In Full Figure

I remember turning 20 and starting to notice these painful “boils” showing up out of nowhere. At first, I thought it was because I wasn’t consistent with my levothyroxine at the time, so I convinced myself it had to be because my TSH levels being off which was making my hormones out of control. 

Then I noticed a pattern: they would flare up right before or during my period.

They were mainly under my arms and breasts and on my groin and my inner thighs.

I started questioning everything.

The pain was so uncomfortable. I couldn’t put my arm down or I would have to sleep with my legs spread, because any contact would have the pain throbbing for hours.

When I saw a video talking about a cream for something called Hidradenitis Suppurativa (HS) I was like… wait. That looks exactly like what I have.

I went to a dermatologist, expecting some sort of help when that cream wasn’t working.

Like every doctor I encounter, I got rushed out of the room with little-to-no explanation on what causes the flare ups and a vague warning about needing to lose weight before I’d have to go on injections for life. 

Because of course, all medical issues are related to weight.

So I got scared.

So I did what a lot of women end up doing, researching themselves.

I compared my symptoms to medical photos and articles, and it was pretty definite:

I was dealing with hidradenitis suppurativa.

I don’t see a lot of influencers talking about it. So let me explain what it is. 

What Is Hidradenitis Suppurativa (HS)?

Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that affects hair follicles, leading to painful lumps, abscesses, and, in more advanced cases, scarring and tunnels under the skin.

HS is not caused by being unclean and is not contagious. It’s actually considered an autoinflammatory condition, which means the body overreacts within the hair follicles, causing recurring flare-ups.

It’s usually mistaken for:

• Ingrown hairs
• Razor bumps
• Cystic acne

And because it shows up in intimate areas, a lot of women don’t talk about it

How HS Starts

HS shows up out of nowhere, but there is actually a process happening under the skin.

It begins in the hair follicles.

Here’s what’s happening:

• Hair follicles become blocked by dead skin cells and keratin
• The follicle swells and eventually ruptures under the skin
• Your body responds with inflammation, creating painful, deep lumps
• This turns into a cycle, where flare-ups return in the same areas

That’s why it doesn’t feel like a one-time issue. It repeats.

Why it shows up in certain areas

HS tends to develop in:

• underarms
• inner thighs
• under breasts
• buttocks

For plus size women, this part matters because these are areas where there’s friction, sweat, and skin-to-skin contact, making follicles more prone to irritation.

What can trigger it

HS is influenced by multiple factors:

• Hormones: Often starts in your teens or early 20s—right when you’re still learning your body and trying to make sense of changes.
• Genetics: Some people are simply more prone to it
• Inflammation: It’s an internal immune response, not an infection
• Friction: Tight clothing, chafing, and shaving can aggravate the skin

It’s also more common in women than men.

What To Do If You Think You Have HS

If any part of this feels familiar, here’s where to start:

1. See a Dermatologist — and Advocate for Yourself

Not every experience will be perfect, and unfortunately, not every doctor will take the time you deserve.

Be direct:

• Describe your symptoms clearly
• Mention how often flare-ups happen
• Ask specifically about hidradenitis suppurativa

If you feel dismissed, go seek a second opinion. You deserve to have all the information. 

2. Track Your Symptoms

Start paying attention to patterns:

• Do flare-ups align with your menstrual cycle?
• Are certain areas always affected?
• Do certain fabrics, shaving habits, or stress levels make it worse?

This information helps both you and your doctor understand your condition better.

3. Know That Treatment Exists

Treatment depends on severity, but options can include:

• Topical treatments
• Oral medications
• Hormonal management
• In more advanced cases, injections

4. Reduce Friction & Irritation Where You Can

Small changes can help manage discomfort:

• Wearing loose, breathable clothing
• Being mindful with shaving
• Keeping areas dry without over-scrubbing

Always make sure you educate yourself. Even if you feel embarrassed that something is happening with your body and you think it’s your fault, still ask questions. Because if I had just asked when it first started, I probably could have prevented it from getting so severe. 

A quick note on the visuals:
The images used in this post are AI-generated to help explain HS in a way that’s easier to understand without relying on graphic medical photos. HS can be visually intense and sensitive for some readers, so this approach is intentional to educate without overwhelming anyone.