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Hidradenitis suppurativa: Who gets and causes

Who gets hidradenitis suppurativa?

Hidradenitis suppurativa (HS) is most common in:

  • Overweight or obese people

  • Smokers

  • Women (three times more common in women than men)

HS usually begins around puberty. Few people develop HS before 11 years of age. When HS appears before 11 years of age, the child is usually experiencing early puberty. Getting HS after menopause or 55 years of age is rare.

What causes hidradenitis suppurativa?

No one knows for sure what causes HS. Because it occurs after puberty, hormones likely play a role. The person’s immune system also seems to play a role.

It is possible that HS develops when the person’s immune system overreacts. HS begins in the hair follicles (where hair grows out of the skin). Like everyday acne, HS forms when the hair follicles clog with bacteria and other substances. It is possible that HS develops in people who have an immune system that overreacts to the plugged hair follicle.

Lifestyle also seems to play a role. It seems that smoking, being overweight, or taking lithium may trigger HS. These things do not cause HS. If a person is susceptible to getting HS, any of these could make HS appear for the first time or worsen existing HS.

Although the exact cause is still unknown, dermatologists have learned the following from studying HS:

  • It is not contagious

  • Poor hygiene does not cause HS

  • About one-third of people who get HS have a blood relative who has HS

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