Though the exact causes of hidradenitis suppurativa are unclear, research suggests that the root of hidradenitis suppurativa lies in specific defects within hair follicles.1,2
Other recent research has hypothesized that inflamed skin lesions associated with HS tend to develop when there is a blockage of hair follicles and inflammation of apocrine sweat glands, 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 apocrine 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 hidradenitis suppurativa is not a a contagious skin condition, 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 hidradenitis suppurativa:2,3,4,5
Additionally, medical research has established a link between hidradenitis suppurativa 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 sweating may actually worsen hidradenitis suppurativa symptoms.2,3,4,6