Alexandra Charrow, MD, FAAD

Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that causes painful lumps, abscesses, skin tunnels, and scarring—often in intimate areas like the buttocks, groin, armpits, and breasts/chest. While doctors know that genetics, hormones and the immune system play a role, researchers are learning that your environment matters too. 

A new study led by first author Natalie Baker, BS, MS, and senior author Alexandra Charrow, MD, FAAD, of the Department of Dermatology at Mass General Brigham, looked at patients with hidradenitis suppurativa across the city of Boston to better understand how neighborhood conditions may affect the disease. 

The team mapped where HS patients live through a collaboration with Boston’s academic centers (MGB, BU, Tufts, BIDMC) and looked at neighborhood factors such as temperature, air quality, obesity rates, access to resources and long-standing social and economic conditions.  

The study showed that HS is not evenly spread across the city. Instead, cases tend to cluster in certain neighborhoods with higher daytime temperatures, more air pollution, higher obesity rates and a higher proportion of Black residents.  

Importantly, the connection to race is not biological. The researchers believe it reflects the impact of long‑standing structural inequities, such as housing segregation, fewer safe outdoor spaces, limited access to healthy food and greater exposure to pollution and extreme heat. 

Published in JAMA Dermatology on May 6, 2026 | Read the paper: “Environmental and Social Drivers of Hidradenitis Suppurativa” 

Summary reviewed by: Alexandra Charrow, MD, FAAD, senior author