Why does HS increase the risk of suicidal thoughts?

HS increases suicide risk through multiple pathways: chronic unrelenting pain that disrupts sleep and daily functioning; profound shame and body image distress from lesions in intimate body areas; social isolation and relationship breakdown; occupational and financial stress; and the systemic inflammatory burden of the disease itself, which may directly affect brain chemistry and mood. The combination of these factors creates a uniquely heavy psychological burden.

What should I do if I am having thoughts of suicide?

If you are having thoughts of suicide, please reach out for help now. In the US, call or text 988 (Suicide and Crisis Lifeline) or text HOME to 741741 (Crisis Text Line). Outside the US, contact your country's crisis line or go to your nearest emergency room. You can also tell someone you trust what you are experiencing. Suicidal thoughts are a medical symptom that responds to treatment, and you do not have to manage this alone.

How do I talk to my doctor about suicidal thoughts related to HS?

You can say directly: 'I have been having thoughts of suicide and I think it is related to the burden of living with HS.' Your doctor needs to know this. It will not result in automatic hospitalization. It will result in a conversation about what support is available. Many HS patients find that once they disclose to their dermatologist or primary care doctor, they are referred to mental health support that genuinely helps.

Can treating HS reduce suicidal ideation?

Yes. Clinical trials of biologic treatments for HS consistently show improvements in depression, anxiety, and quality-of-life scores alongside physical improvements. Effective HS treatment reduces pain, improves sleep, and reduces the inflammatory burden that may directly affect mood. However, mental health treatment should not wait for HS to be controlled - both should be addressed simultaneously.

If you are in crisis or having thoughts of self-harm: Call or text 988 (US Suicide and Crisis Lifeline, free and confidential, 24/7), or text HOME to 741741 (Crisis Text Line).

Call or Text 988

Mental Health

HS and Suicide Risk: What You Need to Know

Q: Is suicidal ideation more common in people with HS?

Yes. Multiple studies have found significantly elevated rates of suicidal ideation in HS patients compared to the general population and compared to patients with other chronic skin conditions. A 2019 systematic review found that HS patients have approximately twice the odds of suicidal ideation compared to the general population. This is a recognized medical complication of HS, not a personal failing.

Suicidal thoughts are a recognized medical complication of living with hidradenitis suppurativa. This page explains why, what the warning signs are, and how to get help - for yourself or someone you care about.

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If You Are in Crisis Right Now

If you are having thoughts of suicide or self-harm right now, please reach out to one of these resources immediately. You do not have to be certain or have a plan to call. If you are struggling, that is enough.

988 Suicide and Crisis Lifeline (US)

Call or text 988

Available 24/7, free and confidential

Crisis Text Line (US, UK, Canada, Ireland)

Text HOME to 741741

Text-based support, 24/7

International Association for Suicide Prevention

Directory of crisis centers worldwide

Find your country's crisis line

Veterans Crisis Line (US)

Call 988, press 1

Dedicated line for US veterans

Trans Lifeline (US)

877-565-8860

Peer support for trans people in crisis

Understanding the Risk

Why HS Increases Suicide Risk

Suicidal ideation is not a rare or unusual experience for people with HS. Multiple peer-reviewed studies have found that HS patients have significantly elevated rates of suicidal thoughts compared to the general population and compared to patients with other chronic skin conditions. A 2019 systematic review found approximately twice the odds of suicidal ideation in HS patients.

This is not a reflection of weakness or poor coping. It is a predictable response to a disease that combines chronic, often severe pain with profound social stigma, body image distress, relationship strain, and financial burden. The depression and anxiety that frequently accompany HS are themselves risk factors for suicidal ideation.

Understanding this connection is important for two reasons: it helps patients recognize that their thoughts are a symptom of a medical condition that can be treated, and it helps healthcare providers and caregivers take the psychological burden of HS seriously.

