Causes of HS

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




  • 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 1/3 of people diagnosed with HS have a family member also living with the skin condition


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

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


  1. Danby FW, et al. Preliminary findings suggest hidradenitis suppurativa may be due to defective follicular support. BJD. 2013; 168; 1034–1039.
  2. Zouboulis CC, Tsatsou F (2012) Disorders of the apocrine sweat glands. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K (eds) Fitzpatrick’s Dermatology in General Medicine. 8th ed, McGraw Hill, New York Chicago, pp 947-959.
  3. Jemec G.  Hidradenitis Suppurativa. N Engl J Med. 2012; 366:158-64.
  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 Health Clinic. Hidradenitis Suppurativa. Available at:  Accessed August 2013.