Dermatologists Reveal Key Strategies to Calm This Chronic Skin Condition

Health Points

• Hidradenitis suppurativa causes painful bumps in areas where skin rubs together, affecting an estimated 1-4% of Americans
• While there’s no cure, lifestyle changes like weight management and quitting smoking can reduce flare-ups by up to 50%
• New treatments including biologics and laser therapy offer hope for managing this often-misdiagnosed condition

For millions of Americans living with hidradenitis suppurativa (HS), the painful bumps and lesions that appear in sensitive areas can feel like an isolating burden. This chronic inflammatory skin condition tends to develop where skin rubs against skin—under the arms, in the groin, beneath the breasts, and around the buttocks—creating tender nodules that can rupture and leak fluid.

But medical experts say there’s genuine reason for optimism. While HS cannot be cured, understanding your triggers and making targeted lifestyle adjustments can dramatically reduce the frequency and severity of flare-ups.

“We’ve made tremendous strides in understanding this condition over the past decade,” notes Dr. Alexa Kimball, professor of dermatology at Harvard Medical School. “Patients who work closely with their dermatologists to identify personal triggers often see remarkable improvement in their quality of life.”

The condition affects an estimated 1-4% of the U.S. population, though many cases go undiagnosed or are mistaken for recurring infections. Women are three times more likely than men to develop HS, and symptoms typically first appear between ages 20 and 30.

Research has identified several key factors that can worsen HS symptoms. Excess weight places additional stress on areas where skin folds meet, creating an environment conducive to inflammation. Studies show that losing even 10% of body weight can reduce flare-up frequency by half in overweight patients.

Smoking stands as another major culprit. The habit not only triggers inflammation throughout the body but also impairs wound healing—a particularly problematic combination for HS sufferers. Data indicates that up to 90% of HS patients either currently smoke or have a history of tobacco use.

“Quitting smoking is one of the most impactful changes a patient can make,” emphasizes Dr. Haley Naik, associate professor of dermatology at the University of California, San Francisco.

Friction from tight clothing represents another common trigger that’s entirely within your control. Dermatologists recommend choosing loose-fitting garments made from breathable, natural fabrics like cotton. Athletic wear with moisture-wicking properties can be particularly helpful for active individuals.

The role of diet in HS remains a topic of ongoing research, though many patients report improvement after eliminating dairy products, refined sugars, and foods high in yeast. While scientific evidence is still emerging, an anti-inflammatory eating pattern emphasizing whole foods, vegetables, and omega-3 fatty acids may offer benefits.

Stress management deserves serious attention as well. The mind-body connection in inflammatory conditions is well-documented, and many HS patients notice flare-ups during periods of heightened stress or anxiety. Regular exercise, adequate sleep, meditation, and professional counseling can all play supportive roles in disease management.

When it comes to personal hygiene, gentle is the operative word. Harsh scrubbing or antibacterial soaps can actually worsen inflammation. Instead, dermatologists recommend cleansing affected areas with mild, fragrance-free products and patting skin dry rather than rubbing vigorously.

“Many patients make the mistake of thinking they need to scrub harder or use stronger products,” Dr. Kimball explains. “But HS isn’t caused by poor hygiene—it’s an immune system disorder. Being too aggressive with skin care often backfires.”

For those experiencing active lesions, warm compresses can provide relief and help lesions drain naturally. Never attempt to squeeze or lance bumps at home, as this increases the risk of infection and scarring.

Beyond lifestyle modifications, medical treatments have advanced significantly. Topical and oral antibiotics may help control mild cases, while biologic medications that target specific immune system pathways have shown promise for moderate to severe disease.

Laser hair removal therapy has emerged as an unexpected but effective treatment option. By permanently reducing hair follicles in affected areas—the sites where HS lesions typically form—this approach can decrease flare-up frequency. Multiple sessions are typically required, and results vary among individuals.

For severe cases resistant to other treatments, surgical removal of affected tissue may be considered. While this represents a more invasive option, it can provide lasting relief for some patients.

The psychological impact of HS shouldn’t be underestimated. The condition’s intimate locations and visible scarring can affect self-esteem, relationships, and mental health. Support groups, both in-person and online, connect patients with others who understand their challenges.

“I always encourage my patients to seek community,” says Dr. Naik. “Knowing you’re not alone in this journey makes a real difference.”

Early intervention remains critical. If you notice recurring painful bumps in areas where skin rubs together, consult a dermatologist rather than waiting for the condition to progress. Prompt diagnosis and treatment can prevent complications and improve long-term outcomes.

The path forward for HS patients involves partnership between doctor and patient, combining medical expertise with lifestyle awareness. While the condition presents real challenges, today’s expanded treatment toolkit—from biologics to behavioral changes—offers more hope than ever before for managing symptoms and maintaining quality of life.

As research continues to unlock the mechanisms behind this complex condition, the future looks increasingly bright for the millions of Americans living with hidradenitis suppurativa.