Lifestyle modifications associated with symptom improvement in hidradenitis suppurativa patients

Background: Hidradenitis suppurativa (HS) is a chronic, inflammatory skin condition that substantially reduces patient quality of life. Many HS patients ask their dermatologist about potential lifestyle modifications, such as following particular diets or avoiding specific products, in an attempt to alleviate their symptoms. However, insufficient research has been conducted to support well-informed lifestyle modification counseling, and patients frequently defer to anecdotal endorsements of various interventions found on social media support groups. Therefore, we sought to clarify what lifestyle modifications were capable of improving HS symptoms. Methods: We conducted a survey-based study to examine modifiable risk factors and their association with the severity of HS. Five hundred and ninety-one patients with HS participated in an online survey detailing the severity of their HS symptoms before and after various lifestyle interventions. Average improvements in both subjective and objective ratings of symptom severity were calculated and statistical differences between the levels of improvement seen among various categories of lifestyle interventions were determined. Results: Numerous lifestyle interventions including substantial weight loss, smoking cessation, use of gentle skin and depilatory products, and menstrual regulation were associated with both subjective and objective improvements in symptom severity. Conclusions: Our results suggest that patients affected by HS may experience clinically significant improvement from a variety of lifestyle modifications.