What lifestyle modifications can I recommend to patients with hidradenitis suppurativa to help manage their condition?

For patients with hidradenitis suppurativa (HS), several lifestyle modifications can be recommended to help manage their condition effectively. Weight management is crucial, as obesity is a known risk factor that can exacerbate HS symptoms; encouraging a balanced diet and regular physical activity may reduce disease severity and improve overall health. Smoking cessation should be strongly advised because smoking is associated with increased HS severity and flare-ups. Good skin hygiene is important; patients should be advised to keep affected areas clean and dry, avoiding harsh soaps or irritants that may worsen inflammation. Loose-fitting clothing made from breathable fabrics can reduce friction and irritation in affected areas, potentially decreasing lesion formation. Stress management techniques may also be beneficial, as stress can trigger or worsen HS flares. Additionally, hair removal in affected areas, such as gentle shaving or laser hair removal, might reduce follicular occlusion and inflammation, although evidence is limited and should be tailored to the individual. Patients should be supported with education about their condition and encouraged to seek specialist care if symptoms persist or worsen despite lifestyle changes.

These recommendations are supported by expert consensus and clinical guidelines emphasizing the role of modifiable risk factors in HS management (Alikhan et al., 2019; Dagenet et al., 2025). While UK-specific guidelines for HS lifestyle advice are limited, the integration of international expert recommendations highlights these key areas for patient self-care and risk reduction (Alikhan et al., 2019; Martora et al., 2024).