The Condition Nobody's Heard Of — And Why Publishers Need to Change That
It affects up to 4% of the population. It's more common than multiple sclerosis. It causes painful, recurring lesions in some of the most sensitive areas of the body, can burrow beneath the skin creating tunnels, and leaves lasting scars — yet most people have never heard its name. Hidradenitis suppurativa, mercifully shortened to HS, is arguably the most underrepresented chronic inflammatory skin disease in medical publishing relative to how many people actually live with it. It also goes by another name — acne inversa — not because it's related to acne, but because it appears in the inverse locations: the skin folds rather than the face. For publishers, educators, and pharmaceutical communicators working in health communications, the gap between HS's prevalence and its visibility in medical media represents both a challenge and a significant opportunity. Science Source has the licensable imagery to help close it.
Hidradenitis Suppurativa Gallery Intended for medical, educational, and publishing professionals; images depict significant disease progression.
What Is Hidradenitis Suppurativa?
HS is a chronic inflammatory condition affecting the apocrine glands — specialized sweat glands concentrated in the armpits, groin, under the breasts, and inner thighs. When these glands and their surrounding hair follicles become blocked and inflamed, the result is painful, recurring abscesses that can rupture, tunnel beneath the skin, and cause significant scarring over time.
It is not caused by poor hygiene — a persistent and deeply damaging misconception that contributes to the stigma patients carry along with the condition itself. HS is an immune-mediated disease, driven by an overactive inflammatory response rather than anything a patient did or didn't do.
Clinicians categorize HS using the Hurley staging system, which describes three progressive levels of severity:
Stages of hidradenitis suppurativa. © Monica Schroeder / Science Source
Hurley Stage I — single or multiple abscesses without tunneling or significant scarring
Hurley Stage II — multiple abscesses with the beginning of tunneling and scarring
Hurley Stage III — extensive abscesses, advanced tunneling, and deep scarring across large areas of the body
That progression — from isolated lesions to a complex landscape of tunnels and scars — is one of the most important visual stories in dermatology, and one that demands more than a single image to tell.
HS in Context: The Most Underdiagnosed Condition in Dermatology
Despite its prevalence, patients with HS wait an average of seven to ten years for a correct diagnosis. In that time, they are frequently told they have recurring boils, infected ingrown hairs, or even sexually transmitted infections — misdiagnoses that delay treatment and compound the condition's psychological toll.
HS disproportionately affects women and people with darker skin tones, two groups historically underrepresented in dermatology photography and clinical research alike. The condition also carries an outsized psychosocial burden — chronic pain, wound care, scarring in intimate body areas, and persistent stigma around a condition many patients are too embarrassed to discuss with anyone, including their doctors.
Growing patient advocacy is beginning to shift that silence. Awareness campaigns, patient communities, and increasing media coverage are driving demand for model-released imagery that reflects who actually lives with HS — across genders, skin tones, and stages of disease. For medical publishers and medical affairs teams alike, that demand is both a responsibility and a market signal.
The pharmaceutical market for HS treatments was valued at $1.2 billion in 2024 and is projected to nearly double by 2033 — a growth curve that will generate sustained demand for pharmaceutical communications, promotional medical education, and continuing medical education resources, all of which require accurate, rights-managed imagery that picture researchers can license with confidence.
A Treatment Landscape Finally Catching Up
TNF Alpha molecule, illustration. © Molekuul / Science Source
For most of its documented history, HS was managed with antibiotics, retinoids, and surgery — approaches that helped manage symptoms but rarely resolved the underlying inflammatory process. The past decade has brought a fundamental shift in understanding, and with it, a new generation of targeted therapies.
The science begins with the immune system. In HS, the body's inflammatory response goes into overdrive, driven by specific proteins called cytokines that signal immune cells to attack. Two cytokines in particular — TNF-alpha and members of the interleukin-17 (IL-17) family — have emerged as central drivers of the chronic inflammation that causes HS lesions to form, persist, and recur.
Biologic therapies work by targeting these specific proteins directly. TNF-alpha inhibitors bind to and neutralize the TNF-alpha protein, interrupting the inflammatory signal before it can trigger a flare. IL-17 inhibitors work along a different but related pathway — blocking the IL-17 proteins that activate immune cells, recruit neutrophils, and drive the cascade of inflammation that leads to abscess formation and tunneling. Some of the most recent biologics target both IL-17A and IL-17F simultaneously, blocking the inflammatory signal at two points in the pathway rather than one.
For patients who don't respond to biologics, a newer class of oral medications — JAK inhibitors — offers an alternative approach, interrupting inflammatory signaling at an earlier stage within the immune cell itself. Each of these mechanisms has a distinct visual story — from molecular pathway diagrams and immune cascade illustrations to clinical photography documenting treatment response — and pharma marketing and medical journal publishers increasingly need imagery that explains not just what these treatments do, but how they work at the cellular level.
Why Accurate HS Imagery Is So Hard to Find — And So Important
HS presents unique challenges for publishers and picture researchers that go beyond the clinical complexity of the condition itself.
Hidradenitis suppurativa on the left submammary fold. © PDC / Science Source
The condition affects intimate body areas, which means photography requires careful patient recruitment, significant sensitivity, and clinical expertise that most generalist photographers simply don't have. Stigma compounds the problem — patients who have spent years being misdiagnosed are understandably reluctant to participate in medical photography projects.
The result is a chronic shortage of quality HS imagery in most stock libraries, at precisely the moment when demand is accelerating. Publishers covering the new wave of biologic approvals, patient advocacy organizations producing awareness campaigns, and pharmaceutical companies developing educational materials for healthcare providers are all searching for imagery that most agencies cannot supply.
Staging matters enormously. Hurley Stage I looks nothing like Hurley Stage III, and publishers need the full spectrum. Skin tone representation is particularly critical, given the condition's disproportionate impact on people with darker skin. And medical illustration is essential alongside photography — staging diagrams, anatomical cross-sections showing tunneling beneath the skin, body location maps, and immune pathway illustrations are all in active demand for clinical and pharmaceutical publishing.
What Science Source Brings to the Table
Science Source has built one of the most comprehensive HS collections available for licensing — developed specifically to serve the needs of picture researchers and publishers working in a space where accurate imagery is scarce and the stakes are high.
The collection includes rights-managed clinical photography across Hurley stages and body locations, including model-released images of underarm, breast, and groin presentations. Medical illustrations document the three progressive stages of the condition with clinical accuracy, including cutaway diagrams showing the tunneling beneath the skin that defines more advanced disease. Body silhouette illustrations map affected areas clearly — ideal for patient education materials, health communications campaigns, and pharmaceutical communications that need to convey complex information accessibly.
Skin tone diversity is represented across the collection, reflecting the real patient population that lives with this condition and the publishing industry's growing commitment to inclusive medical imagery.
Whether you are producing a pharma marketing campaign, a promotional medical education module, a clinical dermatology journal feature, or a continuing medical education resource, Science Source has the depth, the range, and the scientific accuracy to support that work.
Hidradenitis Suppurativa Gallery Intended for medical, educational, and publishing professionals; images depict significant disease progression.
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