Pediatric Dermatologist: It’s 2024, why is Hidradenitis suppurativa (HS) on the rise in younger patients?

Pediatric Dermatologist, Dr. Lisa Swanson, MD, FAAD

It’s 2024, why is Hidradenitis suppurativa (HS) on the rise in younger patients?

One trend that we have started to observe, and I think will continue as we work our way through 2024, is that we’re noticing increased incidencs of Hidradenitis suppurativa (HS) and it tends to be presenting at younger ages. And the reason for that is, is that we’ve noticed over the past few decades that puberty is starting to develop at younger ages. And HS is something that develops typically around the onset of puberty. Hidradenitis suppurativa is a condition that causes these painful acne like or cyst like or boil like lesions in areas like the armpits, the underwear area, or under the breasts in a female.

It’s a condition that really causes a lot of pain and a lot of discomfort. It’s a condition that we have excellent treatment for and we’re going to get new medicines to treat it as time goes on also.

Helpful vs Not Helpful treatments of Hidradenitis suppurativa (HS)

If I make the diagnosis of HS, I’m really optimistic with the patient and their family about the options that are available now and soon to be available in the future. But we’ve definitely noticed this trend of increased incidence of HS and the fact that it’s developing at younger ages. One of the things that bothers me about HS is that often when it first presents, patients don’t know what’s going on and they often will go to an urgent care or an emergency room, and sometimes these lesions will get drained in the urgent care and ER, which is not productive and not helpful. It just makes them more inflamed and irritated and uncomfortable.

So I’m hoping that another new trend will be that other professional doctors will be able to identify HS, that awareness will increase about this condition and that patients will find their way to somebody like me and my colleagues to get appropriate treatment for their condition. So I’m hopeful for that trend to happen too.

Why does my child have Hidradenitis suppurativa (HS) (sometimes called acne inversa)?

Hidradenitis suppurativa (HS) sometimes makes people feel like, oh my gosh, is this a hygiene issue? Am I doing something wrong in my skincare? What am I doing wrong to cause this? And the truth is, you’re not doing anything wrong to cause it. And it’s not a sign that you’re dirty or you’re not keeping good care of yourself. It’s not a sign of that at all.

It’s an issue with what we call our apocrine glands, which are glands in our skin that are in certain areas of our body, like our armpits and our underwear area. And it’s also a product of an inflammatory process in those areas.

There is a genetic component to some people with a condition will also have a family member who suffers with it, too. And some people have family members who suffer with it, too, but those family members aren’t talking about it because it’s not a condition that you typically go around just kind of boasting about. So often there’s family history there, we just don’t know. And so those issues with the apocrine glands and the inflammation create these spots. So it’s nothing you are doing. There’s also a big hormonal component to Hidradenitis suppurativa (HS), which is why it tends to start around puberty.

Learn more about skin conditions affecting children from Dr. Swanson on our Pediatric Dermatology YouTube Playlist:

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