move. You might get heavy limbs and feel like going back to bed.
  • Aches and pains – This includes headaches and sore limbs
  • Itching – Many people with HS report extreme itching before a flare up.
  • Malaise – This is a feeling of being unwell (including in HS, experiencing a fever-like sensation). Malaise is a general feeling of illness, it is hard to describe, but you know something is not right.
  • Nausea – this is an uncomfortable feeling in your stomach. A feeling that you may vomit

If you are experiencing any of these symptoms, please talk to your doctor. The sooner you get a diagnosis of HS, the better.