With hidradenitis suppurativa (HS), the word “manage” comes up a lot. That’s because caring for HS — as with many other chronic conditions — can feel much like a full-time job. Minus any pay or benefits, of course.
With this inflammatory skin condition, you likely have good days and bad. The bad times are marked by flare-ups when painful lumps form. The bumps, which are underneath the surface, may even rupture, causing complications.
Getting the good days, when you have little to no HS symptoms, to outnumber the bad usually involves trying to stave off these flares, which isn’t always easy. But several lifestyle changes have been shown to help. Here are some to try.
Hot and humid weather can cause HS to fire up. That’s because HS flares often occur in areas with more hair follicles and sweat glands. Unfortunately, none of us have the power to control Mother Nature, even if we’d like to tell her to chill out in August (or other times of the year, if you live in an especially sweltering place).
It’s not easy to be a cool cuke 100 percent of the time. But a few tips can help. Keep your workouts indoors on hot days. Crank up that AC or run a fan. Turn on your bathroom vent fan post-shower to suck moisture out of the air. And carry soothing wipes with you to freshen up and soothe sweaty spots on the go.
HS bumps often pop up in areas where skin meets skin — these same regions where friction can occur when you’re just naturally going about your day. Think the bra line, underarms, waist, groin, thighs, etc. And who doesn’t get sweaty in these places?
A 2021 research review suggests that wearing moisture-wicking fabrics that allow heat to escape can help, though. Cellulose-derived rayon fibers or bamboo can be a good choice. Plus, these textiles feel smooth on the skin, which can be less aggravating during an uncomfortable flare. Seamless designs, especially for your underthings, may also help avoid unwanted rubbing on sensitive spots.
If your HS seems to flare when you wear tight clothes, try looser fitting garments, according to the American Academy of Dermatology Association (AAD). But in some cases, loose clothing can also lead to chafing (ouch!), so you might need to sneak bike shorts under your outfit to prevent friction.
Like all things with fashion, a little trial and error might be necessary to find what works best for your skin and your sense of style.
To say that quitting smoking is hard might be the understatement of the century, but take it from the millions of people who ditch cigarettes each year: It can be done. And doing so has countless health benefits, including the potential to ease HS flares.
A 2020 review notes that people with HS who are active smokers tend to have more areas on their body affected by symptoms than those who don’t light up.
Plus, smoking has been shown to make HS treatments less effective. The researchers say smoking promotes inflammatory processes in HS skin lesions.
Even though quitting comes with challenges, there are a number of cessation tools that can make it easier, such as:
- nicotine replacement therapy (think: patches and gums)
- medications that curb cravings and withdrawal symptoms
- alternative therapies (like hypnosis and acupuncture)
- support groups
If you’re ready to quit, get in touch with a healthcare professional to see which cessation methods might be right for you.
No one diet has been found to be best for HS. But avoiding certain foods have been shown to improve symptoms, according to a 2019 research review. Foods to avoid include:
- brewer’s yeast (found in beer, some breads, and some fermented foods)
- high fat foods
That review also found that diets that excluded foods with a high glycemic index also benefited people with HS. The glycemic index ranks foods based on how they affect glucose level (aka your blood sugar). Foods with a high glycemic index can cause a spike, whereas foods lower on the index have less of an impact.
Our cells use glucose for energy. But they require insulin to access that energy. When glucose levels stay consistently high, you could become insulin resistant. Research suggests that insulin resistance is more common among people with HS and could exacerbate processes that affect HS.
The good news is that insulin resistance can often be reversed through dietary changes and exercise.
Still, making changes to your diet can lead to unwanted effects (like nutrient deficiencies), so connect with a healthcare professional or dietitian to help you do it safely.
Losing weight is often a recommended lifestyle change for people with HS who are overweight or have obesity.
A 2019 research review shows a link between HS severity and higher body mass index (BMI). And according to the AAD, some small studies have found that people with HS who had obesity or were overweight saw an improvement in their symptoms after losing weight. This was especially true when a person was in the early stages of HS.
With all that said, there’s no single weight or size that’s right for everyone’s bodies. Before starting a weight loss plan, it’s worth having a chat with a doctor or healthcare professional to see if adjusting your bodyweight is appropriate for you. If so, they can also help you set manageable goals and find safe ways to achieve them.
If you live with HS, you probably don’t need a scientist to tell you that it can make a big impact on your quality of life (but, just in case, that’s exactly what some research has shown). Managing a chronic condition can be intensely stressful. And in addition to sometimes being painful, HS can also impact self-esteem and lead to self-isolation.
All of that combined could impact your emotional well-being. A 2020 research review suggests that up to 25 percent of people with HS may have an underlying mental health condition, such as anxiety, depression, or substance use disorder.
For these reasons and more, taking time for self-care is super important. That can encompass a lot of things, from talking to a mental health professional and joining an HS support group, to meditating, journaling, and practicing yoga — or all of the above. Figuring out which self-care techniques feel best to you and doing them consistently can help lessen the impact HS has on your overall life.
When you have HS, flares are bound to happen from time to time. But making lifestyle changes could help keep those pesky bumps at bay (or at least increase the time you spend between flares). That may involve:
- keeping cool in hot weather
- adjusting your diet
- wearing HS-friendly fabrics
- losing weight (if you are overweight or have obesity)
- quitting smoking (if you use cigarettes)
Making time for self-care, like meditation and journaling, can also help you manage the stress that comes with managing a chronic condition.
Still, it’s important to remember that, although management tactics can be helpful, sometimes flare-ups just happen. When they do, be sure to be as kind to yourself as you are to your skin. You’re managing a lot when you have a chronic condition, a full-time job you definitely didn’t apply for. Hopefully these tips offer some much-needed support.