• HS is a recurrent disease. This means you will have times when the disease will flare up and others times when it will settle down.
• When your HS flares up, you will get one or more boil-like lumps.
• These will start off as small lumps just underneath the surface of your skin. They are usually red and tender.
• The lumps will grow over a couple of days usually to about 1 or 2 cm in size.
• Most lumps then gradually shrink over a week or so. Some lumps burst and discharge pus.
• A few lumps grow larger, sometimes up to the size of a golf-ball. These can be extremely painful and can make you feel ill. The boils tend to burst eventually but can take a few weeks before they heal. They will often leave scars.
• Boils can become chronic through the development of fox-den-like tunnels under the skin, known as sinus tracts. If this happens, the skin will be tender for several weeks or months and there is often ongoing discharge of pus. Flare-ups are common in areas with chronic boils.
• Chronic boils ultimately lead to scarring under the skin surface. This then causes the skin to become tender, raised and thickened in these areas (dermal contractures).
• Many people with HS have blocked pores (large blackheads or comedones) in the areas affected by HS (see ‘What areas of the body are affected?’). Whilst comedones on the face, chest and back are commonplace in people without HS, only those with HS are likely to have comedones in the areas affected by HS.
• Between flare-ups your skin may look entirely normal.
• Click here to see some pictures of HS.

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