“I have nodules in between my thighs, so it’s hard to walk comfortably,” shared a member of myHSteam. Another wrote, “My worst flare is on my inner thighs. It’s hard to walk, sit, or lie down.”

Hidradenitis suppurativa (HS), also called acne inversa, is a long-term, inflammatory skin condition. When it flares up, HS is painful and can seriously affect your quality of life. Symptoms often strike in places where the skin rubs together, like the inner thighs.

While there’s no cure for HS, there are many treatment options to help control symptoms. Here’s how HS on the inner thighs can affect daily life and how to find relief.

“My worst flare is on my inner thighs. It’s hard to walk, sit, or lie down.” — A myHSteam member

Symptoms of HS on the Inner Thighs

The symptoms of HS vary, depending on the type of HS, severity of the disease, and area of skin affected. The Hurley staging system is used to describe the type of HS:

• Hurley stage 1 — Single or multiple lesions with minor scarring
• Hurley stage 2 — Single or multiple lesions with some tunneling (called sinus tracts) and scarring
• Hurley stage 3 — Many lesions throughout the body with tunneling and scarring

Symptoms can develop even without a triggering event. But factors like smoking, menstrual cycle, stress, sweating, weight gain, and family history can raise the risk of HS flare-ups.

HS on the inner thighs may look like blackheads or tiny, itchy bumps on one or both of the upper thighs, right below the pelvis. Often, the area will feel warm, itchy, or sore 12 to 48 hours before lesions show up. Bumps can become painful and filled with pus or fluid as they grow. You may find it harder to move around or exercise with HS symptoms on your inner thighs because of the swelling and discomfort caused by pain.

HS lesions can last days to months. They usually look like deep, pea-size bumps similar to acne cysts or boils. Sometimes, larger lesions burst, draining foul-smelling pus. Over time, lesions may leave scars and form tunnels under the skin that connect. HS symptoms often come and go, sometimes showing up in the same or new areas.

HS can have a tremendous impact on a person’s mental health and self-esteem. In a recent study, researchers surveyed people with HS and found that depression was the most common additional health issue. More than half of people with HS said they experienced depression.

Treatments for HS on the Inner Thighs

Several treatment options for HS can help symptoms happen less often and less severely. Your dermatologist will help create a treatment plan based on your situation. Treating HS in the early stages can help you get better results because it becomes harder to treat if it progresses.

For mild HS (Hurley stage 1) affecting the inner thighs, your doctor may suggest a mix of topical treatments that you put on your skin and medications that are taken by mouth or injected.

These may include:

• Oral antibiotics
• Topical antibiotics
• Metformin (can help reduce inflammation)
• Pain medicines, like ibuprofen and acetaminophen
• Resorcinol cream
• Spironolactone (Aldactone)

For more moderate or severe forms of HS on the thighs, you may also need to try:

• Retinoids (oral)
• Corticosteroids (topical, oral, and intralesional — a shot of medication given directly into a painful lump or lesion)
• Hormonal therapy, such as birth control pills and finasteride
• Biologics — Medications made from living cells that target specific parts of the immune system

One myHSteam member shared their positive experience working with a dermatologist to improve inner thigh symptoms: “I did steroid injections in my inner thighs, and I’d say it was completely worth it! I did have some pain after the injections, but the swelling went down instantly, and I was able to walk with very little pain. After just two days, my skin was so smooth and clear, which I hadn’t seen in years!”

In some cases, people with HS need surgery. This can involve procedures like deroofing, where the skin covering an abscess or sinus tract is removed, or wide excision, which removes the entire problem area. These procedures are best performed by a plastic surgeon. Your dermatologist will refer you to a plastic surgeon if you need a surgical procedure.

People with HS have also found relief after having laser hair removal (which stops hair from growing) or botulinum toxin A (Botox) injections to reduce sweating.

Managing HS on the Inner Thighs

In addition to medical treatments, lifestyle changes and learning how to care for your wounds are key parts of taking care of your HS symptoms.

Healthy Habits

Several risk factors have been associated with developing HS. Adopting certain healthy habits may also help control your skin disease. Try to:

• Quit smoking (if you smoke)
• Get enough sleep
• Reduce stress
• Be active
• Eat a healthy diet

Bandaging

Learning to bandage the wounds on your inner thighs can help manage some of the discomfort associated with HS in this sensitive area. Your doctor can teach you how to bandage your wounds. Some tips include:

• Opt for loose boxer shorts or boy shorts.
• Try HS clothing like HidraWear that’s designed to hold dressings in place.
• Try self-adhesive wound dressings, including repurposed items like menstrual pads.
• Consider attaching dressings to undergarments to make using the bathroom easier.
• Ask your doctor about insurance coverage for more expensive wound supplies.

At-Home Approaches

In the early stages of HS, you may be able to manage flare-ups by following some at-home tips:

• Clean your inner thighs daily with an antibacterial or antiseptic soap or cleanser to prevent bacterial infections.
• Wear loose-fitting clothing that doesn’t rub against the inner thighs.
• Use a warm compress or heating pad on the inner thighs frequently.
• Keep your skin cool and dry.

Avoid using harsh, fragranced skin products (lotions, perfumes, and body sprays) or hard-bristle brushes on the affected area. Also, don’t shave near breakouts on the inner thighs.

Some members of myHSteam have also shared at-home tips and recommendations:

• “I apply tea tree oil and keep it bandaged when I go out.”
• “Press warm tea bags on your boil as often as possible.”
• “Clean all of your wounds daily with alcohol and cover them with Band-Aids to avoid rubbing, tearing, or bleeding.”
• “Apply an anti-chafing gel to prevent flare-ups.”
• “Ice your wounds nightly to reduce swelling.”
• “Wearing boy shorts, women’s boxers, or long underwear reduced my flares and didn’t irritate the area.”
• “Keep wounds clean and regularly change bandages or gauze, especially when it begins to smell.”

“Wearing boy shorts, women’s boxers, or long underwear reduced my flares and didn’t irritate the area.”

— A myHSteam member

Speak with your dermatologist or healthcare provider about the best options for your HS before starting any lifestyle changes or adding these at-home recommendations to your daily routine.

Talk With Others Who Understand

Living with HS can be challenging, but you are not alone. 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 experiences with others who understand life with hidradenitis suppurativa.

Do you have HS on the inner thighs? Does a particular strategy help relieve the pain and itching? Share your thoughts in the comments below or by posting on your Activities page.