Causes of HS

Though the exact causes of hidradenitis suppurativa (HS) are unclear, research suggests that the root of HS lies in specific defects within hair follicles.1,2

Other recent research has hypothesized that inflamed lesions associated with HS tend to develop when there is a blockage of hair follicles and inflammation of sweat glands in the apocrine family, which are found in areas such as the armpits and groin.3,4 It is thought that this blockage can occur when sweat becomes trapped inside sweat gland tubes, which eventually swell up and burst or may form abscesses and become severely inflamed.5

Despite the lack of a definitive cause, the medical community agrees that HS is not infectious, nor is it caused by an infection or connected to poor hygiene (a common misconception about the genesis of HS).2,5

The following are potential factors associated with HS:2,3,4,5




  • HS commonly occurs in young adults in their early 20s, but can occur at any age.
  • Prevalence usually reduces after the age of 50 to 55 




  • Women are more likely to develop HS than men


  • Research shows HS may run in families
  • About one-third of people diagnosed with HS have a family member also living with the condition


  • A link with sex hormones is suggested by prevalence peaking during the reproductive years but there is no of evidence of a direct link

Additionally, medical research has established a link between HS and both smoking and obesity.2,3 However, many researchers are still unsure of the causal relationship between HS and obesity: that is, there is debate as to whether obesity can lead to HS, or if it is HS that can lead to obesity.

Some of these risk factors, such as smoking, obesity, hormonal changes, and excessive perspiration may actually worsen symptoms.2,3,4,6



  1. Danby FW, Jemec GB, Marsch WCh, von Laffert M. Preliminary findings suggest hidradenitis suppurativa may be due to defective follicular support. Br J Dermatol 2013;168:1034–1039.
  2. Zouboulis CC, Tsatsou F. Disorders of the apocrine sweat glands. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K. Fitzpatrick’s Dermatology in General Medicine. 8th ed. New York, Chicago: McGraw Hill; 2012. p947–959.
  3. Jemec GB. Clinical practice. Hidradenitis suppurativa. N Engl J Med 2012;366:158–164.
  4. Collier F, Smith R, Morton C. Diagnosis and management of hidradenitis suppurativa. BMJ 2013;346:f2121.
  5. The British Association of Dermatologists. Hidradenitis Suppurativa. Available at: Accessed August 2013.
  6. Mayo Clinic. Hidradenitis Suppurativa. Available at: Accessed August 2013.