Recognizing the Signs

Warning Signs to Know

Suicidal thoughts exist on a spectrum. Passive ideation (wishing you were not alive) can progress to active ideation (making plans). Both warrant attention and support.

Passive Warning Signs

These thoughts are serious and deserve support, even if there is no active plan.

Feeling that life is not worth living because of your condition
Wishing you could go to sleep and not wake up
Feeling like a burden to the people who care for you
Thinking that others would be better off without you
Feeling completely hopeless that your situation will ever improve

Active Warning Signs

If you or someone you know is experiencing these, please seek help immediately.

Thoughts of ending your life
Thinking about methods of suicide
Making plans for suicide
Saying goodbye to people or giving away possessions
Sudden calmness after a period of severe depression

Call or text 988 now

What Helps

Protective Factors and Treatment

Suicidal ideation in HS is treatable. These are the factors that research and clinical experience show make the most difference.

Connection

Feeling connected to even one other person who understands your experience is one of the most powerful protective factors against suicide. HS communities, both online and in person, provide this connection.

Effective Treatment

When HS is better controlled, the pain, sleep disruption, and functional limitations that drive psychological distress are reduced. Pursuing effective treatment is itself a mental health intervention.

Mental Health Support

Therapy, particularly cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT), has strong evidence for chronic illness-related depression and suicidal ideation. Medication for depression is also effective and should not be stigmatized.

Safety Planning

A safety plan is a written document you create with a mental health professional that identifies your warning signs, coping strategies, support contacts, and steps to take if you feel at risk. It is one of the most evidence-based tools for suicide prevention.

Getting Help

Talking to Your Doctor

Many people with HS who experience suicidal thoughts never disclose them to their healthcare provider. This is understandable - it can feel frightening, or you may worry about the consequences. Here is what you need to know:

Disclosing suicidal thoughts will not automatically result in hospitalization.

Hospitalization is typically only considered when someone is in immediate danger with a specific plan and means. Telling your doctor you have been having passive thoughts of not wanting to be alive will not result in immediate commitment. It will result in a conversation about support options.

Your dermatologist needs to know.

Dermatologists who treat HS are increasingly aware of the mental health burden of the disease. Telling your dermatologist about suicidal thoughts may prompt a referral to mental health support and may also influence treatment decisions - more aggressive HS treatment can improve mental health outcomes.

What to say if you are not sure how to start.

You can say: 'I want to tell you something that is hard to say. I have been having thoughts of not wanting to be alive, and I think it is connected to how much I am struggling with my HS.' That is enough. Your doctor will take it from there.

For Caregivers

If You Are Worried About Someone With HS

If you are a partner, family member, or friend of someone with HS and you are worried about them, trust your instincts. Asking directly about suicide does not plant the idea - research consistently shows it reduces risk by opening a conversation.

Ask directly. You can say: 'I have been worried about you. Are you having thoughts of suicide?' Asking directly is more helpful than hinting.

Listen without judgment. Your role is not to fix the problem or minimize it. It is to listen and to let the person know they are not alone.

Help them access support. Offer to sit with them while they call 988, or to help them make an appointment with their doctor. Practical help is powerful.

Take care of yourself. Supporting someone who is suicidal is emotionally demanding. Make sure you have your own support. You cannot help someone else if you are depleted.

FAQ

Frequently Asked Questions

Related Resources

HS and Depression & Anxiety

Deep-dive into the mental health comorbidities of HS

HS and Mental Health

Overview of psychological impact and support strategies

Men's Mental Health and HS

Shame, silence, and the unique burden for men with HS

HS Support Groups

Online and in-person communities for people with HS

Caregiver Support

Resources for partners and family members

Community Resources

Crisis lines and mental health resources

Medical Disclaimer: This page is for educational purposes only and does not replace professional mental health care. If you are experiencing suicidal thoughts, please contact a crisis line or mental health professional immediately. The information on this page does not constitute medical advice. Read full disclaimer.