How to Track Hidradenitis Symptoms

Updated 29 Oct 2026

HS flares rarely line up with appointment dates. By the time a dermatologist examines the skin, the worst lump may have drained, healed, or moved to another area, and the weeks of pain, dressing changes, and missed sleep are hard to describe from memory.

This guide explains how to track hidradenitis suppurativa symptoms in a short, repeatable format: what to record for each lump, how to log body sites and drainage, how to use photos, how to note pain, itch, sleep, and function, how to record possible triggers, and how to follow treatment over weeks.

What hidradenitis suppurativa symptom tracking is and what it covers

HS symptom tracking means recording each new lump and each flare in the same short, dated format: where it appeared, how large and painful it was, whether it drained, and how it affected the day. Using the same fields every time lets one month, one body area, or one treatment period be compared with another.

The NHS describes HS as a painful, long-term skin condition with boil-like lumps, blackheads, cysts, scarring, and channels in the skin that leak pus. It notes that HS is not infectious and is not linked to poor hygiene, and that there is no definitive test, so diagnosis relies on examining the affected skin (NHS). So what you write down helps your doctor.

HS is uncommon, but you are far from alone. A US population analysis found 98 cases per 100,000 people, with the highest prevalence among adults aged 30 to 39 (Garg et al., 2017). If a diagnosis is still being worked out, a log is still useful; see what to bring to a 15-minute hidradenitis visit.

In Hidradenitis Journey, the Daily check-in records nodule pain, drainage, skin-fold flares, and sleep in the same guided fields each time. Because the questions stay the same, a flare in spring and one in autumn can be read side by side.

What to record for each new HS lump or flare

A lump entry works best when it is short and uses the same fields each time. Fill it in the day the lump appears, then add a line when it changes, drains, or settles.

The HS lump log below, from Hidradenitis Journey (part of Health Journey Labs), lists the core fields and why each one helps.

Sources: NHS and the American Academy of Dermatology.

In Hidradenitis Journey, the Daily check-in holds pain, drainage, and skin-fold flare fields, so most of this table takes a minute to fill. The Flare Tracker records onset, sites, intensity, and a short note for days clearly worse than your usual.

How to log body sites, drainage, and dressing changes

Drainage can stain clothes and make you plan your day around dressings, and noting that is part of the log, not a side detail. The AAD describes HS breakouts that clear for a while and later return in the same area, sometimes in exactly the same spot (AAD). Recording the site precisely, such as "left armpit, front edge" rather than "armpit," makes that repetition visible over months.

Drainage deserves its own line. The AAD notes that when an abscess breaks open, blood and pus can leak and leave wet spots on clothing. Useful drainage notes include:

• the date a lump opened and the date it stopped leaking;
• a simple amount scale, such as spotting, one dressing a day, or several changes a day;
• the number of dressing changes and any clothing changes;
• odor, color, or bleeding, in plain words.

Tip: count dressing changes rather than describing drainage as "a lot." A number such as "four pads before noon" is easy to compare from one month to the next. For more on drainage days, see hidradenitis flare drainage days: what to note for visits.

With Hidradenitis Journey, the Flare Tracker keeps sites and intensity for each flare, and the Daily Journal holds dressing counts and clothing notes, including by voice when typing hurts.

How to photograph HS lesions and track scars and tunnels

Photos help when a lump has healed by visit day. The AAD notes that repeated healing and reopening can cause scars and tunnels to form under the skin, and that for some people scars are the only visible sign when the skin is not flaring (AAD). A dated photo series shows what the visit cannot.

A consistent photo routine makes images comparable:

• use the same room, light, and distance each time;
• take one wide shot to show the area and one close shot of the lesion;
• photograph on the first day, at its worst, and when it settles;
• name or note each photo with the date and site.

Scars can also limit movement. The AAD notes that thick scars can make reaching or walking difficult. If raising an arm or taking long steps has become harder, write down what you can no longer do and since when, because a functional note is easier to act on than "it feels tight." See hidradenitis scar and tunnel questions: what to photograph and log for more detail. Keep photos of intimate areas in a private, locked folder.

With Hidradenitis Journey, a Daily Journal entry can record which photos you took and what changed, and the Flare Tracker dates the same flare.

How to track HS pain, itch, sleep, and daily function

The AAD lists pain, itch, and sleep loss among the ways HS can affect daily life, noting that pain and itch can make it harder to fall asleep and stay asleep, and that continual sleep loss can lead to daily fatigue. It also notes that the groin, armpits, and thighs tend to be the itchiest areas (AAD).

