Addressing HS Misconceptions

In ‘Addressing HS Misconceptions,’ our experts delve into the widespread false beliefs about HS that continue to fuel diagnostic delays and cause lasting harm to patients. Dr. Resnik shares that he now makes it a standard part of his patient intake to clearly explain what HS is and what it is not, directly addressing common false beliefs that the disease stems from poor hygiene, infection, hormones, or issues in deeper tissue layers. He stresses that these are not fringe misunderstandings but rather beliefs that patients frequently arrive with, sometimes because a prior provider told them so, and he recounts how a colleague on the HS Foundation board had her life significantly affected for years after being told her disease was the result of not washing properly.

A central focus of the discussion is the persistent myth that HS is an infectious disease. Dr. Resnik describes a common scenario in which patients visit urgent care, have an abscess lanced and cultured, and are prescribed a short course of doxycycline. While they may feel better temporarily due to the drug's anti-inflammatory properties, symptoms return once the course ends, reinforcing a cycle of mismanagement. He argues that dispelling the infection myth represents the single greatest opportunity to redirect patients toward appropriate care.

Dr. Hsiao adds another prevalent misconception, that HS only affects patients who are overweight or smoke. She notes that many patients disqualify themselves from a potential HS diagnosis because they do not fit that profile, and she stresses that the disease can affect anyone regardless of body weight or smoking history. Dr. Resnik reinforces this point by cautioning against overly rigid diagnostic thinking, noting that flexibility is essential since HS does not always present by the textbook.

Our next episode, ‘Key Distinguishing Features of HS,’ further explores HS, highlighting the clinical clues, diagnostic pitfalls, and distinguishing features that dermatologists use to differentiate HS from mimicking conditions such as acne, folliculitis, and cutaneous Crohn's disease.