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What Makes Hidradenitis Suppurativa Flare-up & How To Avoid Them?

Hidradenitis suppurativa is a rare skin disorder that is characterized by swollen, painful lesions that develop in areas where the skin rubs together, including the armpit, groin, breasts, and the anal regions. The disease happens because of the obstruction of hair follicles, and secondary infection may develop. Inflammation of sweat glands can also cause hidradenitis suppurativa. While the exact cause of hidradenitis suppurativa is known, but there are medications and ways to manage a flare-up of the condition. It is important to identify the potential triggers of hidradenitis suppurativa so that you can avoid them. Read on to know more about what makes hidradenitis suppurativa flare-up and how to avoid them.

Overview of Hidradenitis Suppurativa

Hidradenitis suppurativa is a type of chronic inflammatory skin condition that causes painful, fluid-filled bumps to develop on certain parts of the body where the skin rubs together. The condition is also known as acne inversa.(1,2) These fluid-filled lesions can become infected, in which case pockets can form underneath the skin, and they can become filled with pus. These bumps smell bad once they break open and can also leave scars. Hidradenitis suppurativa tends to affect the underarms, buttocks, groin, and breasts.(3,4) The lesions may also look like boils. This condition typically develops after puberty and is believed to be a genetic disease. The disease is three times more likely to affect women than men.(5,6)

The exact cause of hidradenitis suppurativa is not yet known. Still, there are certain risk factors or triggers that are known to cause a flare-up or breakout of hidradenitis suppurativa. If you live with hidradenitis suppurativa, here are some of the potential triggers that can cause a flare-up of the condition, making your symptoms worse.

What Makes Hidradenitis Suppurativa Flare-up & How To Avoid Them?

What Makes Hidradenitis Suppurativa Flare-up & How To Avoid Them?

1. Diet

Diet is one of the biggest triggers for a flare-up of hidradenitis suppurativa. Many experts believe that hidradenitis suppurativa is partly influenced by hormones. Foods like dairy products and sugar can increase your insulin levels, causing your body to start overproducing certain hormones known as androgens. This can make the symptoms of hidradenitis suppurativa worse.(7)

Studies have also found that brewer’s yeast, which is a common ingredient found in food items like bread, pizza dough, and beer, can cause serious reactions in some people with hidradenitis suppurativa.(8)

By restricting the intake of dairy products, foods containing brewer’s yeast, and sugary snacks and beverages, you might be able to prevent the flare-ups of hidradenitis suppurativa, as well as avoid the development of new lesions from forming. Consuming a healthy and balanced diet can help you manage your symptoms better and keep your condition under control.

2. Overweight or Obesity

Research has shown that people who are overweight or obese have a greater chance of developing hidradenitis suppurativa and also experience more severe symptoms.(9) Because breakouts of the hidradenitis suppurativa lesions typically happen on parts of the body where the skin rubs against the skin, the friction increases the potential for bacterial growth in the area. This is caused by the excess skin folds due to being obese or overweight. All this significantly increases the chances of having a hidradenitis suppurativa flare-up.

If you feel like your weight could be responsible for an increased severity of your symptoms, you should discuss about weight loss with your doctor. Exercising regularly and eating a balanced and healthy diet are vital to losing weight. Losing weight will help reduce any body friction and also reduce some of the hormonal activity that may also trigger a flare-up and further lesions.

Your doctor can help you design a daily exercise regimen and a healthy meal plan that can give you the best results with weight loss.

3. Smoking or Tobacco Use

If you are a smoking or use any form of tobacco, such as chewing tobacco, you should be aware that regular use of tobacco products is harmful to your health. This can also worsen the symptoms of hidradenitis suppurativa.

A 2014 study found that smoking is linked with not just an increased prevalence of hidradenitis suppurativa but also with an increased severity of hidradenitis suppurativa symptoms.(10)

Quitting smoking is not an easy task, but there are several resources available to help you stop. Support groups, prescription medications, and even smartphone apps can all help you quit smoking. You can also talk to your doctor about helpful strategies to quit smoking.

