Hidradenitis Buttock and Inner Thigh Flare Weeks: What to Note for Visits

Updated 29 Oct 2026

Flares on the buttocks and inner thighs are hard to see and easy to play down at a visit, especially when they have settled by the day of the appointment.

This guide explains what to note in flare weeks on the buttocks, around the anus, and on the inner thighs: early signs, each lump, drainage, itch and sleep, movement, and what to bring to a visit.

Why note buttock and inner thigh flares

The NHS lists the areas where hidradenitis lumps develop as around the groin and genitals, the armpits, the bottom and around the anus, and below the breasts, and notes they may also appear on the nape of the neck, waistband and inner thighs (NHS). The AAD notes the first sign is often a painful lump that looks like a deep pimple, acne cyst, or boil, which can also appear on the buttocks or inner thigh (AAD).

The AAD notes breakouts often clear for a while, and later new breakouts may develop in the same area, sometimes in exactly the same spot (AAD). A dated note of each flare shows a dermatologist what happens between visits.

The NHS notes many people with hidradenitis also develop a pilonidal sinus, a small hole or tunnel in the skin at the top of the buttocks, where they divide (NHS). Note anything you notice there as its own site.

For other sites, see what to note in groin flare weeks. In Hidradenitis Journey, the Flare Tracker holds each flare with its date.

How to note early signs and each lump

The AAD notes that before you notice a lump, an area of skin may feel tender or painful, the area may swell, and some people say their skin burns, itches, or sweats excessively (AAD). Note these early signs with the date and site.

For each lump, write the site in plain words, such as left buttock, right inner thigh, or near the anus, and whether it is new or in the same spot as before. Add a pain score from 0 to 10.

The AAD notes that as the condition progresses, lumps can grow and join together, fill with fluid, and become painful; these are called abscesses (AAD). The NHS notes lumps will either disappear or rupture and leak pus after a few hours or days (NHS). Note how many days each lump lasted.

Hard-to-see sites can be photographed for your own record, if you are comfortable doing so.

In Hidradenitis Journey, the Daily Journal holds the site and score of each lump.

How to note drainage and possible infection

The AAD notes that when an abscess breaks open, blood and pus spill out, which can cause wet spots on your clothes (AAD). The NHS notes narrow channels called sinus tracts can form under the skin, break out on the surface, and leak pus (NHS). Note the date a lump opened and how long it drained.

The NHS notes some lumps may become infected with bacteria, causing a secondary infection that will need to be treated with antibiotics (NHS). The AAD notes a bacterial infection can develop in skin with deep lumps or tunnels that are draining (AAD). Note any change from your usual pattern, such as spreading redness, more heat, or feeling unwell, and contact your care team.

For drainage days in detail, see what to note on drainage days.

Note what you used on the area, as your clinician advised, with the date and time.

In Hidradenitis Journey, the Daily check-in holds a daily pain score beside drainage notes.

How to note itch, sleep, and movement

The AAD notes the groin, armpits, and thighs tend to be itchiest (AAD). It notes pain and itch can affect your ability to fall asleep and stay asleep, making the next day feel harder, and that continual sleep loss can lead to feeling fatigued every day (AAD). Score itch and sleep each day of a flare week.

The AAD notes scars can thicken and some become so thick they limit how far you can move, and walking may become difficult (AAD). Note in plain words what was hard on a flare day, such as walking, sitting, or getting dressed.

The AAD notes pain, odor, or draining lesions can affect decisions about what clothes to wear or cause you to feel isolated, and that some people develop anxiety or depression (AAD). The NHS advises speaking to a GP if you're finding it difficult to cope (NHS). A short mood note belongs in the log too.

In Hidradenitis Journey, My Assessments holds questionnaires you can repeat over time.

What to bring to a visit

The NHS notes a GP will examine the affected areas of skin and may take a swab of an infected area (NHS). The AAD advises seeing a board-certified dermatologist for a diagnosis if you have a tender, deep lump in any of the usual areas (AAD). If the site has settled by the visit, your notes describe what the examination may not show.

Bring a short summary: weeks logged, flare weeks, the sites in plain words, how long lumps lasted, drainage days, itch and sleep scores, and what was hard to do. Put your main question at the top.

The NHS notes that in the early stages, hidradenitis may be controlled with medicine, and surgery may be required in severe or persistent cases (NHS). Ask which treatment fits your flares, and log the answer with the date.

For a short appointment, see what to note in underarm flare weeks. In Hidradenitis Journey, the Doctor Report builds a dated summary for a saved doctor.

How Hidradenitis Journey can help

A notebook can hold one bad day. The harder part is keeping flare sites, drainage, itch, sleep, and treatments in one dated record.

Hidradenitis Journey is a personal hidradenitis suppurativa tracker from Health Journey Labs on the App Store and Google Play. It records flares, symptoms, treatments, and visits in one dated history. Below is what you can use and how each part helps:

• Daily check-in — A short guided pass across symptoms, mood, nutrition, sleep, exercise, meds, and external factors, including nodule pain, drainage, and skin-fold flares, so links you would not remember on your own show up side by side.
• Daily Journal — Freer notes, including voice when typing hurts, such as dressing counts, photo notes, and visit debriefs, that add detail a score alone cannot show.
• Flare Tracker — Mark a day clearly worse than your usual, with onset, sites, and intensity, so you can tell a one-off spike from a repeating pattern.
• My Meds — Medicine names and timing, so you can line up a start date or dose change with lump counts, pain, and sleep.
• My Labs — Result dates for swabs, blood work, imaging, and other tests, compared with how you felt in the weeks before and after.
• Weekly Goals — Set one small aim, such as a daily wash routine or looser clothing on long days, and see whether it held and whether flares changed.
• Learn — Short education topics on HS themes such as flares, sleep, pacing, and visit preparation.
• AI companions — Clara and specialist companions already see your logged history, which helps with visit wording or questions after a new diagnosis.
• My Care Team — A profile for each clinician, plus upcoming appointments and notes for each visit, used before, during, and after appointments.
• Doctor Report — Two views: the Appointment Planning Report helps you prepare what to ask, and Generate Report, opened from a saved doctor, builds a dated summary of your recent progress for that doctor.
• My Assessments — Structured check-ins that add context about you across weeks.
• Food Tracker — Meal and drink lines when food is something you and your clinician are watching alongside flares.
• Period Tracker — Cycle dates, so you can see whether new lumps cluster at a certain point in the cycle.
• Weight Tracker — Weight entries when weight is part of what you and your clinician are watching.

Everything you log builds one history. Guided forms include the key questions, and you can add custom symptoms when you need your own labels. Hidradenitis Journey is free to download.

Sources

• AAD — Hidradenitis suppurativa: Signs and symptoms
• NHS — Hidradenitis suppurativa

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