Though hidradenitis suppurativa (HS) is a painful epidermal condition, the effects are more than just skin deep.

HS creates bumps, lesions, scarring, and occasional odors — all of which make living a “normal” life difficult. Living with a chronic illness can take an emotional toll.

Many people with HS experience embarrassment as a result of their flare-ups. They feel like they have to hide their illness. HS is chronic, meaning that these feelings may continue over time. Your mental health can take a hit as a result.

The symptoms may feel frustrating, but you’re not alone, and there are ways to cope, take care of your mental health, and get the support you need to live a happy life.

Before you take care of the mental health side of things, treat the physical symptoms as best you can. Anti-inflammatories like ibuprofen can help relieve pain and swelling during mild flare-ups.

Be sure to bathe the affected area with antibacterial soap and apply a warm compress to reduce irritation.

If these home remedies don’t seem to help, talk to your doctor. They may prescribe a corticosteroid or antibiotic to reduce flare-ups. In some cases, laser treatment or surgery may be necessary.

Taking medication and having surgery may not sound like a road to happiness, but if these measures bring relief from flare-ups, you’ll notice that your mood lifts and you can go about your day a little more easily. Feeling better will support your mental health.

It might feel scary to go to a doctor or ask for help, but remember that you’ve done nothing wrong. HS doesn’t flare up due to poor hygiene or bad behavior. It just happens.

Experts aren’t sure why HS develops, and they haven’t yet found a cure. But they do know that the disease is not contagious and there’s no behavioral cause, even though smoking and obesity have links to HS.Vazquez BG, et al. (2012). Incidence of hidradenitis suppurativa and associated factors: A population-based study of Olmsted County, Minnesota.

You may go through numerous treatments and doctors before finding a symptom management plan that works. But a doctor will not be grossed out by your condition, and they will try to find ways to help you feel better.

It’s definitely worth a try, since reliable pain relief and fewer flare-ups will make life much easier overall. This will help you get on the road to better mental health.

Originally, experts thought HS was a rare disease (a disease affecting fewer than 200,000 people in the United States). But they were wrong — HS affects 1 to 4 percent of the population.

That may not sound like a lot, but that’s millions of people! That means millions of other people understand what you’re dealing with.

People with HS often hide their illness out of shame. To relieve yourself of that burden, talk about your troubles with someone you trust. Tell them you’re angry or sad or frustrated. Sharing your feelings can bring great relief, even if no answers come your way.

Not everyone has a circle of supportive friends who are willing to listen to their emotional pain. Maybe your friends just can’t understand your illness. Or maybe you’d rather talk to a neutral party who won’t just tell you what they think you want to hear.

That’s when a mental health professional can step in.

Though it can be nerve-wracking to open up to a stranger, remember that you’re paying them to listen to you. It’s literally their job! So, get it all out in a safe place that’s free of judgment.

A 2018 study found that 24 percent of people with HS had at least one mental health diagnosis, such as depression or anxiety. By talking to a mental health professional, you can treat the symptoms of these conditions and prevent them from getting worse.

Your therapist can give you tools to better handle negative thoughts, boost your confidence, and help you learn how to live with the disease in a more comfortable and sustainable way.

Though HS isn’t technically a rare disease, most people don’t know much about it.

If you’ve opened up to friends and gotten a lot of sad puppy-dog eyes and “I’m sorry… that’s too bad,” responses, you might want to find some people who truly understand what you’re going through.

Hope for HS provides online resources and support groups for people with HS. Groups meet around the country and online, so you can immediately connect with people who know exactly how you’re feeling.

Sometimes, just having that human connection and reminding yourself that you aren’t experiencing these thoughts and sensations alone can greatly help your mood.

HS is a chronic disease that pops up in flare-ups, which can be frustrating. You know it’s never going away, and it gets worse at random times. You can’t predict or plan for it. Whee. What fun.

Naturally, flare-ups can cause negative, exaggerated thoughts. Instead of letting your mood spiral, take a moment to examine your thinking.

Maybe you think, “I can’t go to the beach. Everyone will see my scars and think I’m disgusting.” First of all, notice the thought without judgment. You’re not right or wrong to think that way. It’s just a thought.

Then, examine it more deeply. Is that really true? Do you have evidence to prove it? Is there another way to look at the situation?

You may have had times in your life when people responded badly to seeing your HS or even mocked you. (It’s OK — no one likes them.)

But has that happened every time? No.

Do you know for a fact it will happen again? Probably not.

Another way to look at the situation is to think, “Most people at the beach are busy having fun and won’t notice me. Even if they do, it doesn’t stop me from having a good time.”

