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Hidradenitis suppurativa in men: what recurring groin and buttock lumps can mean
Recurring groin or buttock lumps? Learn how hidradenitis suppurativa in men looks, how it differs from boils, and when to see an HS dermatologist privately.
Key takeaways
HS is often overlooked in men because its symptoms can look like more common skin problems, such as boils, cysts, or ingrown hairs.
Painful lumps that repeatedly appear in the same areas may be a sign of HS, particularly around the groin, buttocks, scrotum, or anus
HS is a chronic inflammatory skin condition that is not contagious, not a sexually transmitted infection, and not caused by hygiene.
HS is treatable. An HS specialist can help determine what’s causing your symptoms and recommend the right treatment.
Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that causes deep, painful lumps, often in areas where skin touches or rubs. In men, HS commonly affects the groin, inner thighs, buttocks, scrotum, and the area around the anus.
One of the biggest clues is that the lumps keep coming back. They may heal and then return in the same place or nearby.
Because HS can look like a boil, cyst, or ingrown hair, many men do not immediately realize they may have a chronic skin condition. HS is different from these conditions and requires its own approach to treatment. It is not contagious, an STI, or caused by poor hygiene.
The areas affected by HS can also be difficult or uncomfortable to talk about. But groin, genital, and buttock concerns are a routine part of dermatologic care.
Here’s what to know about HS in men, how to recognize it, what else can cause similar symptoms, and when it may be time to see a specialist.
HS in men may be more common than you think
HS is diagnosed more often in women, but it affects a significant number of men.
The 2025 global prevalence analysis in JAMA Dermatology found that the median share of HS patients who were female was 55.6%. It pooled general-population screening studies from 23 countries, with each case confirmed by exam, so close to half of patients were men. Global prevalence was about 1%.
A large US prevalence study published in JAMA Dermatology in 2017 found that 26.2% of 47,690 diagnosed patients were men, about 1 in 4. It counted patients with a recorded HS diagnosis in US health records.
The global analysis counts HS found by screening the general population. The US study counts HS that was diagnosed and recorded, and the higher share of women in that group reflects the data as recorded.
Taken together, these two JAMA Dermatology studies show that HS is not rare in men. It usually begins after puberty, and recurring lumps at any age after that deserve a specialist's attention.
Where HS shows up in men
In men, HS commonly affects the:
Groin and inner thighs
Buttocks
Scrotum
Perineum, the area between the scrotum and anus
Area around the anus
Armpits
A 2021 study of 209 patients at one US academic clinic, UCLA, examined gender differences in HS. It found more buttock and perianal involvement in men than in women (52% vs. 25%). In the UCLA study, men had 2.24 times the risk of presenting at Hurley III, the most advanced stage, though patterns vary between studies.
What HS can look like
HS often begins as one tender, deep lump that lasts days to weeks. Some people notice blackheads in pairs nearby. Less often, lumps appear on the back of the neck or the scalp.
Lumps may open and drain, then heal and return in the same or nearby spots. Over time, sinus tracts (tunnels that form under the skin and connect lumps) and rope-like scars can develop. Our condition guide explains how HS changes over time, including why early bumps are often mistaken for pimples or ingrown hairs.
Dermatologists describe severity with Hurley stages, a three-level scale of how far HS has spread and scarred.
Stage I: occasional lumps without tunnels or scarring
Stage II: recurring lumps with some tunnels and scarring
Stage III: widespread lumps with connected tunnels and scarring across an area
There is no blood or skin test for HS. Diagnosis rests on your history and an exam, and your dermatologist maps your own pattern over time.
A simple record of past flares helps. Note the dates, locations, and how long each lump lasted, and take photos when you can.
Is it HS or something else?
Several conditions cause painful lumps in the groin, buttocks, and genital area. An exam tells them apart, and some can occur alongside HS.
Condition | What it usually looks like | What points toward HS instead |
|---|---|---|
Simple boil (furuncle) | A single infected hair follicle that swells, drains, and heals | Lumps that keep returning in the same regions |
Ingrown hair or folliculitis (inflamed hair follicles) | Small, surface-level bumps around individual hairs | Deeper, more painful lumps that last days to weeks |
Pilonidal cyst | A painful lump or opening at the top of the buttock cleft | Lumps in other areas too, such as the groin or armpits; the two can coexist |
Perianal abscess or fistula (an abnormal tunnel from the anal canal to the skin), including from Crohn's disease (an inflammatory bowel condition) | A deep, painful lump near the anus, sometimes with bowel symptoms | Recurring lumps in other skin folds as well; this lump needs prompt evaluation either way |
Swollen lymph node or other groin lump | A lump beneath the skin rather than in it | Lumps within the skin that drain or scar |
Genital sores from a sexually transmitted infection (STI) | Usually blisters or open sores (ulcers) | Deep, tender lumps under the skin rather than blisters or ulcers |
HS is an inflammatory skin condition, separate from STIs. It cannot pass to a partner or spread through contact, and hygiene habits do not cause it.
Some look-alikes need care from other specialists, such as a colorectal surgeon for a perianal fistula. A dermatologist can coordinate that care when an exam points beyond HS.
Why men often wait, and what changes with the right care
The location of HS, the drainage, and worry that it looks like an STI or poor hygiene keep many people from seeking care. A British Journal of Dermatology survey of HS patients across 24 countries found the average delay before diagnosis was 7.2 years.
