Clinical Stages of Hidradenitis Suppurativa (HS): Understanding Disease Progression & Ayurvedic Intervention

Hidradenitis Suppurativa (HS) is a chronic, relapsing skin condition that typically begins with small, painful nodules and may progress to deep, tunneling lesions and permanent scarring. Clinically, HS is categorized into three stages, known as the Hurley Stages, which help in understanding disease severity and guiding treatment decisions.

From an Ayurvedic perspective, these stages correspond to increasing levels of dosha imbalance, toxin (ama) accumulation, tissue damage (dhatu dushti), and blocked metabolic pathways (srotorodha). At EliteAyurveda, we treat HS at every stage with a tailored, root-cause approach aimed at halting progression, healing damaged tissues, and restoring systemic balance.

Clinical Stages of Hidradenitis Suppurativa

Clinical Stages of Hidradenitis Suppurativa


🔬 The Three Clinical Stages of HS (Hurley Stages)

Stage I: Early Stage (Mild HS)

  • Symptoms: Painful solitary nodules or abscesses, no sinus tracts or scarring
  • Location: Typically axillae, groin, under breasts
  • Frequency: Sporadic episodes
  • Conventional View: Often mistaken for boils or folliculitis

Ayurvedic Viewpoint:

  • Initial imbalance of Pitta and Kapha doshas in the Swedavaha Srotas (sweat ducts)
  • Mild ama accumulation obstructs local channels
  • Inflammation is still superficial; systemic toxicity minimal

Ayurvedic Approach:

  • Ama pachana (toxin digestion) to prevent deep tissue involvement
  • Pitta-Kapha balancing through internal herbs and lepas
  • Dietary and lifestyle regulation to eliminate early triggers

Stage II: Moderate HS (Recurring Abscesses)

  • Symptoms: Repeated nodules, abscesses, and early sinus tract formation
  • Scarring: Mild to moderate
  • Spread: Begins involving multiple adjacent regions
  • Conventional Management: Antibiotics, corticosteroids, incision & drainage

Ayurvedic Viewpoint:

  • Deeper Rakta Dhatu dushti (blood tissue vitiation)
  • Persistent ama blocks srotas, allowing lesions to recur
  • Tridoshic involvement, especially aggravated Vata leading to tunneling and pain

Ayurvedic Approach:

  • Stronger detoxification (Shodhana) via Virechana or Basti for eligible patients
  • Raktashodhana (blood cleansing) to calm inflammation
  • Healing of sinus tracts through specialized herbal oils, pastes, and guggulu-based therapies
  • Immune and metabolic correction through deep tissue rejuvenation (Rasayana)

Stage III: Severe HS (Advanced, Chronic Disease)

  • Symptoms: Multiple interconnected sinus tracts, clustered abscesses, widespread scarring
  • Disability: Severe pain, foul discharge, restricted movement
  • Conventional Outlook: Often considered surgical; biologics prescribed

Ayurvedic Viewpoint:

  • Long-standing Tridoshic vitiation with Mamsa (muscle) and Meda (fat tissue) dushti
  • Chronic ama buildup causes tissue degeneration and fibrosis
  • Ojas depletion, leading to weak tissue immunity and delayed healing
  • Often associated with hormonal imbalances, gut disorders, and stress-related dosha aggravation

Ayurvedic Approach:

  • Deep systemic detoxification using multi-phase Panchakarma
  • Srotoshodhana (channel cleansing) and Mamsa dhatu rejuvenation
  • Long-term Rasayana therapy to repair scarred tissues and immune dysfunction
  • Endocrine rebalancing in cases of PCOS, thyroid issues, or metabolic syndrome
  • Personalized external treatments for healing sinus tracts and preventing secondary infections

🧬 Ayurvedic Understanding of Disease Progression

Hurley StageAyurvedic PerspectiveDominant DoshaTissue Involvement
Stage ISurface-level inflammationPitta-KaphaSweda + Rakta Dhatu
Stage IIRecurrent, deeper abscessesTridoshaRakta + Mamsa Dhatu
Stage IIIChronic sinus tracts, scarringTridosha + VataMamsa + Meda + Ojas depletion

🌿 Personalized Herbal Formulations at EliteAyurveda

Our herbal protocols are designed individually for each stage:

  • Anti-inflammatory and toxin-clearing in early stages
  • Immune-regulating and blood-cleansing in stage II
  • Deep tissue rejuvenating and hormone-balancing in stage III

Note: Specific herbs are not disclosed to prevent misuse or self-medication.


🔄 Preventing Progression from Stage I to III

✅ Early Ayurvedic Intervention Helps:

  • Reverse lesions before sinus tracts form
  • Detoxify channels and stop recurrence
  • Strengthen immunity to prevent future flares
  • Avoid antibiotics, steroids, or surgical dependency

🧘‍♀️ Lifestyle Corrections to Support Healing

  • Avoid suppression of natural urges (sweat, bowel)
  • Maintain regular sleep, warm oil massage, and stress-reducing practices
  • Eat a Kapha-Pitta pacifying diet—light, warm, non-greasy
  • Avoid tight clothes, deodorants, and excessive heat

📍 Ayurvedic Success in All Three Stages

At EliteAyurveda, we’ve seen full remission in patients across all stages—even those advised surgery or lifelong biologics. With a deep-rooted, personalized approach, we restore skin integrity, prevent relapse, and bring back confidence in patients struggling with long-term HS.


📞 Begin Your Healing Journey Today

If you’re living with any stage of HS, don’t wait for it to worsen. Our Ayurvedic specialists are ready to evaluate your condition and design a personalized, stage-appropriate treatment plan.

🔹 Book your consultation now with Dr. Adil Moulanchikkal
🔹 Website: www.eliteayurveda.com
🔹 Phone: +91 88847 22246

Rediscover skin health, comfort, and a life free from HS flares—naturally and holistically.