Examining your thoughts won’t bring instant happiness, but it will help you realize what’s stressing you out about the disease and avoid spiraling into depression. Most people are too wrapped up in their own lives to think about what some parts of your skin look like.

Thoughts like “I can’t do anything” eventually become “My life is different now, but I’m going to find new things I love to do.”

This whole list isn’t just about examining your deepest emotions and spilling your guts to the world. There’s fun stuff too! Stress can make flare-ups worse, so making relaxation a part of your life is a great way to treat the mental side of HS.

Make a list of things you find relaxing. It could include watching “The Great British Baking Show,” baking something your damn self, reading a book, or taking a long walk. Then, try to give yourself a relaxing treat every day.

You’ve earned it just by getting through the day.

It can be difficult to find the time or motivation, but even 5 minutes of dedicated chill time can help. Doing something enjoyable and relaxing will help your mood and possibly reduce your symptoms.

What’s a list about mental health without meditation? Skin conditions of all kinds get worse when you’re stressed, and HS is no exception.

Mindfulness meditation reduces all kinds of stress — and it’s free, which makes it even less stressful. Whether you mediate with an app, put on some peaceful music, or just sit in a quiet room and focus on your breathing, you’ll feel the results.

Try this simple breathing exercise:

  1. Sit comfortably or lie down and let your body relax.
  2. Breathe in while counting to four.
  3. Hold your breath for four counts.
  4. Breathe out for four counts.

This type of breathing exercise forces your mind to focus on one simple task, and the increased oxygen will help you physically and mentally relax.

Another great way to relax is through yoga, the limber cousin of mindfulness meditation.

Yoga has been found to relieve stress in people with skin conditions, and less stress might mean fewer painful flare-ups. Try yoga videos aimed at reducing stress, since these are often gentle on the body and good for beginners.

Be sure to do yoga that works for you. Skip any poses that cause pain or become difficult because of scarring. If you think you’ll be uncomfortable going to a yoga class, don’t do it. You don’t even have to leave your living room.

Start at home, and if yoga isn’t your thing, no problem! Try something else that feels good.

Though ice cream may sing to you from the freezer during an episode of depression, it might not make you feel good in the long run. A healthy diet can help you preserve energy, sleep better, and maybe lose a bit of weight.

HS occurs mostly in the folds of the skin. If your weight is higher, your body may have more folds and more friction between those folds. In a 2014 study, people with obesity and HS reported fewer symptoms after they had lost some weight.

That doesn’t mean you should feel bad about your weight or go on a crash diet. But eating healthy food may help you lose a few pounds, which might make living with HS easier.

To avoid irritating HS-affected areas, wear loose clothes. Choose soft, natural fabrics like cotton or silk. You want to avoid friction, so keep it loose and comfy.

Have fun with your loose clothes. Treat yourself to a lovely pair of comfortable silk PJs or find a dress you adore that’s loose and beautiful.

Find clothes that make you feel good, and you’ll walk around both happier and with less irritation. And nobody looks or feels bad in silk pajamas.

A diagnosis of HS practically comes with a prescription for warm, luxuriant baths.

A warm bath can greatly reduce skin irritation, and antibacterial soaps make sure flare-ups don’t get infected. Try to make a warm bath part of a relaxing ritual. Maybe read a book in the bath or listen to your favorite playlist.

A daily bath can be great for your skin and excellent for your mental health.

Smoking doesn’t cause HS or flare-ups, but there’s some evidence that a high number of people with HS are also smokers.

If you smoke, you already know you should quit. The cats of “Cats” even told you to quit! And anyone involved in “Cats” knows a good life decision when they see it.

HS is just another reason to give up cigarettes for the good of your skin, your mental health, and your life.


Pets can provide incredible emotional support. A dog is definitely not going to judge you for having a flare-up. That kind of undying, unconditional love can be a great help when you’re dealing with a chronic illness.

Plus, a dog gives you a reason to take a short walk every day, which also helps your physical and mental health. In fact, a 2011 study found that having a furry friend made people 34 percent more likely to get their full 150 minutes of exercise every week.

Even if you’re not a dog person, caring for an animal you love can bring light into your life. If you have the means and think an animal could bring joy, this might be a great time to get a pet.

You’re not alone in dealing with HS. The condition can affect your mental health, but there are ways to seek help and feel better. Talk to friends or find a therapist or a support group where you can talk about your feelings freely.

Be sure to find ways to relax and reduce stress, whether it’s through a nice bath or a yoga session. Examine your thoughts to avoid spirals and exaggerated thinking. And maybe get a puppy, because they’re great.

Remember: You’ve done nothing wrong, and it’s completely normal to feel down about your illness sometimes.

By making your mental health a priority, you may be able to reduce your physical discomfort and live a fuller, happier life.