If you’ve had a nasty cystic blemish sprout on your chin or your cheek, you know they can be painful. And while your massive pimple may be less than desirable, it’s still fairly common. What’s  less common, however, is a chronic skin condition called Hidradenitis Suppurativa (HS). People diagnosed with the skin condition are prone to getting deep-set, extremely uncomfortable, pustules, lumps and boils on their body that tend to be much more painful than  the ones on your face. While HS can be managed, it can also be tricky to diagnose. To get more information, we sat down with Skincare.com consultant, board-certified dermatologist and HS specialist, Dr. Joslyn Kirby. What Is Hidradenitis Suppurativa? HS is a chronic, inflammatory condition. While it can present as inflammation in the joints or bowels, it initially starts to show as a skin condition. HS takes the form of boil- or pimple-looking mass that forms in between folds of the skin where there is a high concentration of both sweat glands and hair follicles. “The most common places are under the arms, around the breast, the crease of the leg and on the genital area,” says Dr. Kirby. She explains that while the lesion may not look large or painful on the surface of the skin, it can actually be extremely deep, painful, filled with fluid and can become an abscess. “We’ll typically see a lot of pus or drainage from HS as well.” How Is HS Different Than a Pimple or Razor Burn? The lesions associated with HS can look just like a pimple or razor burn during the early stages, so how can you make the distinction? According to Dr. Kirby, it’s important to pay attention to both when and where you’re experiencing flares. If you have traditional razor burn, chances are the marks will be directly correlated with when you shave. That’s not the case with HS. Patients with HS will also traditionally form lesions in the same area, over and over again. “The abscesses, even after being drained, will come back in the same area or a very nearby region,” says Dr. Kirby. “It’s really hallmarked by multiple episodes in the same body areas.” While these signs are helpful to identify HS, the best course of action is to consult with your dermatologist, gynecologist or general doctor. What Causes HS? One of the most important things to note is that HS is not a hygiene issue. The forming of lesions is not connecting to how frequently you shower or the skin-care products you use. On the contrary, it’s linked to genetics and your immune system. “The cause is multifactorial, but we do know that there’s a genetic component — around 30% of people have a family history of HS,” says Dr. Kirby. “People with HS produce more cytokines, which are the chemicals that cause swelling, redness and pain in the skin. When a skin injury happens in somebody with HS, it causes a cascade of additional recruitment of the immune cells.” As a result of this influx, the body experiences excess pain, inflammation and swelling. How to Treat HSUnfortunately there is no cure for Hidradenitis Suppurativa. While research continues, doctors have found a few ways to help patients manage pain. One option is to have the lesion drained by a medical professional. “These abscesses can be so tight and full of fluid that relieving it by having it drained can take away some of the pain,” says Dr. Kirby. Other times, a patient can try anti-inflammatory antibiotics or hair-removal lasers in certain areas. 