A short daily line covers most of it:

• pain at its worst, 0–10, and where;
• itch at its worst, 0–10;
• hours slept and how many times pain woke you;
• one line on function: walking, sitting, lifting the arms, work, exercise, or plans canceled.

Record joint pain too. The AAD advises telling your dermatologist about joint pain, because people with HS have a higher risk of arthritis (AAD). Note which joints, any morning stiffness, and how long it lasts. Mood belongs in the log as well, since the AAD notes that HS is linked to higher rates of depression.

In Hidradenitis Journey, the Daily check-in covers physical symptoms, emotional state, and sleep in one guided pass. Over weeks, insights can show whether high-pain days follow short nights or come before them, which can help you plan rest and dressing changes around the hardest hours.

How to track possible HS flare triggers

Possible triggers vary between people, so the log lets you check your own instead of assuming. The NHS notes that obesity and smoking are strongly associated with HS and can make symptoms worse, and that some people flare before a period (NHS). The AAD lists sweating and overheating, friction from tight clothing, waxing, and nicks from shaving as things that can irritate skin and lead to flares (AAD).

The trigger checklist below, developed by Hidradenitis Journey, shows what to record for each one.

Sources: NHS and the American Academy of Dermatology.

With Hidradenitis Journey, the Daily check-in records external factors next to symptoms, and the Period Tracker adds cycle dates when relevant. A few weeks of entries make it clear whether new lumps follow hot weeks, a new product, or a certain cycle point, which points to one change worth testing.

How to track HS treatments and skin-care routines over weeks

HS treatment often changes in steps, and each step needs time. The NHS describes short antibiotic courses for infected lumps, longer low-dose courses of at least 3 months to reduce new lumps, antiseptic washes, and, in severe cases, treatments that suppress the immune system or surgery (NHS). Over months like these, dates are what let you and your doctor see what helped.

For each treatment, record:

• the name, dose, and start date;
• missed doses or pauses, with the reason;
• side effects and when they began;
• daily routines, such as an antimicrobial wash, a warm compress, or laser sessions, with dates.

Tip: at the start of each month, count new lumps and drainage days from the previous month. Two plain numbers per month make it easier to judge a 3-month course. The AAD also advises telling your dermatologist if any wound fails to heal, opens up after healing, or becomes more painful (AAD), so add those dates when they happen.

In Hidradenitis Journey, My Meds keeps medicine names and timing, and My Labs holds test dates and results.

How to bring an HS log to a dermatology visit

A visit goes further when the log is condensed to one page. Weeks of entries are useful to you; your dermatologist needs the summary. The NHS notes that recognizing HS early helps prevent it from getting worse (NHS), so a clear record matters from the first visit onward.

A short summary for the visit can include:

• new lumps per month and the body sites involved;
• drainage days and dressing changes per week;
• worst pain, sleep, and function in the last month;
• current treatments with start dates, missed doses, and side effects;
• 2 or 3 dated photos of the worst flare;
• your top three questions, written in order.

Tip: write your most important question first and read it aloud early in the appointment, before the examination. Short visits often end before the last question on a list. After the visit, add what was decided and when to follow up while it is fresh, so the next log period has a clear starting date.

With Hidradenitis Journey, My Care Team stores each clinician and visit notes, and the Doctor Report builds a dated summary from what you logged.

How Hidradenitis Journey can help

A notebook can hold HS entries. The harder step is relating them over months: seeing whether new lumps follow hot weeks, friction, a new product, short nights, or a treatment change, and whether flares are becoming fewer or shorter.

Hidradenitis Journey is a personal hidradenitis suppurativa tracker from Health Journey Labs on the App Store and Google Play. It records each flare with its sites, pain, and drainage, together with sleep, mood, medicines, and visit notes. Its insights show which habits and treatments come before calmer or harder weeks. Learn explains the condition in plain words, and the AI companions, such as Clara, answer questions when a new symptom or result is hard to read. 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 give insights detail a score alone cannot show.
• Flare Tracker — Mark a day clearly worse than your usual, with onset, sites, and intensity, so insights can separate a one-off spike from a repeating pattern.
• My Meds — Medicine names and timing, so insights can relate a start date or dose change to 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 give insights more 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 insights can show 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

• NHS — Hidradenitis suppurativa (HS)
• American Academy of Dermatology — Hidradenitis suppurativa: Signs and symptoms
• American Academy of Dermatology — Hidradenitis suppurativa: Tips dermatologists give their patients
• Garg A, et al. Sex- and Age-Adjusted Population Analysis of Prevalence Estimates for Hidradenitis Suppurativa in the United States. JAMA Dermatol. 2017

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