Patient-Reported Triggers for HS

August 1, 2024

This plain-language research summary was generated by AI, courtesy of HS Simplified.

AI Generated Content Verified By: Christopher Sayed, M.D. | UNC School of Medicine

Patient-Reported Triggers for HS

Hidradenitis suppurativa (HS) is a painful skin condition leading to nodules, abscesses, and tunnels predominantly in areas where skin rubs together. A 2024 study revealed that common patient-reported triggers include sweating, emotional stress, and hormonal changes, particularly in women during menstrual cycles. Addressing these exacerbating factors could enhance HS management by helping patients avoid known triggers and potentially alleviate symptoms.

What Makes Hidradenitis Suppurativa Worse?

Hidradenitis suppurativa (abbreviated as HS) is a skin disease where people get painful lumps, abscesses (pockets of pus), and tunnels under their skin. These usually happen in areas where skin rubs together, like the armpits or groin. Scientists, including Shams and Sayed, wanted to know what things make HS worse for different people.

They gave new patients a form to mark which things made their HS flare up. The options included sweating, stress, heat, exercise, and for women, things like their menstrual cycle or hormonal birth control. There was also a spot to write in other triggers. Over five years, over 1,400 people completed the survey—most were women, Black, obese, and did not smoke.

What Did Patients Say Were Their Biggest Triggers?

The most common triggers were sweating (about half the patients), emotional stress (almost half), heat, and exercise. For women, many noticed flares around their periods. Some people also said certain foods made them worse, especially sugary foods, fatty foods, and dairy, but these were less common. A few mentioned things like friction, shaving, and even deodorant.

Do Triggers Differ for Different People?

Yes! People with more serious HS (Hurley stage III) were more likely to report pregnancy or food/alcohol as triggers, but less likely to say shaving made them worse (probably because they avoid shaving those areas). Obese patients were more likely to report heat and exercise as triggers, but less likely to mention food. Women were less likely than men to say heat or food made things worse. Black patients reported fewer triggers overall. Smokers or people who used to smoke were more likely to say their period, stress, or heat triggered their HS.

What Does This Mean?

This study suggests that sweating, stress, heat, and exercise are the most common things that can make HS worse. Triggers can be different depending on a person’s body, their sex, race, and habits like smoking or being overweight. Knowing what makes HS worse can help people avoid those things, like staying cool, managing stress, and reducing skin friction.

Limitations

There are some limitations to this study. The researchers only asked people what they remembered, so some may have forgotten or guessed. People might have checked boxes for things that weren’t really triggers, just because they were listed. The form didn’t ask how often people did things like exercise or shave, so it’s hard to know if they were really exposed to those triggers. But the study is strong because it had lots of different kinds of patients and carefully collected the information over time.

In summary, if you have HS, avoiding things like sweating, heat, and stress might help you feel better, but triggers are different for everyone.

Author(s)

Rayad B Shams, Christopher J Sayed

Read Original Paper

https://www.jaad.org/article/S0190-9622(24)00543-7/abstract