The Painful Skin Condition She Lived With for Years Before Getting Diagnosed

Health Points

• Hidradenitis suppurativa often begins with small bumps that resemble pimples or boils in areas where skin rubs together
• Early diagnosis and treatment can prevent permanent scarring and tunneling under the skin
• The condition affects approximately 1-4% of the population and often runs in families

When small bumps first appeared in areas where her skin folded and rubbed together, Alesandra Bevilacqua dismissed them as ordinary pimples. It would take years before she learned the truth: she was living with hidradenitis suppurativa, a chronic inflammatory skin condition that affects millions of Americans.

The painful reality of misdiagnosis isn’t uncommon. Many people spend years treating symptoms without understanding the underlying condition, missing crucial early intervention opportunities that could prevent permanent damage.

Hidradenitis suppurativa, often called HS, develops in areas where skin touches skin—under the arms, in the groin, under the breasts, and between the buttocks. What starts as small, pimple-like bumps can progress to painful abscesses, tunneling connections under the skin, and permanent scarring if left untreated.

I wish I had known that recurring bumps in the same spots weren’t normal, Bevilacqua reflects on her journey to diagnosis. I kept thinking they would just go away on their own.

The early warning signs are deceptively simple. Small, tender bumps that appear repeatedly in the same locations—particularly in areas with apocrine sweat glands—should prompt a visit to a dermatologist. These bumps may feel like hard knots under the skin and can become inflamed, painful, and eventually rupture.

Medical experts emphasize that early recognition matters tremendously. When caught in its initial stages, hidradenitis suppurativa responds better to treatment and lifestyle modifications. Delayed diagnosis often means dealing with more severe symptoms and limited treatment options.

The condition affects women more frequently than men and typically appears between puberty and age 40. Family history plays a significant role—if a close relative has HS, the risk increases substantially. Obesity and smoking are also associated with higher rates of the condition.

The sooner you get diagnosed, the sooner you can start managing it effectively, Bevilacqua emphasizes. Don’t wait like I did.

Beyond the physical symptoms, hidradenitis suppurativa carries emotional weight. The chronic nature of the condition, combined with its impact on intimate areas of the body, can affect quality of life, relationships, and mental health.

Treatment approaches vary depending on severity but may include antibiotics, anti-inflammatory medications, hormone therapy, and in advanced cases, surgical intervention. Lifestyle changes such as maintaining a healthy weight, quitting smoking, and wearing loose-fitting clothing can help manage symptoms.

Recent advances in understanding the condition have led to better treatment options. Biologic medications that target specific inflammatory pathways have shown promise for moderate to severe cases, offering hope to those who haven’t responded to traditional therapies.

Dermatologists recommend keeping detailed records of symptom patterns, taking photos to track progression, and being prepared to advocate for proper diagnosis. Many patients see multiple doctors before receiving the correct diagnosis, making persistence and self-education critical.

The key signs to watch for include: recurring bumps in the same areas, bumps that last weeks or months, painful nodules under the skin, drainage from bumps, and scarring in affected areas. If any of these symptoms sound familiar, seeking evaluation from a dermatologist experienced in hidradenitis suppurativa can make all the difference.

For Bevilacqua, sharing her story means potentially shortening someone else’s path to diagnosis. Early recognition and treatment can preserve skin integrity, reduce pain, and improve overall quality of life for those living with this challenging condition.