Urgent-care drainage treats a single flare. HS benefits from a longer-term plan that addresses why lumps keep returning.
Dermatologists aim to treat HS early because repeated flares in one area can lead to tunnels and scarring. Early lumps are usually easier to control than established tunnels.
A few steps make the first visit more useful.
Know that dermatologists examine the groin, genitals, and buttocks as a routine part of skin care.
Ask about early treatment, which can reduce flares and help prevent tunnels and scarring.
Bring your list of past flares, with dates, locations, and photos.
HS, sex, and intimacy
Lumps in the groin, scrotum, and buttocks can make sex painful. Drainage, odor, and scarring can also affect confidence and closeness with a partner.
In a small 2022 study on HS and intimacy, 19 of 30 men (63.3%) at clinics in Spain and Poland screened positive for erectile dysfunction. The men completed a standard questionnaire, and larger studies are needed to confirm the finding.
Sexual health is a normal part of HS care. These steps can help.
Raise sexual health with your dermatologist so it becomes part of your treatment plan.
Treat the underlying inflammation, which often matters most for comfort during sex.
Plan intimacy around quieter periods between flares when possible.
Talk openly with your partner, and share that HS cannot pass between partners.
Partners often have questions too. Sharing what you learn from your dermatologist can help both of you understand the plan.
How dermatologists treat HS
Treatment for hidradenitis suppurativa in men follows the same principles as treatment for women. It is matched to your stage and to how often flares happen, and most plans combine several approaches.
Topical treatments and antibiotics to calm inflammation and reduce flares
Injections into individual lumps to calm a painful flare
Biologic medications, injected medicines made from living cells that target specific parts of the immune system
Laser hair reduction, which can reduce new lumps in treated areas
In-office procedures to drain or remove lumps and tunnels that keep returning
The AAD guide to HS treatment notes that the FDA has approved adalimumab (Humira) for moderate or severe HS in people 12 and older. It also lists bimekizumab as FDA approved for adults with moderate to severe HS. Secukinumab is another biologic option.
Biologics are usually considered for moderate to severe HS and are given as regular injections or infusions. Your dermatologist checks how you respond and watches for side effects at each follow-up.
Daily habits support medical treatment. According to the NIH, smoking and obesity may be linked to HS, so dermatologists often recommend quitting smoking and managing weight. In the UCLA study above, men were more often active smokers than women (28% vs. 12%).
Loose, breathable clothing can also reduce friction in skin folds. Plans are personalized, and response varies between people. Ongoing follow-up lets your dermatologist adjust treatment as your HS changes.
When a lump needs same-day care
Not every painful lump should wait for a routine dermatology appointment.
Seek urgent or same-day medical care if a lump is accompanied by:
Fever or chills
Redness that spreads quickly, or red streaks from the lump
Severe or rapidly worsening pain
A hard, very painful swelling near the anus
Feeling generally unwell
Any of these signs with diabetes or a weakened immune system
At urgent care, mention that you have or may have HS, and share your flare record. Afterward, a dermatologist can build the longer-term plan that HS needs.
A private next step with an HS specialist
HS can be difficult to recognize, and symptoms in intimate areas can make seeking care feel uncomfortable. You do not have to wait for symptoms to become severe before talking to a specialist.
Tono's hidradenitis suppurativa program is an HS Center of Excellence where specialists treat every stage of HS. Every visit is led by a specialist.
Private video visits from home, with the option to share photos before your appointment
In-person care coordinated when needed, including exams, labs, and procedures
Appointments in 2 days or less
No referral needed, with most insurance accepted
Video visits are one way to reach the right specialist for HS. Photos shared ahead of time help your specialist see lumps that have settled by the day of the visit. Our patient guide explains what to expect at your visit, including how to share photos.
Clinical care is led by co-founder and chief medical officer HS researcher Dr. Mondana Ghias. She is a board-certified dermatologist.
Tono has cared for more than 20,000 patients across 33 states. Dr. Ghias explains the care model in why virtual-first HS care works.
Care continues after the first visit. Your specialist schedules follow-ups, sends prescriptions to your local pharmacy, and manages biologic treatment over time. Tono is an ongoing specialty medical home for your HS care.
Coverage questions are answered in our insurance and referral details.
Frequently asked questions
Is HS a sexually transmitted infection?
No. HS is a chronic inflammatory skin condition, not an STI. It is not contagious and cannot be passed to a partner.
Can HS affect the scrotum or penis?
HS can affect genital skin, including the scrotum and surrounding areas. A dermatologist can evaluate symptoms in these areas privately, either through a video visit with photos or in person when needed.
Can HS go away on its own?
HS is a chronic condition. Symptoms can improve or disappear for periods of time and then flare again. Treatment is designed to reduce flares, control inflammation, and help prevent the disease from progressing.
What kind of doctor treats HS?
HS is treated by a dermatologist, ideally one with specific experience diagnosing and managing the condition. Dermatologists may also work with surgeons or other specialists when additional procedures or care are needed.
Can a dermatologist evaluate groin or buttock lumps by video?
Often, yes. A dermatologist uses your history, the video visit, and your photos, and arranges in-person steps when an exam or procedure is needed.
Schedule an in-person or virtual appointment with a Tono Health specialist. Use our search page to find an HS specialist.
