No routine inspections
Suspecting HS is not a reason to inspect intimate body areas. What needs medical assessment is assessed in the practice, not by the family. Watch what is becoming difficult in daily life instead, and offer the appointment.
For parents and carers
Supporting a Teen With HS
What you might notice, how to raise it, how to help them get assessed — and where your child’s own authority over their body begins.
Supporting a Teen With HS
Recurring painful lumps or draining lesions in a child or teenager deserve medical attention — particularly when they come back or leave scars.
HS can begin during adolescence and is frequently recognised late in this age group. Your role is mainly to make access to care possible — while leaving your child increasing control over conversations about their own body.
What you might notice
The visible skin is rarely the clearest signal; what changes in daily life usually is. Every point below can be observed without looking at anything.
- Repeated complaints about painful “boils”, “lumps” or “abscesses”.
- Difficulty sitting or walking, or a changed way of moving.
- Sport, swimming or changing rooms are suddenly avoided.
- Dressings or plasters are being used up regularly.
- Marks on clothing or bedding with no obvious explanation.
- More frequent absences, or withdrawal from activities.
- An appointment is refused out of embarrassment even though something is clearly painful.
Suspecting HS is not a reason to inspect intimate body areas. Say what you have noticed instead, and offer to help get an appointment.
How to raise it
The left column keeps the conversation open; the right column usually ends it. The difference is almost always about who decides.
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Helpful: “I’ve noticed this seems painful. Do you want help getting it checked?”
Better avoided: “Let me see.”
Why: An offer leaves the decision with the young person. A demand to see it takes away exactly the control they most need over an intimate part of their own body.
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Helpful: “You don’t have to show me if you don’t want to. We can ask a doctor to look at it instead.”
Better avoided: “Have you been washing properly?”
Why: The hygiene question is medically wrong, and it lands squarely on the shame a young person has usually already brought with them.
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Helpful: “This isn’t your fault, and you haven’t done anything wrong.”
Better avoided: “Why didn’t you tell me?”
Why: “Why didn’t you tell me?” lands as an accusation. The answer is almost always embarrassment, and that is a hard thing to say out loud.
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Helpful: “Do you want to ask your own questions at the appointment, or shall I start?”
Better avoided: Answering on the young person’s behalf during the appointment without asking.
Why: A young person who gets to speak in the consulting room learns to do it alone later. Over time that matters more than an efficient appointment.
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Helpful: “Tell me what actually helps right now — even small things.”
Better avoided: Comments about weight, diet or smoking as an explanation for the condition.
Why: Comments like these are heard as blame. What is medically relevant in an individual case belongs in the consultation — not at the kitchen table, and not on a website.
This section is communication support, not medical evidence. It reflects what young people with visible or intimate skin conditions describe as helpful or hurtful.
Clearing the path to medical assessment
In practice, support usually means: booking the appointment, getting there, sorting out costs and paperwork, keeping dressings in the house, and persisting when a first assessment does not help.
If a practice tells you it is “just boils” and the lesions keep coming back, that is a reason to seek a dermatology second opinion — not a reason to stop.
Supporting without taking over
Three places where well-meant support takes something away from the young person that should stay with them.
Leave space in the consulting room
Ask before the appointment what the young person wants to say themselves — and whether part of the conversation should happen without you. If confidentiality matters to them, ask the practice together what applies: the rules depend on age, maturity, setting and country.
Make decisions together
What has been studied in adults cannot simply be transferred to adolescents: the evidence base in younger patients is more limited, and age and developmental stage matter. Ask at the appointment which options are appropriate for your child — and involve them in that conversation as far as their development allows.
School
What the school needs to know is primarily your child’s decision. For many teenagers it is easier to hand over a short written note than to have the conversation themselves — there is a card here for that, built in the browser, and it does not have to name a diagnosis.
Treatment: what you can ask
These pages deliberately name no medicines and give no age-based treatment recommendations. The evidence base in younger patients is more limited than in adults, and age, developmental stage and other conditions all matter.
Our treatment pages explain which categories of treatment exist at all. Which of them are appropriate for your child is something to settle at the appointment.
When your teenager starts taking over
A useful handover is not the same as suddenly stepping away.
If you have been the person who remembers appointments, treatments and previous procedures, some of that information may currently exist only in your head. Before responsibility changes, help turn it into information your teenager can access themselves.
Give them the history
Help them obtain a treatment list, important letters and the names of clinicians involved.
