I. Introduction

HS is more common after puberty, but younger kids can have it as well. In the United States, girls are more likely to have HS than boys. In pediatric patients with HS, you often find that other close family members also have HS, suggesting there might be genetic factors that contribute to having the disorder.

II. Clinical Features of Children with HS

A good screening question to ask if you are trying to determine if your child has HS is: have they had outbreaks of boils or abscesses during the last six months? Another good question to ask is: did they have at least two boils in one of the following locations: armpits, groin, genitals, under the breasts, buttocks, neck, or abdomen)?

A healthcare provider familiar with HS will be able to make the diagnosis of HS just by taking a medical history and examining the skin. No biopsies or lab tests are required.

III. Associated Conditions

Pediatric patients with HS have a higher chance of being obese or overweight, having acne, and having other conditions such as inflammatory bowel disease, inflammatory joint disease, anxiety, and depression. Kids with Down syndrome are at increased risk of HS. Sometimes your healthcare provider will need to do further work-up to rule out other associated diseases.

IV. Treatment of Children with HS

Treating HS is challenging. Unfortunately, treatments have largely not been studied in pediatric patients with HS, and treatment recommendations are taken from adult data. Early interventions might potentially modify disease progression. If inflammation is controlled early and disease severity does not progress, one could expect to prevent complications like scarring, but we need to study this further. Your healthcare provider might decide to start with topical treatments if the severity of the disease is mild; if moderate or severe, oral or injectable medications would be considered. Treatment options include antibiotics, retinoids, hormonal medications, biologics, laser, and surgery among others. As HS is made worse by heat, sweat, and friction, kids sometimes stop doing physical activities. It is important to control HS so they can continue to remain active and healthy.

V. Tips to help your child with HS

It can be helpful to educate your child about HS

The more your child understands about what is happening to their body, the easier it will be for them to talk to their friends about it, ask for help, and make healthy decisions for themselves.

Talking to your child to find out what bothers them most about their HS can also be helpful. As adults, our perceptions and values are different than that of our kids. You may focus on the long term effects of the disease, whereas your child may just be trying to figure out how they can change their clothes for gym class without anyone noticing, or how to apply their skin care while staying overnight at a friend’s house.

Finally, it is important to observe your child for signs of pain or depression and also assess their overall well-being. Pain related to an infection or worsening inflammation may be perceived by your child as “the usual chronic pain” they endure, and they may miss the opportunity to prevent a larger flare. Kids with HS have higher rates of depression. The emotional stress associated with HS can lead to feelings of sadness and hopelessness, causing kids to withdraw from normal activities and relationships. Growing up is challenging, but growing up with a chronic health problem can be overwhelming for some children. It is important to be aware of all the support services available to you and your child, and to encourage your child to talk to someone about their HS and how it affects them. This can happen through a counselor, support group, or even by joining a recommended online support group.