Purulent Hidradenitis: Causes and Risk Factors


Although the exact cause of hidradentis suppurativa is unclear, it is believed to be the result of a blockage of a hair follicle ( hair follicle ) in areas of the skin that contain apocrine sweat glands. Other influencing factors are family history of the disease, smoking, and obesity. There are several conditions that are associated with the development of purulent hidradenitis, including inflammatory bowel disease , metabolic syndrome, spondyloarthritis , and acne conglobata.

Nicolas Balcazar / EyeEm / Getty Images

Common causes

Although purulent hidradenitis is not uncommon (it is estimated that between 1% and 4% of the population is affected), not much is known about the exact cause of this skin condition.

Most experts believe that purulent hidradenitis is caused in part by a blockage of the hair follicle by keratin. Keratin is a key protein that forms skin, hair, and nails. It is speculated that keratin can form a plug in the scalp or in what is commonly known as a pore or hair follicle.

This keratin plug causes irritation of the follicle. Then the follicle becomes inflamed and leads to the development of a painful lump called a nodule. These nodules can then progress to abscesses, which damage the underlying skin tissue, leading to sinus formation and scarring.

Another thought is apocrine gland blockage. Apocrine glands are special sweat glands found in the armpits, groin, genital area, and chest .

However, friction in areas prone to purulent hidradenitis also appears to play a role.

It is widely believed that there are several factors that together cause the development of purulent hidradenitis. When these factors are present in those who are already genetically predisposed, the condition occurs.

Purulent hidradenitis most often appears immediately after puberty or by the age of 20 years. It rarely develops before puberty or after age 40. The disease is more common in women than in men, in a ratio of three to four to one .

It is important to understand that purulent hidradenitis is not caused by poor hygiene. It's also not contagious, so don't worry if other family members get it.

Conditions associated with hidradenitis suppurativa

There are several conditions associated with purulent hidradenitis:

  • Inflammatory Bowel Disease: Inflammatory bowel disease increases the likelihood of developing purulent hidradenitis. One study found that 17% of people with Crohn's disease and 14% of people with ulcerative colitis also had purulent hidradenitis .
  • Metabolic syndrome : Several studies have shown a dramatic increase in metabolic syndrome in people with purulent hidradenitis .
  • Spondyloarthritis The prevalence of purulent hidradenitis is higher in those with spondyloarthritis than in those without this rheumatic disease .
  • Acne Conglobata : Hidradenitis suppurativa is more common in people with this rare form of inflammatory acne. Interestingly, however, purulent hidradenitis is more common in people who have had any form of acne, even mild acne vulgaris.


There seems to be a strong genetic component here. Up to 40% of people with purulent hidradenitis have a family member who also has this disease .

Some studies suggest that a mutation in the y-secretase gene may be the cause, but no dominant gene responsible for this disease has yet been identified.

Lifestyle risk factors

There are several risk factors that make you more susceptible to developing purulent hidradenitis. This is especially true if you are genetically predisposed to the disease or have a family history.

Smoking : Cigarette smokers are more likely to develop purulent hidradenitis than non-smokers. In fact, smoking is believed to be the main trigger for the development of this condition. It is not clear how and why cigarette smoking causes the development of hidradenitis.

Obesity : The prevailing opinion is that excessive friction between the skin in the folds of the body of overweight people is what contributes to development or deterioration. Obese people are more likely to develop purulent hidradenitis. They are also more likely to have more severe and prolonged cases of the disease.

Stress : Stress does not cause illnesses, but it can exacerbate existing ones. Many people find that stress exacerbates or triggers an attack.

Heat and sweat : Like rubbing, heat and sweat can irritate the follicles and cause or worsen breakouts.

Menstrual cycle : Some women find that their condition worsens around their period.

Get the word of drug information

While the causes of purulent hidradenitis may not be clear, there are some risk factors that can be reduced. If you are overweight or obese, losing weight can help. If you smoke, quitting can lower your risk for this and many other conditions. Avoiding the development of abscesses will improve your quality of life.

Frequently asked questions

  • No. Although lesions often occur in the groin, anus, or chest, you cannot get purulent hidradenitis through intimate contact with someone with the condition.

  • No. There are no known vaccines, medications, or strategies to prevent the development of hidradenitis suppurativa in susceptible individuals. However, once it does appear, there are ways to treat it that can help prevent flare-ups, or at least make them less severe.

  • Bad idea. Lesions often open and drain spontaneously, but each time they do so, scar tissue forms. Better not to encourage this unnecessarily. Opening the lesions also increases the risk of infection.

Related Articles
Thyroid adenoma: Causes, Treatment, and Diagnosis

The thyroid is a small, butterfly-shaped gland in the front of your throat that produces hormones affecting a number of Read more

NSAIDs and You Thyroid Function

Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most frequently taken over-the-counter medications. Due to their systemic or whole body effects, it's Read more

How Doctors Are Failing Thyroid Disease Patients

The thyroid disease community has continually mentioned the lack of support they experience and the difficulty they have navigating the Read more

How the Family Deductible Works in an HDHP

If your family’s health insurance is a high-deductible health plan, your family deductible may work differently than it did when Read more