Let them practise
Where appropriate, let them answer questions, ask their own questions and handle parts of appointment planning themselves.
Ask what role they want you to have
Support can continue without automatically speaking for them.
See the page for teenagers
Nobody has to disclose a condition. “I don’t want to tell anyone yet” is a completely valid outcome of these pages.
Evidence and editorial review
Last editorially reviewed: · Next review:
That HS often begins during adolescence, usually after puberty starts, is described in reviews and in patient information from national health bodies. That it is not contagious and not caused by poor hygiene is well established.
That the condition is often recognised late in young people has been described repeatedly. The reported delays differ substantially between studies, because they use different data sources and definitions.
Quality-of-life research in younger patients consists mostly of small cross-sectional studies. They show that substantial burden can occur even when the skin looks relatively unaffected. They do not support any statement about how often that is the case overall.
A higher rate of new-onset depression among young people with HS has been reported in large retrospective cohorts. That says nothing about any individual — which is why these pages run no test and make no assessment.
Treatment recommendations for adults cannot be transferred to adolescents unexamined. The evidence base in younger patients is more limited, which is why these pages name no medicines and give no age-based treatment recommendations.
On handing HS care from paediatric to adult services, the only HS-specific guidance we found is a short, clinician-facing visit guide, not trial evidence. Large studies show that young people with HS often pass through several kinds of services before diagnosis — paediatricians, family doctors, emergency departments and dermatologists. A 2026 US study of treatment records for 6,659 children with HS found that most stayed on their first treatment for about a year before it was changed. None of this shows that a handover checklist improves outcomes; it explains why an accurately carried-forward history is worth having, which is all the handover page claims.
Related resources
What is Acne Inversa? The basics of the condition, scientifically researched, editorially reviewed, and readable without prior knowledge. What HS can look like An illustrated, non-diagnostic guide to affected body areas and skin changes. When to get medical help The page to turn to when it is unclear whether something needs looking at quickly. HS, Shame & Stigma Why shame is so common with this condition — and how to prepare a conversation. Hair removal with HS Shaving, trimming, waxing and laser hair reduction compared — a common question in the teen years. Find a specialist A directory of practices and clinics with experience in treating HS. Patient stories Accounts from people living with HS — lived experience, not evidence. Taking Over Your HS Care A private checklist for keeping your treatment history, appointments and questions together when your care starts becoming more your responsibility. Studying With HS For later: a private planner for university, training and exams.
Sources
- Hidradenitis suppurativa — overview, including onset often after puberty and that the condition is not contagious NHS (United Kingdom) · Link checked: 2026-08-07
- Hidradenitis suppurativa self-care — why washing and scrubbing do not prevent the condition American Academy of Dermatology · Link checked: 2026-08-07
- Hidradenitis suppurativa — onset usually after puberty, arising from several interacting factors MedlinePlus Genetics, US National Library of Medicine · Link checked: 2026-08-07
- Diagnostic delay in paediatric and adolescent hidradenitis suppurativa — reviews and cohort studies PubMed, US National Library of Medicine · Link checked: 2026-08-07
- Quality of life in younger patients — predominantly small cross-sectional studies PubMed, US National Library of Medicine · Link checked: 2026-08-07
- New-onset depression among children and adolescents with hidradenitis suppurativa — retrospective cohort studies PubMed, US National Library of Medicine · Link checked: 2026-08-07
- Guideline work on special patient populations, including paediatric patients PubMed, US National Library of Medicine · Link checked: 2026-08-07
- Toledo et al., “A visit guide for adolescent hidradenitis suppurativa: Bridging the divide between pediatric and adult care” (JAAD International, 2022) — the clinician-facing visit guide behind the handover page PubMed, US National Library of Medicine · Link checked: 2026-09-29
- Hallock et al., “Differences Between Children and Adults With Hidradenitis Suppurativa” (JAMA Dermatology, 2021) — 1,094 paediatric vs 7,633 adult patients; contact with paediatricians, family doctors, emergency departments and dermatology before diagnosis PubMed, US National Library of Medicine · Link checked: 2026-09-29
- Aflatooni et al., “Treatment Patterns in Pediatric Hidradenitis Suppurativa” (Pediatric Dermatology, 2026) — 6,659 children with HS; a mean of 386 days on the first treatment before switching PubMed, US National Library of Medicine · Link checked: 2026-09-29
- Hidradenitis Suppurativa Foundation — patient organisations and materials, explicitly including families HS Foundation · Link checked: 2026-08-07