Hidradenitis Suppurativa has it's own vocabulary, it's own list of definitions and more acronyms than you can count. Here's a crash course in HS!
What do I call these...things?
Recommended: Boil like, lesions, abscesses
Not recommended: Cysts
Why does it matter?
When you're telling others about your illness it is important to get the facts straight. Correct terminology will also help ensure a proper diagnosis. Putting cysts in the same category as hidradenitis is downplaying disease that we all live with and suffer from.
What are the differences between Abscesses, Cysts, Boils and Folliculitis?
Lesions or Abscesses:
Abscesses are typically larger raised areas on the skin that are more tender and filled with pus in the deeper tissue. HS is a chronic inflammatory illness follicular occlusion which manifests in recurring chronic abscesses.
Abscesses do not have a sac, they are often pus, fluid or blood-filled. Abscesses can be very painful and develop quickly. In a situation such as HS they can last days, months, or even years.
Abscesses can form on their own or they can occur when a cyst becomes infected regardless of whether you have HS.
For some people Hidradenitis is progressive and they have several different affected areas with anywhere from 3 to 50 plus abscesses at a time on their bodies. This can deform the affected areas with tunneling, tracts and scarring. For many of us there are years of constant pain, oozing, and odor; cysts do not behave this way.
A cyst is not the same thing as an abscess or having HS. HS sufferers are prone to cysts, which can become inflamed or infected and can potentially turn into an abscesses from infection.
Cysts have a sac and are enclosed by a distinct abnormal cell (usually benign). The sacs or cavities are usually filled with fluid, pus or a creamy, foul-smelling substance. Unlike an abscess, cysts develop and sometimes "grow" or don't change at all. You can have them for years with no problem and in many cases they do not need for medical intervention. It is possible for them to become infected and turn into an abscess; if this becomes chronic they may have to be surgically removed.
Boils are more superficial than an abscess and typically smaller in comparison. Abscesses are typically larger and deeper in the tissue and in most cases are more tender and painful than a typical boil.
Folliculitis is an infection or inflammation of a hair follicle. Little red or white "pimple like" sores can develop at the base of a hair on the body and can sometimes scab. There may be one infected or inflamed follicle or several infected hair follicles.
It is not uncommon for us to look to HS as being the reason for any other skin spot, irritation or other symptom. It is important to keep in mind that not everything is related to our HS.
Below is a list of the most common skin cysts. If you are not sure what these are, take some time and look these up as well as the different pictures.
All diagnoses should come from a dermatologist or trained professional; this is information to help you be more informed, not to self diagnose.
Ingrown hair cyst
HS can look or present like acne, folliculitis, a typical boil, or cysts to people who are unfamiliar with our condition.
There is a lot of misdiagnosis happening regarding HS. If your doctor says that you DO or DO NOT have hidradenitis, and you are not sure (this is common) do your research. If needed, get a second opinion.
Please make sure you’ve done your research and are able to articulate the experiences you have had with your abscesses to be sure you get a proper diagnosis.
Content in this article is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay seeking treatment because of something you have read on this website.
Written by Denise Panter-Fixsen
Edited by Brindley Kons