How many of us have heard that HS impacts women more predominantly than men? <Insert hand raise here>. While it may appear that way based on US studies, we’re finding that the male demographic is more predominantly affected in other countries. It is unknown if the studies in the US show a higher prevalence of women because that is in fact the case, or if the reason is that men are not as forthcoming or do not seek treatment for their HS as often as women.
What we do know about the number of men vs women affected with HS:
We see more women than men with HS in general, but are unsure how accurate this is.
Fewer men typically seek treatment for their HS, or may have been misdiagnosed, etc.
Men are less likely to speak out about their HS diagnosis or seek support from groups on FaceBook or the like.
Men are less likely to go to the doctor, not just for HS, but for general health issues.
Men are less likely to participate in clinical trials, studies or surveys, etc.
These are all reasons that may help explain the discrepancy between men and women impacted by HS.
The impacts of HS on men are profound and long reaching. There are many similarities in the impacts on men and women in that HS affects our self esteem, lives, children, intimate relationships, mental status, and pain, but there are separate and distinct impacts on the male population that go under reported.
US vs. Other Countries
While based on studies in the West women are more commonly afflicted, in other parts of the world the male HS population is much larger than the female population In a Turkish study of 208 patients who were diagnosed with HS between June 2012 and July 2017, 68.3% were male compared to 31.7% female.
In a South Korean study, a total of 438 patients diagnosed with HS from May 2007 to April 2017, revealed that male patients were predominant with a male to female ratio of 2.5 to 1 and male patients had severe disease compared with females.
In the Middle East, 54 studies comprising of 7649 HS patients revealed the sex ratio of HS patients is different in that men reported to be affected at a higher rate than women in the West.
A German study of pediatric patients revealed a male to female ratio of 1.86 to 1.
Most Impacted Body Part by gender
Italian dermatology centers studied 124 patients and found that the clinical characteristics were similar between men (of which there were 53 participants) and women (71 participants). They found that lesions were more frequent in the gluteal region in men (32.3% in men vs 8.7% in women). Although the severity of HS was similar between the sexes, the localization of lesions was different.
Another study of 1221 patients showed that the axillary, genital and neck regions were more frequently affected in men than in women and a German study of 1795 patients noted neck involvement tended to decrease quality of life more than any other location affected by HS.
Singapore studied 58 patients over a 13 year period between 2004 and 2016, 34 of whom were male (58.6%). The axilla was the most common site for men, followed by groin and buttocks. They report that the higher proportion of male HS patients in their cohort compared to the West may reflect differences in the prevalence of obesity and smoking in the 2 populations.
Sexual Impacts
HS has a considerable impact on quality of life, however, sexual health has scarcely been studied. Sexuality is a central aspect of quality of life and more recently there has been increasing attention paid to sexuality and HS.
A cross-sectional study using a crowd-sourced online questionnaire spread by the Spanish HS Patients Association (ASENDHI) revealed that of the 393 participants, erectile dysfunction was found in 60% of men. Factors of ED were related to increasing age, presence of active lesions in the genital region and number of areas affected by active lesions.
In another study, 42,729 patients with HS revealed that the prevalence of sexual dysfunction ranged between 51% and 62%, and in the case of erectile dysfunction, it ranged from 52% and 60% of patients studied. Potential risk factors for sexual dysfunction among men and women were identified, mainly related to disease activity, symptoms and partners. Mood disorders like depression and anxiety appear to be associated with sexual dysfunction. HS patients with sexual dysfunction had a decreased overall quality of life.
Men seem to be more commonly affected in countries other than the US and we know that more long term and robust studies need to be done to determine the true prevalence in men. We do know that men suffer just as much as women, and in some cases as shown above, more than women.
If you'd like to share your story or journey with HS and the impacts on your life as a male, we'd love to share your story with the rest of the community for perspective and to encourage other men to come forward as well.
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.
Read more on Men with HS HERE.
Written by Brindley Kons