4. Weather Changes

Changes in weather can also have an impact on the severity of your symptoms of hidradenitis suppurativa. Many people experience flare-ups or breakouts when exposed to hot and humid climates. If you find that you are usually feeling uncomfortable and sweaty, you should try to manage the temperature in your home with a fan or air conditioner. You should also use a soft towel to keep your skin dry by dabbing away the sweat.

There are many antiperspirants and deodorants that are known to irritate the underarm areas that are already prone to hidradenitis suppurativa breakouts. This is why you should choose brands that contain antibacterial ingredients like baking soda and are also gentle on your sensitive skin.

5. Wearing Tight-Fitting Clothes

In some cases, it is also a possibility that your wardrobe is aggravating your symptoms. Wearing tight-fitting clothes or synthetic clothing creates friction that can irritate the parts of the body where hidradenitis suppurativa lesions usually form. It is best to stick to wearing loose and breathable fabrics like cotton, especially when you are experiencing a flare-up. Avoid wearing underwear that is made with tight elastics and bras that have an underwire.

6. Stress

Chronic stress or high levels of stress can be another trigger for hidradenitis suppurativa. If you are often stressed or anxious, it is possible that your symptoms get worse. It is a good idea to practice stress-reducing activities like meditation, yoga, deep-breathing, and progressive muscle relaxation techniques to help you remain calm when feeling tense and to better manage your stress levels.


Lifestyle changes will not cure hidradenitis suppurativa, but they can help in the management of symptoms and flare-ups. Healthy lifestyle changes will help reduce your symptoms and also reduce some of the irritation and discomfort that comes along with a hidradenitis suppurativa flare-up. If you feel like you have already tried all these tips and your condition has still not improved, you should consider talking to your doctor about whether your prescription medications can be changed or surgery might be a better option for you.


  1. Jemec, G.B., 2012. Hidradenitis suppurativa. New England Journal of Medicine, 366(2), pp.158-164.
  2. Revuz, J., 2009. Hidradenitis suppurativa. Journal of the European Academy of Dermatology and Venereology, 23(9), pp.985-998.
  3. Alikhan, A., Lynch, P.J. and Eisen, D.B., 2009. Hidradenitis suppurativa: a comprehensive review. Journal of the American Academy of Dermatology, 60(4), pp.539-561.
  4. Jemec, G.B., Heidenheim, M. and Nielsen, N.H., 1996. The prevalence of hidradenitis suppurativa and its potential precursor lesions. Journal of the American Academy of Dermatology, 35(2), pp.191-194.
  5. Sabat, R., Jemec, G.B., Matusiak, Ł., Kimball, A.B., Prens, E. and Wolk, K., 2020. Hidradenitis suppurativa. Nature Reviews Disease Primers, 6(1), pp.1-20.
  6. Dufour, D.N., Emtestam, L. and Jemec, G.B., 2014. Hidradenitis suppurativa: a common and burdensome, yet under-recognised, inflammatory skin disease. Postgraduate medical journal, 90(1062), pp.216-221.
  7. Mortimer, P.S., Dawber, R.P., Gales, M.A. and Moore, R.A., 1986. Mediation of hidradenitis suppurativa by androgens. Br Med J (Clin Res Ed), 292(6515), pp.245-248.
  8. Cannistrà, C., Finocchi, V., Trivisonno, A. and Tambasco, D., 2013. New perspectives in the treatment of hidradenitis suppurativa: Surgery and brewer’s yeast–exclusion diet. Surgery, 154(5), pp.1126-1130.
  9. Dufour, D.N., Emtestam, L. and Jemec, G.B., 2014. Hidradenitis suppurativa: a common and burdensome, yet under-recognised, inflammatory skin disease. Postgraduate medical journal, 90(1062), pp.216-221.
  10. Dufour, D.N., Emtestam, L. and Jemec, G.B., 2014. Hidradenitis suppurativa: a common and burdensome, yet under-recognised, inflammatory skin disease. Postgraduate medical journal, 90(1062), pp.216-221.
Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:February 11, 2022

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