You may be used to seeing red bumps on your skin while living with hidradenitis suppurativa (HS). But if those red bumps turn purple, you might wonder what’s happening. Is it a normal part of healing or a sign of something more serious? HS abscesses can change color over time. While some changes are harmless, others may require medical attention.

“I’ve had an abscess for a month now on my inner thigh,” one myHSteam member wrote. “At first, it was small and pink and didn’t hurt — only when touched. Now it’s purple and hurts (not crazy — I will say a 5 or 6 out of 10). It also got bigger. I believe it popped within and spread, but it doesn’t have a head. I have an appointment next week with my dermatologist to see why it turned purple. My only worry is if it got that color, does this mean it’s infected?”

This guide can help you evaluate what a painful purple abscess may mean for people with HS.

Why an HS Abscess May Turn Purple

For people with darker skin tones, HS symptoms may look purple rather than red. In this case, a purple abscess may be nothing to worry about. If your abscesses usually appear red, here are a few reasons you might have a purple abscess.

The Boil May Be Filled With Blood

Some myHSteam members have shared that their HS abscesses turned purple due to blood buildup. “When my lesions turn purple, it is usually due to blood filling the abscess,” one member said. “Sometimes, they will pop and drain on their own, and sometimes they slowly go away.”

An HS boil may contain blood or a mix of blood and pus. In addition, tunnels may form under the skin that fill with blood and pus, which later drain. These tunnels form when nodules connect, heal, and reopen.

You May Have a Skin Infection

An HS boil may fill with blood if it becomes infected. When bacteria enter an HS nodule, it can lead to a bacterial infection. Not everyone’s skin turns purple when it’s infected, but some skin tones may take on a purple hue during inflammation or infection.

Since HS lesions leak pus or blood when ruptured, it can be hard to tell if an abscess is infected or healing normally. Some skin infections, such as staph infections and cellulitis, must be treated with antibiotics to prevent dangerous complications. Get medical advice from your healthcare provider right away if you’re unsure whether you have an infection.

You May Have Hyperpigmentation

After an HS flare-up, the skin may produce excess melanin, leading to postinflammatory hyperpigmentation. This condition can cause patches to appear darker than the surrounding skin, ranging in color from purple to brown or tan, depending on your skin tone.

Managing HS Discoloration

If you have an abscess with blood or one that’s painful, you may be able to manage it at home. Cold packs or over-the-counter numbing creams, such as those that contain lidocaine or benzocaine, may help curb the pain. If the boil appears to be close to bursting, you can hold a warm compress over it to help it along. Once it begins to leak fluid, cover it with absorbent bandages and change them often.

If you notice signs of infection, contact your dermatologist immediately. Skin infection symptoms vary depending on the infection type but may include:

• Rash
• Discoloration
• Itching
• Pus
• Swelling
• Pain
• Increased local temperature or warmth

If you experience chills, fever, or discolored streaks moving under your skin away from the wound, go to the emergency room. You may need intravenous antibiotics or other treatment.

Talk to Your Doctor

A purple abscess can have several causes, including trapped blood, infection, or skin discoloration after healing. While some cases resolve on their own, others require medical attention — especially if you notice signs of infection. Keeping track of changes in your HS symptoms and staying in touch with your doctor can help you manage your condition with more confidence.

Find Your Team

On myHSteam, the social network for people with hidradenitis suppurativa, and their loved ones, more than 46,000 members come together to ask questions, give advice, and share their stories with others who understand life with hidradenitis suppurativa.

Have you ever had a painful, purple abscess on your skin? How did you manage it? Share your experience in the comments below, or start a conversation by posting on your Activities page.