With hidradenitis suppurativa (HS), at least one thing is clear: Obesity is a major risk factor for the chronic inflammatory skin condition that affects roughly 1 in 100 Americans, says Blair Murphy-Rose, M.D., a clinical assistant professor of dermatology at New York Presbyterian Hospital Weill Cornell Medical Center in New York City. Making lifestyle tweaks like exercising on the regular and checking your diet have been associated with improvements in HS signs and symptoms. “In fact, weight loss can be one of the most effective ways to reduce HS symptoms,” she says.
And one of the keys to weight loss, of course, is working out. “Exercise helps keep body weight down, which is helpful in patients with hidradenitis,” says Joshua Zeichner, M.D., a dermatologist in New York City and associate professor of dermatology at Mount Sinai Hospital. Experts agree—reducing body fat not only leads to less overall inflammation in the body, but also fewer skin folds, which can ease the symptoms of HS as well.
But for those with HS, it’s not as simple as grabbing a water bottle and hitting the gym. Not only does sweat itself exacerbate the inflammatory condition, but because those with HS are more likely to be overweight, it’s more likely they’ll have skin folds, which can get particularly irritated during a workout. “We know that being overweight leads to friction and sweating in areas like the underarms and groin,” Dr. Zeichner adds.
When all those factors are compounded, it’s a recipe for some extremely painful and particularly inflamed HS symptoms. “Be cautious in exercises that can lead to friction,” says Dr. Zeichner, such as a heated Bikram yoga class or a HIIT routine. But caution doesn’t mean skipping workouts altogether. By planning ahead with these strategic tips, tricks, and doctor-backed ideas, you’ll minimize the effect exercise has on HS.
1. Pick an easier workout.
While jogging may be a beneficial form of exercise, the inherent and copious amount of skin-on-skin contact between thighs (pretty much regardless of body size) is not advisable for those with HS. Instead, opt for workouts with minimal friction involved, suggests Dr. Zeichner, including swimming, yoga, or weightlifting.
Dr. Murphy is a huge fan of swimming for her patients with HS. “Swimming is an excellent exercise because the water reduces the rubbing of skin on skin,” she explains. But that’s not the only reason swimming works wonders for patients: “The chlorinated water can also reduce skin bacterial flora,” that can amplify inflammation, Murphy notes.
2. Apply anti-chafe balms or creams before gearing up.
“Skin on skin contact should be avoided to the best of your ability, but this may not always be possible,” says Dr. Zeichner. For those areas where irritation is eminent, apply a protective salve or balm directly on the tender area (it’s okay to apply directly on the bumps). Think about the spots that have the most potential for irritation, like underarms or groin, and lube up generously. One to try: Megababe Thigh Rescue ($14, target.com).
3. Be mindful of what kind of deodorant you’re going to use—or using any at all.
Antiperspirant use is a challenge if you have HS, as the chemical makeup of the antiperspirant itself—think aluminum and synthetic fragrances—could lead to irritation. So, if the skin is actively flaring with HS near or on your underarms, you should skip the stuff altogether, says Dr. Zeichner. But if workout B.O. is an issue, Dr. Zeichner recommends using a deodorant formulated without antiperspirant, like Lavanila “The Healthy Deodorant” ($12, lavanila.com), which will neutralize odor without irritating already sensitive skin.
4. Take inventory of your workout clothes.
To avoid the skin-on-skin rubbing, Dr. Murphy-Rose recommends wearing clothes that act as a literal barrier. “Thin, breathable spandex-containing exercise pants, for example, may be a better choice than shorts that can leave skin exposed to chafing,” she says. “Sleeveless tops, similarly, should be avoided if possible.”
However, it’s important to recognize that what may work for some won’t work for others. “Experiment,” says Dr. Murphy-Rose. “Some patients have told me that fitted stretchy exercise pants prevent leg chafing the best and are the most comfortable during exercises, while others have expressed that loose clothing feels better so that there is less pressure on tender nodules.”
Level up by choosing gear that’s made from moisture-wicking fabrics to help alleviate any of the potential irritating effects of sweat. “The best moisture-wicking materials are primarily made of polyester, polypropylene, and spandex blends,” explains Dr. Murphy-Rose.
5. Seek a well-ventilated space.
Working out at home has its perks, one of them being the ability to fine-tune the room temperature. While you may love the way a hot yoga class feels, it’s important that the room you’re working out in be cool and well-ventilated, says Dr. Zeichner. “A hot, humid environment may lead to more sweating, friction and flares.” Got access to windows? Open ‘em. Likewise, Dr. Murphy recommends staying hydrated to keep your internal body temp down.
6. Get in the shower as soon as you finish up.
This is advice that Dr. Zeichner gives across the board to all his patients, but he says it’s particularly important for those managing HS, as it helps get rid of inflammation-inducing bacteria. He recommends avoiding loofahs and washcloths, and sticking to “gentle, soap-free cleansers that will wash the skin without disrupting the outer layer.” One he likes: Dove Sensitive Skin Body Wash ($6, walmart.com), because it uses the same types of hydrating ingredients found in traditional moisturizers.