Hidradenitis Suppurativa vs. Folliculitis: How to Tell the Difference

Red, acne-like rashes are the hallmark of two skin conditions: hidradenitis suppurativa (HS) and folliculititis. HS is more severe and usually chronic.

Folliculitis is a bumpy, pimple-like rash that can be red or discoloured and is brought on by a variety of infections.

The rash known ashidradenitis suppurativa (HS) resembles acne as well, however, it frequently manifests as deeper nodules or boils. It is a chronic illness that is believed to be related to immune system problems and heredity, however, scientists are unsure.

Here are some further details regarding how these two conditions differ from one another.

Hidradenitis suppurativa vs. folliculitis: Symptoms and photos

Folliculitis can cause:
  • a rough, itchy, red, or discoloured rash
  • pus-filled blisters surrounding the follicles
Causes of Hidradenitis Suppurativa (HS) include:
  • red, purple, or discoloured nodules or pimples that resemble acne
  • between lesions, there are underground tubes that create
  • cysts or boils that contain pus
  • irritation and pain
The redness or discoloration linked to both of these disorders may be more visible to people with darker skin tones.

How can you tell the difference between HS and folliculitis?

The conditions differ in several important ways, such as:
  • Severity: Usually quite minor, foliculitis goes away in 1-2 weeks either on its own or with topical medication. Being a recurrent illness, HS usually necessitates more substantial medical care, including surgery in certain situations.
  • Incidence rate: Since folliculolitis is more common, your chances of contracting it are higher. Only approximately 1% of people have HS, although folliculitis is a highly prevalent condition (though precise numbers are still unknown).
  • Cause: Usually, some types of fungus or the bacterium Staphylococcus (staph) cause foliculitis. Although the exact aetiology of HS is unknown, your immune system and family history are assumed to play a role.
  • Contagion: It is possible for bacterial folliculitis to spread from person to person or through objects like clothes, towels, and razors. Since staph flourishes in moist or wet environments, it is particularly spread through these objects. A common bacteria found in poorly maintained hot tubs or pools is the source of Pseudomonas folliculitis, sometimes known as "hot tub folliculitis."
  • Rash type: While red, pimple-like bumps can be seen on either type of rash, HS eruptions are typically more severe and deeper. Additionally, HS lesions are typically bigger and can resemble boils or cysts. Between HS lesions, deep, inflammatory channels may also develop.
  • Rash location: HS usually affects places where the skin rubs together, such as the armpits, groyne, anus, inner thighs, under the breasts, or between the buttocks. It affects the sweat glands and hair follicles. A common location for foliculitis includes the neck, breasts, buttocks, groyne, face, back, arms, or scalp. It affects the hair follicles. For instance, if you have folliculitis from swimming in a pool or hot tub, the rash will usually be more severe where your skin comes into touch with your swimsuit.

Are HS and folliculitis treated differently?

For the most part, folliculitis goes away on its own in 1-2 weeks, but HS is harder to cure.

The negative effects and symptoms of folliculitis may be lessened by applying topical antibiotics or diluted white vinegar. Other therapies, such as the following, could be suggested if the rash is extremely severe and doesn't go away with topical medication:
  • oral antibiotics
  • medications that aren't steroidal anti-inflammatory
  • antifungal drug (for fungal-induced folliculitis)
  • antihistamines (to reduce itchiness or pain)
Although there isn't currently a treatment for HS, there are several ways to manage it, such as:
  • antibiotics
  • pain medication
  • hormone therapy
  • retinoids
  • acne washes
  • topical medication
  • zinc
  • biologics
  • steroids
Surgery could be required in some circumstances to eliminate uncomfortable lesions. Surgical procedures could involve:
  • deroofing
  • electrosurgical peeling
  • total or partial excision

How do you diagnose hidradenitis suppurativa versus folliculitis?

Seeking medical attention is always advised if you have a rash that:
  • is uncomfortable or gets in the way of your routine
  • doesn't get better in roughly two weeks
  • vanishes and then reappears
A dermatologist may identify your problem just by looking at the inflammatory regions; they may even be able to diagnose it that way. Inquiries will also concern your lifestyle, medical history, family history, and any additional symptoms you may have encountered.

To help determine the cause, the doctor may take a sample from the lesions and run lab testing if they are leaking fluid.

Seeking medical attention as soon as possible is a good idea because untreated HS may worsen.


Red, acne-like rashes are the hallmark of two skin conditions: hidradenitis suppurativa (HS) and folliculititis. A bacterial or fungal infection is the cause of folliculosis, whereas HS is a chronic illness with a genetic component.

Over time, HS outbreaks recur and are typically characterised by larger, more severe lesions. There are strategies to assist manage HS even if there isn't a known treatment for it.

Less severe folliculitis usually goes away on its own in a few weeks.

See a doctor right once for a diagnosis and treatment if your rash is uncomfortable or bothersome.

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