If you live with hidradenitis suppurativa (HS), you already know it’s more than a “skin problem.” The pain, flares, scarring, and emotional toll can be exhausting, especially when symptoms keep coming back despite treatment. Lately, I’ve been seeing more women struggling with HS, often alongside weight challenges, hormonal changes, and chronic inflammation.

While there is no single cure for HS, growing research shows that systemic inflammation, metabolic health, and lifestyle factors play an important role in symptom severity and flare frequency. Understanding these connections can help women feel more empowered and supported in managing this condition.

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What Is Hidradenitis Suppurativa?

Hidradenitis suppurativa is a chronic inflammatory skin condition characterized by painful nodules, abscesses, and tunnels that typically develop in areas where skin rubs together (such as the underarms, groin, buttocks, and under the breasts). Over time, repeated flares can lead to scarring and significant discomfort.

HS is not caused by poor hygiene, and it is not simply an infection. It is now recognized as an immune-mediated inflammatory condition, meaning the immune system plays a central role in driving symptoms.

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HS and Chronic Inflammation: The Bigger Picture

At its core, HS is fueled by chronic inflammation. Research has shown elevated inflammatory markers and immune signaling in people with HS, which helps explain why flares can be persistent and difficult to control. Chronic inflammation doesn’t exist in isolation. It is often linked to:

• Insulin resistance
• Metabolic dysfunction
• Hormonal shifts
• Stress and poor sleep
• Excess adipose (fat) tissue

When inflammation is high throughout the body, skin conditions like HS may become more active or severe.

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The Connection Between Weight and HS (Without Blame)

This is an important and sensitive topic. Weight does not cause HS, but there is a strong association between HS and obesity. This relationship is rooted in biology, not blame.

Excess adipose tissue is metabolically active and releases inflammatory substances that can worsen systemic inflammation. Additionally:

• Insulin resistance is more common with higher body weight and may contribute to immune dysregulation.
• Skin friction and moisture in skin folds can aggravate HS-affected areas.
• Hormonal imbalances often seen with weight gain can influence flare patterns.

For many women, improving metabolic health — even modestly — can help reduce inflammatory burden and support symptom management.

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Nutrition and HS: What the Evidence Suggests

There is no single “HS diet,” but research increasingly supports anti-inflammatory nutrition patterns for managing chronic inflammatory conditions, including HS. Rather than extreme elimination diets, the focus should be on consistent, sustainable nutrition changes that support blood sugar balance and reduce inflammatory load. Helpful nutrition principles include:

• Emphasizing whole, minimally processed foods
• Supporting stable blood sugar through balanced meals
• Reducing ultra-processed foods and added sugars
• Including adequate protein to support healing and muscle mass
• Supporting gut health, which plays a role in immune regulation

Some individuals notice symptom improvement when reducing highly processed carbohydrates, sugary beverages, and inflammatory fats, but responses vary. The goal is progress, not perfection.

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Can Weight Loss Help HS?

Weight loss is not a cure for HS, but sustainable, health-focused weight loss can support HS management by:

• Lowering systemic inflammation
• Improving insulin sensitivity
• Reducing mechanical stress on affected skin areas
• Supporting hormonal balance

The key is that weight loss should be gradual and supportive, not extreme. Crash dieting and chronic restriction can actually worsen inflammation and stress responses, potentially triggering flares.

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A Holistic Approach: Where Ample Health & Wellness Fits In

At Ample Health & Wellness, the focus is on whole-body health, not quick fixes. For women living with HS, a holistic approach can be especially important.

The FRESH Start Holistic Weight Loss Program supports women through:

• Food, Freedom & Foundations: Anti-inflammatory nutrition without rigid rules
• Rewiring the Mindset: Reducing shame, frustration, and burnout around chronic conditions
• Elevating Habits: Small, consistent changes that support long-term health
• Simplifying the Environment: Stress reduction, which directly impacts inflammation
• Honoring Whole Health: Sleep, hormones, mental health, and medical support

This approach recognizes that HS affects the whole person — physically and emotionally.

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Living With HS: A Compassionate Reminder

HS can be physically painful and emotionally draining. If you’re living with this condition, know that you are not failing your body. Managing inflammation through nutrition, weight support, stress reduction, and medical care is not about perfection …it’s about creating an environment where healing is more possible. Small, sustainable changes can make a meaningful difference over time.

A Practical Downloadable Resource to Support You

Living with hidradenitis suppurativa often means navigating daily decisions that affect inflammation, energy, and overall health. To make this easier, I’ve created a complimentary one-page HS Nutrition & Inflammation Support Checklist designed specifically for women.

This checklist focuses on:

• Simple nutrition foundations that support inflammation balance
• Blood sugar–friendly habits that may help reduce flare triggers
• Gentle guidance around weight and metabolic health
• Lifestyle factors that influence chronic inflammation
• Mindset reminders for living with a long-term condition

It’s meant to be a supportive, educational tool and not a cure or a restrictive plan. This checklist can be used alongside your current medical care. Please note this resource is for educational purposes only and does not replace medical care.

About the Author: Dr. Kisha Pickford, DNP, is a board-certified nurse practitioner and holistic nutrition weight loss coach at Ample Health & Wellness. She helps women over 40 achieve sustainable weight loss and whole-body wellness through holistic, evidence-based coaching.

📚References

1. Ingram, J. R., Jenkins-Jones, S., Knipe, D. W., Morgan, C. L., & Cannings-John, R. (2020). Population-based clinical practice research on hidradenitis suppurativa. British Journal of Dermatology, 183(6), 1086–1093.
2. Goldburg, S. R., Strober, B. E., & Payette, M. J. (2020). Hidradenitis suppurativa: Epidemiology, clinical presentation, and pathogenesis. Journal of the American Academy of Dermatology, 82(5), 1045–1058.
3. Zouboulis, C. C., et al. (2020). Hidradenitis suppurativa as a systemic disease. Experimental Dermatology, 29(4), 343–350.