8 Ways to Manage Stress if You Have Hidradenitis Suppurativa

“These patients really struggle sometimes, understandably, because they may spend every day in pain, or spend 30 minutes or an hour just putting dressings on every day,” says Christopher Sayed, MD, an associate professor of dermatology at the University of North Carolina School of Medicine in Chapel Hill. “It’s a huge amount of time they have to dedicate, a huge amount of stress.”

1. Work With Your Doctor to Find a Treatment Plan That Works for You

By improving your HS symptoms, you might be able to reduce your stress. “A lot of patients would say, ‘My mental health would be much better if I could just get this disease better,’” Dr. Sayed says. This may involve reducing pain, drainage, and the need for bandaging so that HS doesn’t affect you as much, he notes. If your condition is not improving, you might need to seek the next level of expertise: a dermatologist who specializes in treating HS. The Hidradenitis Suppurativa Foundation maintains a list of HS specialty clinics.

2. Make Healthy Lifestyle Changes

3. Reach Out for Help During Stressful Flares

Your healthcare provider can help you if your symptoms are flaring and causing you stress. “Somebody who has HS once described it to me as ‘the roller coaster from hell,’ because it can flare up suddenly without warning and really impact your ability to get through the next day or the next week,” Dr. Kirby says. “And so I think that it can be helpful for us as providers to work with people to recognize we have treatments for when [flares] happen, and we have treatments we can use in between flares to try and make them less frequent and less severe when they do pop up.” Call your doctor or send them a message through your online patient portal to ask for help instead of struggling on your own.

4. Talk to a Therapist or Counselor

A mental health professional can teach you coping skills, which is helpful since stress might exacerbate HS symptoms. “Learning to successfully use stress management techniques is helpful for everyone, but it may be especially helpful for people with HS,” says Elizabeth Seng-Tamaccio, PhD, a psychologist at Montefiore Medical Center in New York City.

You can find psychologists who specialize in health psychology through the American Psychological Association or the National Register of Health Service Psychologists. Another option: Start with your insurance plan, and search for the keyword “health” under the psychologists category to find one with training in chronic medical conditions, Seng-Tamaccio says.

5. Join an HS Support Group

Connecting with fellow HS patients could help you feel less alone. “I think these communities can help people realize how normal their symptoms are for HS,” says Seng-Tamaccio. “You are not dirty. You are not disgusting. You are not at fault. You have a disease that is painful and difficult to manage. I also think these communities can be great places to share practical tips and resources about how to find care and manage the disease in day-to-day life.”

Some local hospitals have support groups, so check the websites of your local medical systems. You can also find online support groups and in-person meetings in select cities at Hope for HS, a nonprofit organization dedicated to supporting people with HS.

6. Try Yoga, Mindfulness, or Meditation

Yoga, mindfulness exercises, and meditation can be useful daily practices for people living with a chronic disease, says Seng-Tamaccio. “In particular, yoga and other forms of nourishing movement can help people with HS reclaim their bodies as their own and become a source of beauty, strength, and personal expression,” she says. “Mindfulness and other forms of meditation can help people shift their perspective and build resilience.”

7. Practice Deep Breathing

“I would highly recommend using deep breathing, or diaphragmatic breathing,” Seng-Tamaccio says. “Set aside a few five-minute periods to keep your stress levels low throughout the day.”

Once you isolate the muscle, take deep, slow diaphragmatic breaths. “It can be helpful to count in and out,” Seng-Tamaccio says. “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.”

When you feel confident, try practicing deep breathing while standing and then while sitting up straight, Seng-Tamaccio says. “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 says.

8. Start a Journal

“Many people with HS have legitimately traumatizing experiences with the medical system, where their symptoms were dismissed and they were blamed for their disease,” says Seng-Tamaccio. “Journaling can be a useful way to work through this type of trauma.”

Speaking with a therapist or counselor might help you develop a series of journaling prompts that will guide you through processing what has happened, she says.

The Takeaway

• Psychological distress is common among people with hidradenitis suppurativa, which can cause symptoms to flare.
• Lifestyle changes like eating a healthy diet and quitting smoking, practicing meditation and yoga, and speaking with a therapist or counselor, can all be helpful tools in relieving stress and getting HS symptoms under control.
• Talk to your doctor about treatment options for HS and for help finding a mental health professional with experience in treating individuals with chronic conditions.