Better HS care starts here


The average diagnostic delay for psoriasis is 1.6 years.1

But for patients with hidradenitis suppurativa (HS), it takes 7.3 years on average to receive a diagnosis.1-3 It’s time to stop HS falling through the cracks of our healthcare systems.4

Better HS care starts here.

What is HS?

What is HS?

HS is a chronic, recurrent, and debilitating inflammatory skin condition. While it can occur at any age, it usually presents after puberty. It is characterised by lesions on the skin, including abscesses, painful nodules, draining tracts and fibrotic scars.5,6 The exact underlying cause of HS is unknown. But it’s thought to be due to a combination of genetic, environmental and hormonal influences.7


The prevalence of HS in Europe is estimated to be 1% or more. This means there are currently over 7 million people living with HS in Europe alone.1,8 It affects three times as many women than men.3 Although HS is considered a common condition, it’s often misunderstood.

HS in the armpit across Hurley stages:

The Hurley staging system describes three clinical stages, and is commonly used to assess the severity of HS:5

Hidradenitis suppurativa in the armpit across Hurley stages - Stage 1

Stage I

Single or multiple abscesses without tunnels or scarring.

Hidradenitis suppurativa in the armpit across Hurley stages - Stage 2

Stage II

Recurrent abscesses, single or multiple widely separated lesions, with tunnels and scarring.

Hidradenitis suppurativa in the armpit across Hurley stages  - stage 3

Stage III

Diffuse or broad involvement, with multiple interconnected tunnels and abscesses, and scarring.

Images reproduced from DermNet New Zealand. Distributed under the terms of a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 (New Zealand) License: .

HS pathogenesis9

Pathogenesis of hidradenitis suppurativa follicular occlusion

1. HS is initiated by follicular occlusion and dilation

Pathogenesis of hidradenitis suppurativa follicular rupture

2. Subsequently, the inflammatory cascade with cytokine-driven positive feedback results in follicular rupture and the formation of inflammatory nodules and abscesses

Pathogenesis of hidradenitis suppurativa tunnels and scar tissue

3. A chronic state of inflammation and imbalance of fibrotic factors eventually leads to tunnels and scar tissue

Image adapted from Goldburg SR, et al. J Am Acad Dermatol. 2020;82:1045–58.

The need for change

Many patients with HS live with unbearable pain, every day. The physical symptoms, fatigue, and high comorbidity burden, coupled with the isolating and stigmatising nature of the disease, dramatically affect quality of life.4,9


It’s no surprise that HS is ranked in the top five skin diseases with the most negative impact on patients’ quality of life.10


It’s time we raise awareness of this debilitating disease and help improve the lives of people living with HS.


Only through educating all those involved in the management of HS can we strive to shorten the time to diagnosis, alleviate the patient burden, and optimise the management of HS for our patients.

The burden of HS
The burden of HS

Find out more about how we are raising awareness of HS to eliminate diagnostic delays

The HIDRACENSUS 7.3 programme logo
HIDRACENSUS 7.3 programme

Learn more about our ongoing expert-led initiative, which aims to enhance the standard of care for patients living with HS across Europe



  1. Ingram JR, et al. Br J Dermatol. 2020;183:990–8.
  2. Barmatz S, et al. Dermatology. 2022;238:772–84.
  3. Nguyen TV, et al. J Eur Acad Dermatol Venereol. 2021;35:50–61.
  4. Howells L, et al. Br J Dermatol. 2021;185:921–34.
  5. Zouboulis CC, et al. Dermatology. 2015;231:184–90.
  6. Anduquia-Garay F, et al. Ann Med Surg (Lond). 2021;68:102679.
  7. Diaz MJ, et al. Curr Issues Mol Biol. 2023;45:4400–15.
  8. Worldometer. Europe population. Accessed November 2023
  9. Goldburg SR, et al. J Am Acad Dermatol. 2020;82:1045–58.
  10. Tzellos T, Zouboulis CC. Exp Dermatol. 2022;31(Suppl 1):29–32.



Date of preparation: January 2024