How Does Hidradenitis Suppurativa Affect Black Americans?

Hidradenitis suppurativa — a chronic skin condition that causes painful, inflamed nodules under the skin — tends to affect Black Americans at a higher rate than white Americans, according to Erum Ilyas, MD, Dermatologist at Montgomery Dermatology in Pennsylvania.

The exact cause is unknown. One theory is that hidradenitis suppurativa (HS) may also be associated with other conditions, such as high blood pressure and diabetes. These occur more frequently in Black Americans.

How is HS different in Black Americans?

While HS nodules may appear red or pink on lighter skin tones, these nodules can be slightly purple in appearance on darker skin tones. Instead, dermatologists may have to rely on the feel of the nodules deep under the surface of the skin rather than their visual appearance. 

One issue with the diagnosis of HS in Black Americans is that some dermatologists may not have been trained to recognize it in darker skin tones. This may mean that Black Americans are not always diagnosed with HS as quickly. Without treatment, their condition may progress into more severe symptoms like open wounds, scars, or infections.

As such, it may be helpful for Black Americans with symptoms of HS to seek out dermatologists who have experience treating people of color. 

How do barriers to care affect HS diagnosis and treatment?

Black or biracial Americans may already experience barriers in access to healthcare. This may include lack of access to high-quality health insurance, not having a primary care doctor, or not having the time or money to see a specialist.

These barriers may contribute to delays in diagnosis. Early HS diagnosis may lead to better treatment outcomes.

“We want to make sure that as many people are aware of this condition as possible, so they can seek out care earlier,” says Ilyas. 

References

Ballard, K., et al. (2023). Hidradenitis suppurativa. StatPearls.

Lofton, H., et al. (2023). Obesity among African American people in the United States: A review. Obesity: A Research Journal.

Ludmann, P. (2022). Hidradenitis suppurativa: Overview. American Academy of Dermatology Association. 

MedlinePlus. (2023). Hidradenitis suppurativa. 

National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2022). Hidradenitis suppurativa (HS).