Section Summary
- HS commonly begins during adolescence and may be present before a patient reaches adult care.
- Early adolescent HS may resemble acne, folliculitis, infection, or an isolated cyst; recurrence and distribution reveal the pattern.
- Confidential, developmentally appropriate questioning may uncover sensitive locations and psychosocial burden.
- School function, sleep, activity, stigma, and mental health are part of the clinical assessment.
- Timely referral is appropriate before extensive tunnels or scarring develop when disease is recurrent, burdensome, structurally significant, or inadequately controlled.
| Key takeaway: When a young person reports recurrent painful ‘boils’ in areas where skin touches skin, ask about the pattern, create private space for disclosure, and consider HS early. |