Hidradenitis suppurativa (HS) and acne conglobata are both chronic skin conditions that can affect your skin and overall quality of life. While these two types of inflammatory skin disease share some similarities, they are distinct conditions with unique causes, symptoms, and treatments.

Understanding these disorders can help you and your medical team diagnose and manage your symptoms more effectively.

HS vs. Acne Conglobata

While HS and acne conglobata may look similar, they are different diagnoses.

Understanding Hidradenitis Suppurativa

HS is a chronic inflammatory skin condition characterized by painful pustules, nodules, abscesses, and tunnels (also known as sinus tracts). These lesions typically occur in areas where skin rubs together, such as the armpits, groin, buttocks, and under the breasts. HS can lead to scarring and painful skin symptoms that can greatly affect your physical and emotional well-being.

Understanding Acne Conglobata

Acne conglobata is a rare, but severe, form of acne. It’s characterized by deep abscesses, inflammation, and scarring. It’s a chronic condition that typically affects the face, chest, back, and buttocks. Acne conglobata is considered one of the most severe types of acne due to its tendency to cause serious disfigurement and scarring.

Causes and Risk Factors

There are different genetic and lifestyle factors that may make it more likely for you to get either HS or acne conglobata.

Causes of Hidradenitis Suppurativa

HS can be caused by a variety of factors, including family history, lifestyle, hormones, and other medical conditions.

• Genetic factors — A family history of HS increases the likelihood of developing the condition.
• Lifestyle factors — Smoking and obesity are significant risk factors for HS.
• Hormonal changes — Fluctuations in hormones, especially during puberty, can trigger HS symptoms.
• Associated conditions — HS is often associated with metabolic syndrome, Crohn’s disease, and other inflammatory conditions.

Neither infections nor poor hygiene will cause HS.

Causes of Acne Conglobata

Acne conglobata is caused by a combination of factors:

• Genetic factors — A predisposition to severe acne can be inherited.
• Hormonal imbalances — Androgens (a type of sex hormone) can worsen acne conglobata.
• External factors — Exposure to certain chemicals or medications can trigger or worsen the condition.

Additionally, other factors such as stress, diet, and certain medical conditions may play a role in the severity of acne conglobata.

Symptoms of HS and Acne Conglobata

Many of the symptoms of these two conditions overlap, but there are some distinctions.

Symptoms of Hidradenitis Suppurativa

Common symptoms of HS include the following:

• Painful lumps under the skin
• Abscesses that can rupture and leak pus
• Formation of tunnels under the skin

These skin symptoms usually appear in areas of the body that experience the most friction, such as the groin and underarms. HS lesions often lead to chronic pain and scarring.

Symptoms of Acne Conglobata

Symptoms of acne conglobata may include:

• Deep, painful nodules and cysts
• Extensive inflammation
• Abscesses and sinus tracts
• Significant scarring and skin disfigurement

Treating HS and Acne Conglobata

Your dermatologist can help you find the best treatment, whether you’re experiencing HS or acne conglobata.

Treatment of Hidradenitis Suppurativa

Treatment for HS includes a combination of the following:

• Medications — Antibiotics, steroids, anti-inflammatory drugs, and hormonal treatments
• Surgical procedures — Incision and drainage, laser therapy, and removal of affected skin
• Lifestyle changes — Daily skin care routines, weight management, dietary changes, and smoking cessation

People with HS should work with their dermatologist to find a treatment plan that works best for them.

Treatment of Acne Conglobata

A combination of oral medications, topical ointments, and surgery can be used to treat the symptoms of acne conglobata.

• Medications — Oral retinoids such as isotretinoin (Accutane), antibiotics, and corticosteroids
• Topical treatments — Topical retinoids and benzoyl peroxide
• Laser therapy — Not widely used but has shown some promise
• Surgical options — Drainage and excision of large cysts and abscesses

Similarities Between HS and Acne Conglobata

There are a lot of features that make these two conditions similar.

Chronic Inflammatory Diseases

Both HS and acne conglobata are chronic conditions that require long-term management. They may last for many years, with some periods of flare-ups and other periods of symptom remission. This is partly because they are inflammatory diseases. In HS, inflammation occurs in the hair follicles and sweat glands, and in acne conglobata, it’s in sebaceous glands. Neither disease is contagious to others.

Types of Lesions

Both HS and acne conglobata can cause painful abscesses and tunnels under the skin. These often drain pus and lead to a risk for infection and scarring. People with both conditions should look out for flu-like symptoms when they have a draining wound.

Overlapping Treatments

Some of the treatments prescribed for HS are also prescribed for acne conglobata. Antibiotics are frequently used to manage infections and inflammation in both conditions. Surgery is also used in both diseases in severe cases to drain abscesses and remove severe lesions.

Differences Between HS and Acne Conglobata

These two skin conditions also have some key differences.

Location of Symptoms

While HS primarily infects areas where the skin rubs together, like the armpits and groin, acne conglobata affects areas that have a lot of sebaceous glands, such as the face, chest, and back.

Who It Affects

HS usually begins when people are in their teens and 20s, after puberty is complete, but it can occur throughout a person’s lifetime. Acne conglobata usually develops in young adults between the ages of 18 and 30, though infants also can develop it.

HS is more common in women than in men, according to StatPearls, and acne conglobata is more common among men than women.

The Impact of Hormones

HS is strongly linked to changes in hormones occurring during menstrual cycles, pregnancy, and menopause. Acne conglobata is influenced by androgens, but the link is not as strong as it is for HS.

What’s the Connection?

Current research shows that if you have HS, you’re more likely to also have acne (including acne conglobata). These two conditions do have some shared risk factors that make you more likely to get the other one. For example, both smoking and having obesity (a body mass index, or BMI, of 30 or higher) can increase inflammation in your body, raising your risk for both conditions.

If you’re living with skin symptoms of either HS or acne conglobata, seek professional help from a dermatologist. They can provide a personal evaluation of your skin and overall health, diagnose your skin disorder, and provide personalized treatment including lifestyle recommendations.

Talk With Others Who Understand

On myHSteam, the social network for people with HS and their loved ones, more than 43,000 members come together to ask questions, give advice, and share their stories with others who understand life with HS.

Do you experience HS or acne conglobata? What steps have you taken to improve your skin symptoms? Share your experience in the comments below, or start a conversation by posting on your Activities page.