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Does Size Matter with HS Abscesses?

Whether you have an abscess the size of a gumball or a cantaloupe (yes, this does happen to some), HS is painful. But what about the pea sized or the ones that look like mosquito bites on the surface; do

they hurt too?


Here are some common things we hear in the HS community or those who don’t have HS:

  • “That isn’t any bigger than a mosquito bite, it can’t possibly hurt that bad”

  • “It’s just a little bump, you’ll be FINE”

  • “I’ve had a cut/wound like that before, it's not a big deal”

  • "My HS doesn't act that way, you need to go to the ER!"

  • "I wish my armpits looked as good as yours” or ”I wish my HS was as mild as yours"

Let's Clear Some Things Up


Hidradenitis Suppurativa is a very personal illness. Our abscesses may look different, different in size, color, shape, and each abscess may also behave differently, which is another challenge when dealing with HS. Some abscesses rupture, some don’t. Some come and stay for short or long periods of time, taunting us as if they’re healing, and then don’t. Others come, rupture, heal and move on with life. Some come, rupture and leave you with a nice hole to remember them by; there are so many scenarios.


Don’t Let Size Fool You


Something that may appear small physically can feel like a volcano waiting to erupt. The pressure and pain can be overwhelming, it’s intense and can take your breath away with one wrong move. While it may appear to be the size of a "small mosquito bite", it feels nothing like a mosquito bite


There are times when a smaller abscess may be more painful than a larger abscess. No matter the size, they are typically accompanied by some level of pain. Please also keep in mind everyone’s pain tolerance is different and others may be dealing with additional ailments or illnesses, which also contributes to the pain.

Abscesses are typically like icebergs, you can only see the tip of what’s happening, but below the surface is the pain and irritation you can’t see and can include nerve pain and deep inflammation. Sometimes there are very large nodules underneath that cannot be seen with the naked eye.


Size, pain, smell, color of drainage, redness and inflammation/swelling are not necessarily indications of infection; these are all typical parts of HS flares. However, it is important to pay attention to signs of infection, such as cellulitis, which you can read more about here.


Stage Shaming


Comparing your hidradenitis with others often leads to "stage shaming": For example, when someone posts about their HS or posts a picture of their HS and others comment things such as: "I wish my arms looked as good as yours" or "I'm worse than you, you're lucky". This behavior diminishes and minimizes the poster’s personal HS, pain and suffering. This type of thing can be and is often crippling to others, causing people to further retreat into isolation, which HS already contributes to. This can be the case, especially if this is the first time the poster has opened up or shared, or they may be feeling extra vulnerable or depressed at that time. We all know how this can feel; please be kind to others who suffer the same or differently than you with their HS.


Read more about external symptoms with HS here and systemic symptoms with HS here.


Our Abscesses vs. Boils article can be found here.


Our Abscesses, Lesions, and Boils, Oh My article about the HS language can be found here.


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.


HSconnect.org


Written by Denise Fixsen and Brindley Brooks

Edited by Brindley Brooks


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