Many of us have dealt with ingrown hairs at one time or another — those bumps that resemble pimples and itch and cause irritation. But if these bumps persist, grow, or spread, they could point to something more serious, including hidradenitis suppurativa (HS).

HS is a chronic (long-lasting) inflammatory skin condition that causes painful lesions and abscesses. It typically appears in areas where skin rubs together, such as the armpits, groin, inner thighs, buttocks, and breasts.

Because HS looks like ingrown hairs and other skin conditions, it’s often misdiagnosed. This makes it difficult to find effective treatment early. So, how can you tell the difference before symptoms progress? Below are five differences that can help you determine whether you’re dealing with ingrown hair or HS.

1. HS and Ingrown Hairs Have Different Causes

New hairs grow from hair follicles under your skin. Sometimes, these hairs grow back into the skin rather than outward. This causes ingrown hairs. You’ll likely notice them after hair removal, like shaving, waxing, or tweezing. People with thick, coarse, or curly hair are more likely to experience ingrown hairs.

HS begins with blocked hair follicles. However, the challenge is that researchers aren’t sure what causes this blockage. Healthcare professionals have discussed a few contributing risk factors, including hormones, genetics, smoking, and weight.

HS is an ongoing health problem, and flare-ups can happen unexpectedly. According to Cedars-Sinai, women may notice their symptoms getting worse before their menstrual period. Some myHSteam members notice flare-ups at night. “I just want to have one night where I can sleep without pain,” one member shared.

2. HS and Ingrown Hair Have Distinct Features

Ingrown hairs are recognizable as small bumps that resemble pimples. They are often purple, red, or brown. You may see hair or pus inside.

HS may initially look like pimples and acne cysts. However, these lumps can grow much deeper than ingrown hairs. Over time, they fill with fluid to form painful abscesses, which eventually break open. This repeated swelling, draining, and healing cycle forms sinus tracts — tunnels beneath the skin that connect lesions.

HS is also recognizable by its unpleasant odor when abscesses break open and leak.

3. HS Is More Pain Than Ingrown Hairs

Most ingrown hairs cause mild burning, stinging, or itchiness. They may be tender to the touch, but this discomfort is usually short-lived.

HS can be much more painful. Lesions often begin with mild itchiness but can quickly progress to cause severe pressure and discomfort. This can feel like throbbing, shooting pain from nerve damage in abscesses and sinus tracts. You may experience some relief when the lesions drain. However, in advanced stages of HS, pain can become debilitating and may impact your quality of life. “The pain never gets any easier. Even walking is a pain,” one myHSteam member shared.

4. HS and Ingrown Hairs Have Different Treatments

Ingrown hairs typically heal on their own within a few days or weeks when the hair grows and releases from your skin. You can help the hairs release by applying a warm compress to open your pores.

Sometimes, healing takes longer if the ingrown hair becomes infected. Avoid picking or squeezing the affected area. The bumps may grow, become more painful, and lead to scarring. If your symptoms worsen, talk to your healthcare provider or dermatologist. They can recommend medications (like oral antibiotics) or other treatments (like topical corticosteroids) to reduce inflammation and improve infection.

HS is a chronic condition, so it may never fully go away. Home care is important, but you will likely need prescribed treatments to manage your symptoms. There are many treatment options, including topical antibiotics, biologic drugs, and sometimes surgical procedures. You may also need to talk to your doctor about pain management.

5. Ingrown Hairs Are Easier To Prevent Than HS Flares

The best way to prevent ingrown hairs is by not shaving, but this isn’t an option for everyone. If you need to shave, there are a few important practices you can follow:

• Lubricate your skin with warm water and shaving cream.
• Shave in the same direction the hairs are growing.
• Don’t shave too close or hard against the skin.
• Rinse the razor off after each stroke.
• Apply a cool, wet cloth after shaving.
• Use an exfoliating scrub to release any trapped hairs.
• Avoid shaving every day, if possible.
• Consider laser hair removal or hair removal cream.

HS is a chronic condition, so you may not be able to prevent it entirely. However, you can take steps to reduce flare-ups:

• Quit smoking if you smoke
• Avoid hot, humid environments.
• Opt for loose-fitting, breathable clothing.
• Care for your skin at home
• Follow your treatment plan correctly.

Connect With Others Who Understand

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

Do you have ingrown hairs or HS? What are your symptoms and treatment methods? What advice do you have for others experiencing these skin conditions? Share your experience in the comments below, start a conversation by posting on your Activities page, or connect with like-minded members in Groups.