Riley Moscicki, a 25-year-old public relations specialist from Rochester, New York, never had skin problems growing up. But at age 24, after a trip to Georgia, she developed small bumps anywhere her clothing had rubbed against her body. She figured it was a reaction to the intense heat, or perhaps some ingrown hairs. But they doubled in size over a few weeks, becoming so painful she couldn’t exercise or work comfortably. A trip to the emergency room revealed she had hidradenitis suppurativa (HS)—a chronic condition that causes painful, pus-filled lumps under the skin. Here’s her story, as told to health writer Julia Ries.
I had just returned home from Savannah in July 2023 when I noticed that my skin felt super sensitive and irritated. There were a handful of tiny pea-size bumps on my bikini line, armpits, and underboob area. They didn’t concern me at first. I figured my skin was reacting to the Georgia heat. I’ve also dealt with ingrown hairs forever—I’m a person of color with naturally curly hair, so for me, a little bump here and there was normal. I didn’t tell anybody about them at first because my friends and family always yell at me for picking at my skin. I assumed the issue would go away after a few days.
Within a week, however, the bumps grew to the size of a quarter. I showed them to my mom, who thought they were strange. That’s because the mounds were hard and also sensitive to touch. Pus started coming out of the ones near my groin after a few days. I thought maybe I picked up a random skin infection on my trip.
Around early August, the bumps went away. I felt relieved, but a couple of weeks later, I noticed new ones appearing in my armpits and near my groin. Some were the size of a penny, but others were as big as a quarter. I went to another friend’s wedding in mid-August—but the discomfort was so bad that I couldn’t even dance. I don’t even know how to describe the sensation—it’s like any time I moved, my skin stretched. It was so unbelievably painful—even walking hurt—so I ended up leaving the wedding early.
Around that time, I stopped using lotions and scented soaps because I thought maybe one of my skin care products was making things worse. I also started to wear loose clothing because I wanted to hide what was going on. I was embarrassed and confused about how the lumps looked. I also had a tough time getting through the workday. Sitting at my laptop was horrible. If I moved my body, the bumps in my armpits burned. The pain was really affecting my mental health. I felt best lying down—even going to the bathroom hurt. I’m pretty active—I’m always working out or going hiking—but I couldn’t exercise at all. Plus, pus was now regularly leaking out of the bumps. I had no idea what was going on. I decided to see my primary care doctor.
After examining me, she told me I might have HS—a chronic condition that causes lumps and abscesses under your skin—though I wasn’t given an official diagnosis. She just said I needed to have the bumps (which I learned are called nodules) lanced. This is when a doctor numbs the area, slices it open with a scalpel, and lets pus and blood drain out of it. It was painful and gross seeing everything come out. But I felt a lot better after it was done—the lancing relieved so much pain and pressure. She only treated the lumps on my stomach and in my left armpit—the ones in my right armpit were small enough to leave alone.
Since I wasn’t given an official diagnosis, I still hoped I was just having a weird, random flare-up and that everything would settle down. But two days after seeing my primary care doctor, the lumps in my right armpit tripled in size and the groin bumps came back. They were red, inflamed, and hot to the touch, shooting pain down the side of my torso. I thought something was seriously wrong—like I had a bad infection or something. It was the worst pain I ever had in my life. It was very scary.
I went to the emergency room, where I was immediately seen by a physician’s assistant who previously worked for a cosmetic surgeon (so he was familiar with HS). He examined my skin and said, “I’ve seen this before, and I think you have HS.” (Editor’s note: There’s no single test that can diagnose the condition. Doctors determine if you have it by examining your skin, looking at your health history, and swabbing your lesions to rule out other problems.) He explained that I also had a “tunnel of HS” along my abdomen—a deep cavity that can form between nodules. He said all of them needed to be lanced because they were so inflamed.
He injected a numbing agent into each one and, telling me it would be excruciating, lanced the nodules in my right armpit first. I was shaking and sweating from the pain, almost passing out at one point. After he lanced all of the bumps, he squeezed the blood and pus out of them and took a swab of the abscesses. Then he packed my wounds, or basically put a bunch of gauze into the open areas. That was such a weird sensation—to just have paper towels stuffed deep in your skin.
Although I had a bunch of scar tissue from the lancing, my skin slowly started to heal, thankfully. I thought I was in the clear until September when I went to Tennessee for another wedding. I got two horrible lumps on my right hip where my jean shorts rubbed against my skin. (I’ve since learned that being in hot temperatures and wearing tight clothing contributes to flare-ups.)
I couldn’t get an appointment with my primary care doctor when I got back home, so I reached out to a local laser hair removal and dermatology practice. Though they told me “there’s not much you can do” to treat HS lumps, besides keeping them clean and not aggravating them, the docs recommended laser hair removal to help prevent HS flares. They also told me to apply hand warmer pouches to my skin to soothe the pain, which was really helpful.
I’ve been doing laser hair removal for the past 11 months. For the most part, my skin is clear. I know this isn’t always common, because so many people with HS struggle to find a treatment that works. Though the lumps are gone, I still feel insecure about my scars. As a person of color, I scar easily and they’re very visible. But I feel super lucky that I got diagnosed with HS relatively quickly. The condition often goes mis- or undiagnosed for years, especially in people of color.
Though the docs aren’t sure what caused it, HS is something I’ll have to deal with for the rest of my life. I’m worried that it’ll affect me if and when I get pregnant. But I’ve found that there are always resources and people around to help—I did so much research on my own and explored different solutions until I found something that worked for my symptoms. I learned how to deal with it, for the most part, and now I know that with time and treatment, my HS can get better.
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