If you ask a sufferer you'll receive a far different answer than a research dermatologist or a surgeon or an immunologist or a family doctor. It is not contagious nor is it caused by hygiene or obesity. In its worst form, it looks like boils. Because this condition occurs in areas rich in apocrine sweat glands it has been associated with them. And speaking of what is also not a primary event, infection is only a secondary event to the actual disease process and is not always there.
Research continues to find out the cause of the follicular occlusion.
Because more women than men appear to have the condition, hormonal triggers are suspected however no conclusive research has been done. The classification of HS has changed from a disease of the apocrine gland to a disease of the hair follicle. J. Lapins, C. Jarstrand and L. Emtestam. Hidradenitis suppurativa is a chronic inflammatory disorder, usually located in the axillae and genitocrural areas. Histopathologic studies suggest that HS is a disease of the follicles with apocrine involvement as a secondary event, so the term acne inversa has been suggested.