Dr. Kory Kitagawa is a cosmetic and medical dermatologist in Honolulu. He specializes in various skin disorders and diseases, including hidradenitis, a chronic skin condition also known as acne inversa.

What distinguishes Kitagawa Dermatology from other dermatological practices is their training and experience. Board-certified dermatologist Dr. Kitagawa and his staff understand not only the physical aspect of troublesome and painful skin conditions but also the emotional side. A variety of treatments is offered, but each patient is different, so rest assured that your hidradenitis treatment will be customized.

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To learn more about treatment for hidradenitis or other chronic skin conditions, contact Kitagawa Dermatology today at 808.533.4434 and let Dr. Kitagawa diagnose your symptoms and recommend the right treatment for hidradenitis.

Signs and Symptoms of Hidradenitis

Hidradenitis is characterized by small, painful bumps beneath the skin. It’s a rare chronic skin condition that normally starts after puberty and can last the rest of your life. In fact, hidradenitis can worsen with time, causing adverse effects in your daily life and on your emotional health.

Normally, the lumps associated with hidradenitis are found in places where the skin rubs together, such as inner thighs, under the breasts, and between the buttocks. Acne inversa also commonly develops in areas with many hair follicles and oil or sweat glands, like the armpits, groin, and anus. If untreated, the hidradenitis lumps can rupture, create subcutaneous tunnels, and/or emit a foul odor.

Hidradenitis is unpredictable; it can affect people in different ways. For example, the skin condition can affect only one area of a person’s body, yet affect other people over multiple parts of the body, often starting as a single bump that doesn’t go away for weeks or even months. For every person who suffers through the worsening of the condition, there’s another person whose symptoms remain mild for the duration.

Stress, heat, humidity, hormonal changes, and being overweight can contribute to the worsening of hidradenitis symptoms. A more detailed breakdown of common acne inversa symptoms are as follows:

  • Blackheads commonly appear in pairs in small, depressed pitted areas of your skin.
  • Reddish bumps appear and often break open and leak pus, which could have a bad odor. There may also be constant itching and burning.
  • Hard, painful, lumps the size of peas can develop under the skin. They could persist for years, or enlarge and become inflamed.
  • Subcutaneous tracts can develop over time, connecting in tunnel-like ways with other lumps that have formed. These don’t heal very quickly. Sometimes, they don’t heal at all.

Causes, Risk Factors, and Complications

It is not clear what causes hidradenitis, but what is known is that it develops due to blocked and inflamed hair follicles, although why the blockage happens is also up for debate. This may explain the common misconceptions about what causes acne inversa, such as infection, sex, or poor hygiene. However, none of them are true; as acne inversa is not a contagious condition.

A variety of factors are suspected as triggers for hidradenitis, including:

  • Smoking
  • Being overweight
  • Family history
  • Changes in hormones
  • Issues with your immune system

Other factors are important to keep in mind, as well. Age can be an issue if hidradenitis develops while you’re an adolescent. This can indicate a higher likelihood that the condition will eventually be widespread and long lasting. Women are more likely than men to develop hidradenitis, and it’s been linked with other health conditions, including arthritis, Crohn’s disease, inflammatory bowel disease, diabetes, and more.

Additionally, if your hidradenitis is severe enough that it doesn’t subside, complications could arise:

  • The afflicted area could become infected.
  • Scars, depressed or pitted areas, and darker-than-normal skin patches can develop.
  • Depending on the area of the body, a person’s movement could be limited or painful, particularly if your armpits or inner thighs are affected.
  • Often, hidradenitis affects areas with lymph nodes, which could block the lymph system and cause swelling in various parts of your body.
  • If the sores are in easily visible areas or emit foul odors, this can be such an embarrassment that you’re hesitant to have a social life.
  • Advanced cases can result in squamous cell cancer, although this is rare.


Hidradenitis has no known cure, so early detection is crucial to getting effective treatment and managing your symptoms.

Kitagawa Dermatology is proud to offer treatment for hidradenitis, so talk with their excellent staff about the benefits and risks of each to decide which hidradenitis treatment works for you.

Medications such as biological injectables, topical ointments, oral drugs, hormones, and prescribed pain relievers can help reduce hidradenitis symptoms. Depending on the severity, the extent, and the affected areas, various types of surgery might be recommended, as well. Sometimes, alternative treatments for hidradenitis (such as zinc supplements) are used to reduce inflammation and prevent future flare-ups.

To learn more about this chronic skin condition and other hidradenitis treatments, please visit eMedicine.com.

Schedule an Acne Inversa Consultation with Kitagawa Dermatology

To understand more about hidradenitis treatments, symptoms, and more, contact Kitagawa Dermatology for a personalized consultation.

Don’t allow hidradenitis or any other skin disorder to ruin your social life and emotional health. Dr. Kitagawa and his staff are trained to address all your needs, so call 808.533.4434 to schedule a consultation with our cosmetic and medical skin care center in the Kuakini Medical Plaza in Honolulu.

Next, read about Melasma.