Hidradenitis suppurativa (HS) and lupus are two distinct conditions that sometimes overlap. Many members of myHSteam have shared their experiences of managing lupus alongside HS symptoms.

“I also have lupus, so when I get HS flare-ups or am having high stress in my life, my lupus kicks my butt,” shared one member. (“Flare-up” refers to periods of active or worsening symptoms.)

“It’s a real nightmare having both disorders,” wrote another member. “If I have a lupus flare, my HS goes crazy! 😣 Lupus attacks your entire body, including your brain. I get brain fog more and more. It’s humiliating.”

One member explained that lupus makes it harder for their body to deal with HS lesions. “I have lupus, so the healing process is grueling.”

A lupus diagnosis can feel overwhelming — especially when you’re already managing HS. The good news? Many of the same lifestyle strategies and treatments can help with both conditions.

Here’s what you should know about the similarities, differences, and potential connections between HS and lupus.

Shared Lupus and HS Risk Factors

Anyone can develop HS or lupus, but some people face a higher risk.

Gender and Race

• HS is three times more common in women than men and affects Black people more often than other racial groups, according to Mayo Clinic​.
• Similarly, lupus is more likely to affect women and is more common in Black people, Asian Americans, and Hispanics, Mayo Clinic reports​.

Age and Family History

Both conditions are most likely to develop between puberty and age 40 to 45 and tend to run in families.

Environmental and Lifestyle Triggers

While lifestyle factors don’t directly cause HS or lupus, they can increase the risk and worsen symptoms:

• Smoking is linked to HS, possibly by increasing inflammation​.
• Lupus may be triggered by sun exposure, infections, or certain medications, which can set off the immune system​.

Autoimmunity

Lupus is an autoimmune disease, meaning it’s caused by an overactive immune system that mistakenly attacks the body’s healthy tissues and organs​. There are various types of lupus, including:

• Systemic lupus erythematosus (SLE) — The most common form, which can affect multiple organs, including the skin, joints, kidneys, heart, lungs, brain, and blood cells​
• Cutaneous lupus erythematosus — A type of lupus that primarily affects the skin, causing rashes, sores, and sun sensitivity​
• Drug-induced lupus — A temporary form of lupus caused by certain medications, which typically resolves after stopping the drug.

Several factors influence the risk of autoimmune diseases, including genetics, stress, and environmental triggers.

Scientists have found various genes linked to autoimmunity. People with one autoimmune disease — or a family history of autoimmune diseases — are more likely to develop another​.

Unlike lupus, HS is not officially classified as an autoimmune disease. However, it shares traits with autoimmune disorders, such as chronic inflammation, immune system involvement, and associations with other autoimmune conditions.

People with HS have higher rates of several autoimmune disorders, including:

• Ankylosing spondylitis (a type of arthritis affecting the spine)
• Crohn’s disease (a chronic inflammatory bowel disease)
• Rheumatoid arthritis (an autoimmune condition that affects the joints)
• Type 1 diabetes (an autoimmune disease that affects blood sugar regulation)
• SLE

People with HS may carry genetic traits that make them more vulnerable to autoimmune diseases like lupus. However, other unknown factors could also contribute to the overlap between these conditions. Doctors don’t always know exactly why some people develop both conditions, but ongoing research continues to explore the connection.

Drug-Induced Lupus and HS

Adalimumab (Humira) is approved by the U.S. Food and Drug Administration (FDA) for the treatment of HS. It works by blocking tumor necrosis factor-alpha (TNF-alpha), a protein that drives inflammation in the immune system. By lowering inflammation, TNF inhibitors help prevent HS flare-ups and can be life-changing for some people.

Like all medications, adalimumab comes with potential side effects. One rare but possible reaction is drug-induced lupus, which affects less than 1 percent of people who take TNF inhibitors​.

Symptoms of drug-induced lupus are similar to SLE and may include:

• Joint pain and swelling
• Muscle pain
• Fatigue
• Fever
• Skin rashes

If you develop lupus-like symptoms while taking adalimumab, your doctor can use blood tests to check for drug-induced lupus. The good news? These symptoms usually go away after stopping the medication. However, never stop your HS treatment without talking to your healthcare professional first, as they can help find an alternative approach if needed.

Is Drug-Induced Lupus Linked to HS?

There’s no evidence that medications like TNF inhibitors cause HS. Instead, these drugs are a key treatment for reducing HS symptoms. However, because HS and lupus share some immune system abnormalities, people with HS may be more likely to develop lupus — even without medication​.

Overlapping Symptoms and Complications

HS primarily affects the skin, while lupus can affect any part of the body. However, both conditions involve chronic inflammation, which increases the risk of serious health complications.

The main symptoms of HS are:

• Painful nodules (tender lumps under the skin)
• Abscesses that burst (swollen, pus-filled lumps that can rupture and drain)
• Tunneling under the skin (sinus tracts that connect lesions beneath the surface)

Lupus often affects the kidneys, brain, heart, and lungs. It can potentially impair the function of vital organ systems, raising the risk of serious complications. Lupus can also cause skin symptoms, such as a butterfly-shaped rash across the nose and cheeks and skin lesions. As with HS, people with lupus are more likely to get infections.

Since inflammation is a key issue in both HS and lupus, they increase the risk of other serious health conditions.

Heart disease is the leading cause of death worldwide and is an even greater risk for people with lupus or HS. In addition, lupus and HS are associated with certain cancers. People with HS have a higher chance of skin cancer. Lupus appears to slightly raise overall cancer risk, particularly for certain cancers like lymphoma and cervical cancer. More research is needed to fully understand this connection.

Managing HS and lupus can be physically and emotionally draining. Both conditions can feel isolating, and many people experience anxiety or depression. Seeking support from loved ones, healthcare providers, or online communities can help ease the emotional burden.

Treatment Options for Lupus and HS

Some treatments for HS and lupus overlap, especially those that aim to lower inflammation and reduce pain. However, each condition also has unique treatment approaches.

Nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids are used for both conditions. For HS, steroid injections are sometimes given directly into sores. However, people with lupus take corticosteroids like prednisone orally (by mouth) to control inflammation throughout the body.

In addition, doctors use biologics to treat HS and lupus, though not the same ones. If you’re diagnosed with both conditions, your healthcare provider will recommend the best treatment course based on your symptoms and medical history.

Hydroxychloroquine (Plaquenil) is an oral antimalarial drug that’s used for treating lupus, but not HS. Depending on disease severity, blood pressure medications, kidney dialysis, or stronger immunosuppressants may be needed​.

Treatments that are specific to HS include topical treatments, like retinoids and antibiotic creams, and hormone therapy. In some cases, laser therapy and surgery may also be part of the treatment plan.

The Role of Lifestyle in Managing Lupus and HS

Managing a chronic condition like HS or lupus goes beyond medication. Healthy habits can reduce flare-ups and improve overall well-being:

• Avoiding smoking — Smoking worsens both conditions and increases heart disease risk.
• Staying active — Regular movement reduces inflammation and supports mental health.
• Building a support system — Connecting with others who understand your experience can help with emotional challenges.

By working with your doctor and making lifestyle adjustments, you can take control of your health and improve your quality of life.

Talk With Others Who Understand

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

Do you have HS and a co-existing condition (comorbidity)? If so, how does it affect your daily life? Share your experience in the comments below, start a conversation by posting on your Activities page, or connect with like-minded members in Groups.