HS is typically concentrated in skin folds, such as the armpits and groin. This means there can be skin-to-skin friction in these areas during movement, which causes discomfort and pain. Even contact with clothing can hurt. At the same time, regular physical activity is especially beneficial for people with HS who are overweight, as research has found obesity to be a major risk factor for severe HS. And according to the American Academy of Dermatology, weight loss can reduce flare-ups, prevent HS from worsening, or even cure the condition — in part, at least, by increasing the amount of space within skin folds. Exercise also can help reduce stress, decrease the risk of other health conditions, such as heart disease and diabetes, and bring about a general sense of well-being, even in people who are not overweight. “I encourage all our patients to try to establish a good exercise routine, and that can be different for every patient,” says Benjamin Kaffenberger, MD, a dermatologist at The Ohio State University Wexner Medical Center in Columbus. “But it’s challenging for most patients, due to pain, and body weight can also be a significant challenge.” The key to exercising with HS is to recognize the challenges the condition poses for certain activities, and modify those activities as needed. This can include changing your exercise clothing, trying a new activity, and taking steps to control sweat.
What to Wear
A guiding principle of exercising with HS is minimizing skin-on-skin contact, according to Dr. Kaffenberger. One way to do that is by choosing your fitness wear carefully. Even if you typically find loose clothing to be most comfortable during the day, when you exercise, you may need to dress in clothing that minimizes friction in your thighs, groin, and armpits, such as compression shorts and skintight tops. It’s also important to consider what your workout clothing is made of. There are materials designed to wick sweat away from the skin, such as Coolmax® and Supplex®. Shirts, shorts, and tights made of such fabrics can be good options, according to Kaffenberger.
Best Activities for HS
When you have HS, your exercise routine may look different from other people’s, including others who have the condition. “It’s a very individual thing,” says Kaffenberger. “What’s key is finding activities that don’t cause pain and that you enjoy doing.” Whether you’re new to exercise or trying out a new activity, Kaffenberger emphasizes the importance of starting slowly. “It’s not just going out and running a marathon the next day,” he says. “It’s taking smaller steps in the first place.” Swimming can be a good choice, “because your skin isn’t rubbing on itself much,” says Kaffenberger. “The water lubricates it.” In addition, he says, the chlorine in swimming pools can be beneficial for many people with HS by controlling the growth of bacteria on the skin. Yoga may be a great option, Kaffenberger says, since it involves slow movements that cause minimal skin friction. Bicycling can be a good choice, too, but, “There is a lot of skin rubbing, so finding the right type of bike shorts is very important,” he adds. Simply walking is an excellent way to get physical activity, especially if you’re not used to more intense exercise. “Start with 30 minutes of walking three times a week, and increase that over time,” Kaffenberger suggests.
Dealing With Sweat
For many people with HS, perspiration can cause a burning sensation on the skin. “If you have early-stage disease and it’s not particularly active, sweat probably isn’t a big issue at all,” says Kaffenberger. “But as the disease gets more severe and there are chronic open areas, sweating can become very painful.” Wearing moisture-wicking fabrics when you exercise can help reduce the effects of sweat, but there are also measures you can take to minimize how much you sweat.
Work out in a well-ventilated area. If you’re indoors at home, try using an electric fan to create a breeze in your workout area. Plan to exercise outdoors only in cooler weather, or stick to shaded areas.Use an antiperspirant. A spray-on formulation can be easier than traditional stick or liquid versions to apply to large areas of skin.Wear moisture-wicking dressings. These are special sheets, available at pharmacies and other stores that sell medical products, that can be positioned in deep folds of the thighs, groin, and armpits to separate skin and wick away moisture during exercise or at other times you’re prone to sweating, Kaffenberger says.Shower as soon as you can after your workout. This will reduce the amount of time sweat stays on your skin. Your dermatologist may recommend an antibacterial body wash to combat bacteria. If you can’t shower immediately, change out of your sweaty clothes and put on clean ones to help stay dry in the meantime.
Once you’re taking all the steps you can to improve your comfort during exercise, try to have fun with physical activity. “That’s the easiest way to make exercise a habit that can help lead to weight loss and the separation of skin folds,” says Kaffenberger.
