Hidradenitis Suppurativa: PCOS skin tags

People with PCOS have many symptoms to contend with, many of which are dermatological. This could include acne, excess body hair and hair loss on the head. Another skin condition that impacts people with PCOS is Hidradenitis Suppurativa (HS). HS is a chronic inflammatory skin condition where pea-sized lumps develop around hair follicles.

Hidradenitis suppurativa (HS) is not directly associated with PCOS, but if it is impacting your life let’s give you some answers. Keep reading to learn more about hidradenitis suppurativa and PCOS.

What is PCOS?

PCOS, or Polycystic Ovarian Syndrome is an endocrine or hormone disorder, affecting approximately 1 in 10 people with ovaries in the UK.

PCOS displays as a collection of symptoms including; acne, oily skin, lack of or irregular periods, lack of ovulation (anovulation), excess hair growth, insulin resistance, increased testosterone levels and fertility issues. 

What is hidradenitis suppurativa?

Hidradenitis suppurativa (also known as acne inversa) is a chronic inflammatory condition of the skin which is present in lumps developing around hair follicles, commonly around the underarms, thighs, groin and under the breasts.  These are usually places where the skin rubs together, which can be painful and unpleasant. 

It is thought to affect 1 in 100 people and usually begins to present after puberty.

The condition tends to begin with blackheads, then pus-filled spots before becoming firm lumps. The lumps will either disappear on their own or rupture and leak pus after a few hours or days.

Unfortunately, some of the lumps can become infected with bacteria. This causes a secondary infection that can be treated with antibiotics.

What causes hidradenitis suppurativa?

The exact cause of HS is unknown. Historically hidradenitis suppurativa was viewed as a skin condition of the sweat glands. Recent studies suggest it is a disorder of the follicular epithelium, in this case, the skin tissue covering hair follicles. This is affected by various factors such as genetic susceptibility, diet, hormonal changes, stresses on the skin and smoking.

HS usually begins around puberty, suggesting that sex hormones are involved. Many people with HS also have acne and excess hair growth.

A systematic review in 2022 focusing on the role of hormones in hidradenitis suppurativa. Insulin resistance is often present in people with HS. HS causes more androgen overproduction that can stimulate proinflammatory adipokines to be released from fat tissue. Similar pathways are found with PCOS.

What is the link between hidradenitis suppurativa and PCOS?

Although the link between HS and PCOS is not fully understood, according to a 2018 study of over 2000 people, the prevalence of PCOS in a person with hidradenitis suppurativa is 9%, in comparison to 3% of the rest of the population. The probability of a person with hidradenitis suppurativa also having a diagnosis of PCOS is twice as likely. 

What are the 4 stages of hidradenitis suppurativa?

The symptoms of hidradenitis suppurativa range from mild to severe. 

  1. Blocked hair follicle
  2. Blackheads, spots filled with pus or firm pea-sized lumps 
  3. Rupture and leak pus
  4. Formation of long sinus tracts or tunnels 

What triggers hidradenitis suppurativa?

It is commonly reported that individuals diagnosed with hidradenitis suppurativa find a hormonal link with their symptoms, and during certain times during the menstrual cycle will result in breakouts. As where symptoms present where the skin rubs, often tight clothing can trigger HS, so often looser clothing is recommended. 

Other known triggers include smoking, high alcohol intake and use of other substances. A 2022 study has also found other triggers including pregnancy and post-partum, however again this can vary from person to person. 

Is hidradenitis suppurativa a STD?

No, the exact cause of hidradenitis suppurativa is unknown. It is not infectious and it isn’t caused by poor hygiene practices. 

How do you get rid of and manage hidradenitis suppurativa?

Hidradenitis suppurativa is a chronic inflammatory skin condition. There is strong genetic susceptibility with about 1 in 3 cases. This means it is life-long and can’t be cured, but it can be managed to improve your symptoms and hopefully keep HS at bay. 

In the early stages medication can be used: 

  • Antiseptic washes applied daily 
  • Retinoids 

If lumps progress to become severe and more painful other options such as antibiotics, steroids or immunosuppressive treatments can be prescribed as per NHS guidelines

Can diet help?

There is growing interest surrounding our skin health and our diets. Although more research is required, there are some dietary changes we can try to see if they help with HS.

As HS is an inflammatory skin condition, it could be helpful to focus on foods which are considered anti-inflammatory. Choose omega-3 foods such as oily fish or nuts and seeds as these foods have anti-inflammatory properties. Fruits and vegetables are packed with antioxidants, so make sure you are getting enough in your diet on a daily basis.

One study conducted on the impact of diet in the prevention of hidradenitis suppurativa found that preliminary observations suggest that a low dairy and low GI diet may provide relief from HS. But, this study was small and only a pilot study, so more evidence is required. Cutting out food groups from your diet can be damaging so always speak to your doctor, dietitian or nutritionist before trying a new way of eating.

Key takeaways

There was nothing you did that caused hidradenitis suppurativa to develop for you. I often find I need to remind people of that. This is a chronic inflammatory condition of the skin that is not contagious, nor caused by poor hygiene. Being aware of our skin is vital, get to know what your skin is like so you can identify earlier if anything changes with your symptoms that may lead you to seek medical advice sooner.

+ posts

Sophia Boothby RD Author at The PCOS Collective

Lead Author | Head Dietitian | Registered Dietitian


Sophia is a Registered Dietitian working as a Specialist Community Dietitian within a London NHS Teaching Hospital specialising in gut health such as irritable bowel syndrome (IBS) and the low FODMAP diet, type 2 diabetes, PCOS, and cardiac rehabilitation. Sophia offers 1:1 PCOS support in our virtual PCOS clinic.

Leave a Comment

Your email address will not be published. Required fields are marked *

Scroll to Top