Hidradenitis suppurativa (HS), also known as acne inversa, is a chronic skin condition characterized by often-painful abcesses and lumps. These flare-ups usually occur when hair follicles become clogged in friction-prone areas of the body, like the groin, under the arms, and buttocks. While this disease can be difficult to manage, Dr. Barry Resnik offers some steps you can take to reduce the severity of the symptoms. 

1. Stay on top of your treatment plan.

There is no single trick to treating HS, nor is there usually one medication that solves all HS symptoms by itself. Treating HS requires a multipronged approach that depends in large part on a patient’s willingness to use a combination of washes, drug therapies, topical medications applied to the skin, and healthy habits. For example, depending on how severe your condition is, I might prescribe a daily topical solution to reduce the amount of bacteria on the skin, an antiseptic wash three times a week, and an oral drug. These all work together to ease HS symptoms, making flare-ups less frequent and less severe. Making these treatments part of a routine will help you treat your HS effectively.

2. Maintain a healthy weight.

Maintaining a healthy body weight is a common-sense strategy that can make a big impact in controlling your HS flare-ups and symptoms. Being overweight doesn’t cause HS, but it does make it worse. Because HS symptoms occur in areas of the body where skin rubs together, like under the arms and in the groin, excess weight can make that friction worse and create an environment where bacteria can ovegrow in moisture-rich areas. These conditions, along with blocked follicles (pores where hair grows), can lead to the development of painful boils. Talk to your doctor about whether or not you’re at a healthy weight and if weight-loss methods like portion control and exercise should be part of your treatment.    

3. Avoid smoking and consuming too much dairy.

The way cigarette smoke interacts with your skin can become a huge contributing factor in making HS flare-ups worse. Smoking leads to clogged pores–a major irritant for people living with HS. Toxins in cigarette smoke also interfere with proper healing throughout your body. Similarly, we’ve found a strong correlation between dairy consumption and HS outbreaks. Dairy increases inflammation in your skin, so I recommend my patients cut out as many dairy products as they can to see if this eases their symptoms. 

4. Wear clothing that’s gentle on your skin.

Reducing friction in the areas where you have recurrent flare-ups can give your skin a reprieve and help to reduce outbreaks. Choose loose-fitting cotton clothing, avoid underwear with seams that rub in areas that could give you new lesions, and wear light, cool clothing to prevent overheating and unnecessary sweating. I also recommend washing your clothes and bedsheets with enzyme-free detergent, which is gentler on your skin.

5. Don’t accept pain and discomfort–persevere.

Hidradenitis suppurativa is a difficult disease to manage, but that’s not the end of the story. I encourage patients to persevere until they find a physician with the experience to treat their condition and identify the right therapy for their skin. There are new surgical methods, drugs and other medications that a dermatologist can employ to help patients stay in control of their HS, so a willingness to try different options is a must.

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