The Ultimate Guide to Telling HS Apart From Acne—Without Google Guesswork
Let’s be real—skin issues are confusing. You notice painful bumps, maybe some drainage, and suddenly you’re doom-scrolling WebMD at 2 a.m., asking: “Is this just acne... or something more serious?”
If you’ve ever asked that question, especially about deep, recurring bumps in places like your armpits or groin, you’re not alone. In fact, many people mistake Hidradenitis Suppurativa (HS) for severe acne, and it delays the right treatment for years.
This guide is your no-nonsense breakdown of how to tell HS apart from acne—without relying on confusing Google rabbit holes or self-doubt.
What Even Is Hidradenitis Suppurativa?
Hidradenitis Suppurativa (HS) is a chronic inflammatory skin condition that causes painful, recurring lumps in areas where skin rubs together—like underarms, groin, buttocks, and under the breasts. These lumps can rupture, leak fluid, and form tunnels under the skin called “sinus tracts.”
It’s not contagious, not caused by poor hygiene, and definitely not “just acne.”
Top Signs You’re Dealing With HS—Not Acne
Let’s cut through the noise. Here are the biggest red flags that what you’re experiencing may be HS and not your typical breakout:
1. It Shows Up in Friction Zones, Not Your Face
- HS usually targets places like armpits, groin, inner thighs, and under the breasts.
- Acne mostly hangs out on the face, back, shoulders, and chest.
2. The Bumps Hurt—A Lot
We’re talking deep, tender nodules that feel sore even when you’re not touching them. Many describe HS flares as feeling like boils or abscesses, not pimples.
3. You Get Flare-Ups in the Same Spots Over and Over
This is a classic HS trait. The same area flares, drains, goes down... and then comes back weeks later.
4. There’s Drainage, Odor, and Scarring
HS lesions can break open and drain pus or blood, sometimes with a strong smell. It’s unpleasant—and emotionally exhausting. Over time, this can lead to thick scars and tunnels under the skin (a.k.a. sinus tracts).
5. OTC Acne Treatments Aren’t Doing a Thing
You’ve tried it all—benzoyl peroxide, salicylic acid, retinol—but nothing touches the swelling or pain. HS often doesn’t respond to standard acne treatments because it’s a different disease entirely.
So... What Causes HS?
Doctors aren’t 100% sure, but HS is linked to immune system dysfunction, genetics, hormones, and inflammation. It often runs in families and may be more common in people with PCOS, obesity, or metabolic syndrome.
It’s not your fault. You didn’t cause this with dirty skin, the wrong soap, or your diet. And it’s time that myth dies.
What Can You Do If You Suspect HS?
- See a dermatologist—preferably one familiar with HS.
- Track your symptoms: where the bumps appear, how often, how painful they are.
- Don’t downplay it. HS is a real, chronic medical condition and deserves care, not shame.
Treatment Looks Different for Everyone
Depending on severity, you might be treated with:
- Antibiotics or hormone therapy
- Biologics (like Humira)
- Steroid injections
- Surgery for severe cases
Early treatment can reduce pain, flares, and long-term damage. The sooner you get a diagnosis, the better your quality of life.
Final Thoughts: You Deserve Answers—And Relief
If you’ve been stuck thinking, “Why won’t this acne go away?” or “Why does it keep coming back in the same place?”—you might be facing HS.
And guess what? You’re not alone. You’re not gross. And you’re not imagining it.
Understanding the difference between HS and acne is the first step toward healing—not just your skin, but your confidence too.
Tags: Hidradenitis Suppurativa, HS vs Acne, Chronic Skin Conditions, Painful Bumps, Skin Health, Dermatology, Acne Awareness, HS Diagnosis
