Living with hidradenitis suppurativa (HS) and dealing with painful lumps forming under your skin in sensitive areas such as your armpits and groin can be stressful. While stress is understandable, it can actually cause flare-ups and make your condition worse.
The primary link between HS and stress is chronic inflammation. While short-term inflammation helps the body heal, chronic inflammation can damage the systems it is meant to protect.
Stress as a Trigger: Stress triggers an immune response that increases inflammation in the body. For someone with HS, this systemic inflammation often manifests as a new or worsening skin flare.
HS as a Stressor: Living with HS is inherently stressful. Managing pain, dealing with the self-consciousness of scarring, and navigating the daily logistics of wound care can lead to feelings of being overwhelmed, anxious, or isolated.
Luckily, there are ways to manage your stress.
“While there’s no cure for HS, there are lots of treatment options we can try. The more information you share with us, the easier it will be to rule those treatments in or out,” dermatology specialist Patrizia Visconti, PA-C says.
Here’s what you can do.
The proper management of your HS symptoms can help reduce your stress.
The good news is that there are many treatment options available for HS, including topical washes and creams, antibiotics, biologic medications, and surgical procedures. Your dermatologist can help you find the right one.
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If you’re stressed, adopting healthy habits may help. Exercising, eating a nutritious diet, getting plenty of sleep, maintaining a healthy weight, and quitting smoking if you smoke have all been proven to be great stress relievers and ways to keep HS under control. Many of these are also healthier ways of coping with stress than picking up a cigarette.
You are not alone in your journey. Your healthcare provider can help with symptoms and flare-ups that are causing you stress and impacting your day-to-day life.
Sometimes we just need to talk to a therapist who understands what we are going through.
A mental health professional can teach you coping skills for dealing with stress. A therapist or counselor can also help you work through any stigma you may face due to living with HS.
Talk to your dermatologist or primary care physician, who might already partner with a team of health psychologists who work with people who have chronic conditions. He or she may be able to recommend someone in their practice or give you a direct referral.
You can also find psychologists who specialize in health psychology through the American Psychological Association or the National Register of Health Service Psychologists.
It’s also a good idea to check with your insurance plan, where you can usually search for the keyword “health” under the psychologists category and find one with training in chronic medical conditions.
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Support groups are a great way to connect with patients who understand what you are going through because they help you feel less alone.
Many local hospitals have support groups. Hope for HS, a nonprofit organization dedicated to supporting people with HS, also offers online and in-person support groups in select cities.
Yoga, mindfulness exercises, and meditation can be useful daily practices for people living with a chronic disease because they are great for relieving stress and shifting your perspective and mindset.
“There’s lots of research showing mindfulness may help relieve chronic pain, reduce stress and improve quality of life. It’s one of those things that’s always worth trying. Maybe it will help and maybe it won’t. But it’s free. And it can’t hurt,” Visconti adds.
Lie flat on your back with one hand on your chest and another on your stomach. “When you breathe in, your stomach should expand (your hand on your stomach should move away from your spine). When you breathe out, your stomach should contract (your hand on your stomach should move in toward your spine),” Elizabeth Seng-Tamaccio, PhD, a psychologist at Montefiore Medical Center in New York City, tells Everyday Health. “The hand on your chest should not move.” This activates the diaphragm, a muscle in your midsection that is under your lungs.
Once you isolate the muscle, take deep, slow diaphragmatic breaths. “It can be helpful to count in and out,” Seng-Tamaccio adds. “You may even start with a shorter count like 4 and then increase it to 5, 6, or even a count of 8 as you get more comfortable.”
With some practice, you may even be able to try practicing deep breathing while standing and then while sitting up straight, according to Seng-Tamaccio. “Practice it for 5 to 10 minutes every day, and then you will be able to use it in the moment when you are in a stressful situation,” she advises.
Journaling is a good way to process and cope with the trauma of living with HS. A therapist or counselor can further help through that process.
Living with HS is undeniably a heavy burden, and the relationship between your skin and your stress levels is a powerful one. However, understanding this connection is the first step toward breaking the cycle of chronic inflammation. By addressing both the physical flares and the emotional weight they carry, you aren’t just managing a skin condition—you are reclaiming your quality of life.
Remember that managing HS is a marathon, not a sprint. As Visconti emphasizes, “Treating HS is a process. So, it’s important to keep an open line of communication with your doctor.” Whether you choose to start a daily journaling practice, join a support group, or master the art of diaphragmatic breathing, every small step you take toward lowering your stress is a step toward calmer skin.
You don’t have to navigate this journey in isolation. With a dedicated medical team, a supportive community, and a toolkit of stress-relief strategies, you can find a balance that works for you. Take it one breath, one treatment, and one day at a time.
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