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Tips for talking to a doctor about embarrassing HS symptoms

Hidradenitis suppurativa can cause a number of embarrassing symptoms than can be difficult to discuss.

A healthcare provider comforts a patient who is having a difficult time talking about embarrassing skin disorder symptoms.

Hidradenitis (hi-drad-uh-NIE-tis) suppurativa (sup-yoo-ruh-TIE-vuh), or HS, is an inflammatory skin disorder.

HS causes painful, inflamed lesions that typically affect the areas of the body where skin rubs against skin—the underarms, groin, buttocks, and under the breasts. Lesions are hair follicles that have become clogged with bacteria, keratin, and sweat. These lesions are small, hard lumps at first, but can progress to abscesses that rupture and leak pus.

The typical age of onset for HS is puberty or early adulthood. HS is believed to affect at least 1 percent of the adult population in the United States and is much more common in women. Having psoriasis increases a person’s risk of having HS.

HS is painful and can lead to complications, including infections and severe scarring. People who have HS often experience significant distress that negatively impacts their mental health, relationships, employment, and overall quality of life.

Embarrassing symptoms

People living with HS often feel ashamed, stigmatized, and experience feelings of low self-worth. They may find it difficult to talk about their symptoms with a healthcare provider.

People may also be embarrassed that HS lesions may be mistaken for an infection, such as a sexually transmitted infection or an infection that is caused by poor hygiene. (It is important to understand that HS is not an infectious disease, cannot be transmitted from one person to another, and is not caused by poor hygiene.)

Talking to a healthcare provider

While it is normal to feel embarrassed, it is important to be honest and upfront with your healthcare provider about all the symptoms you are experiencing and how those symptoms are impacting your life.

Here are some things to keep in mind and tips to help discuss an embarrassing topic with your healthcare provider:

  • Remember that your healthcare provider is not there to judge you and any information you share is confidential.
  • Understand that a dermatologist will have seen these symptoms or similar symptoms before.
  • Write down what you want to discuss ahead of time and bring a list of important topics and questions to your appointment.
  • Tell your healthcare provider that this is a sensitive topic and that you are embarrassed to talk about it. Your healthcare provider might have their own strategies for discussing sensitive topics or putting you at ease.
  • Try to do something relaxing before your appointment.

If you find you really cannot talk to your healthcare provider about your symptoms and concerns, you may want to think about finding a different healthcare provider.

The importance of treatment

While symptoms may get worse at times and better at other times, HS will not go away on its own and it can get worse over time and lead to severe scarring. While there is no cure, there are treatment options that can help control symptoms, prevent complications, and ease the burden of living with HS. Treatment for HS should be overseen by a dermatologist.

Article sources open article sources

Mayo Clinic. "Hidradenitis suppurativa."
Gina Ambrose and Donald Berlin. "Incision and Drainage." Roberts and Hedges’ Clinical Procedures in Emergency Medicine and Acute Care. Seventh Edition, 2019.
MedlinePlus. "Hidradenitis suppurativa."
American Academy of Dermatology Association. "Hidradenitis suppurativa: Who Gets and Causes."
Fred F. Ferri. "Hidradenitis Suppurativa." Ferri's Clinical Advisor 2021.
American Academy of Dermatology Association. "Hidradenitis suppurativa: How to Cope When Depression Hits."
Laura Huilaja, Hannu Tiri, et al. "Patients with Hidradenitis Suppurativa Have a High Psychiatric Disease Burden: A Finnish Nationwide Registry Study." Journal of Investigative Dermatology, 2018. Vol. 138.
UpToDate. "Hidradenitis suppurativa: Management."
E. Keary,  D. Hevey and  A.M. Tobin. "A qualitative analysis of psychological distress in hidradenitis suppurativa." British Journal of Dermatology, 2019. Vol. 182, No. 2.
Dimitra Koumaki, Ourania Efthymiou, Evangelia Bozi, and Alexander C Katoulis. "Perspectives On Perceived Stigma And Self-Stigma In Patients With Hidradenitis Suppurativa." Clinical, Cosmetic and Investigational Dermatology, 2019. Vol. 12.
Diana Kelly. "How to Talk to Your Dermatologist About Hidradenitis Suppurativa." Healthgrades.com. September 26, 2019.
Cleveland Clinic. "Hidradenitis Suppurativa."
Emily Boynton. "How to Talk to Your Doctor About Awkward Health Topics." Right as Rain by UW Medicine. November 4, 2020.
Cedars-Sinai Blog. "How to Address Uncomfortable Topics With Your Doctor."
Johns Hopkins Medicine. "Don’t Be Shy: 4 Tips for Talking to Your Doctor."
National Organization for Rare Disease. "Hidradenitis Suppurativa."

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