Topic 5: Ask Sensitively About Stigma and Intimate Effects

Patients may have experienced years of embarrassment, dismissal, painful procedures, or advice that felt blaming. In a 2023 qualitative study, patients described feeling misunderstood, unheard, and dismissed in healthcare encounters. These experiences can reduce trust and willingness to disclose symptoms.⁵

Communication practices

• Explain why you are asking: “HS can affect areas that people may not feel comfortable bringing up, so I ask everyone with these symptoms.”
• Ask permission before discussing intimate locations or examining sensitive areas.
• Use the patient’s language for body parts when it is clinically clear and respectful.
• Offer privacy, appropriate draping, and a chaperone according to policy and patient preference.
• Use neutral language about drainage, odor, weight, smoking, sexual health, and mental health.
• Avoid implying that hygiene caused HS or that the patient must change weight or smoking status before deserving treatment.
• Acknowledge the burden: “That sounds painful and difficult to manage.”