Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition, and for sufferers, the struggle is real. Characterized by painful nodules, abscesses, and sinus tracts in areas where the skin abrades, the symptoms most commonly flare up in the underarms, groin, and under the breasts.
And many times, these flare-ups are caused by friction, heat, and sweat. Together, these three culprits can take minor HS issues from a nuisance to a truly debilitating condition.
This is where your wardrobe comes in. The right fabrics, fits, and designs not only minimize irritation, but they also boost confidence for any occasion. Date nights? Office work? Everyday events and activities?
Let’s explore the top scientifically informed clothing strategies, trendy options, and DIY alterations to help calm HS once and for all…
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Understanding HS and Clothing’s Role
Impacting approximately one to four percent of the population, HS actually has a higher prevalence in women. Driven by blocked hair follicles and inflammation, the mechanical stress of clothing makes up much of the problem. According to research from Dermatology, suboptimal clothing can increase friction and exacerbate HS lesions, while breathable, loose-fitting fabrics have the opposite effect.
In other words, the goal is to select clothing that minimizes pressure, wicks moisture, and allows airflow to sensitive areas.
This is more than just aesthetics and looking good. It’s about proactively managing symptoms. While not a cure-all, the right wardrobe can complement numerous medical treatments, such as biologics, lifestyle changes, and other natural remedies.
Let’s discuss the top clothing choices for managing your HS today.
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Seamless Undergarments
Undergarments are the first layer of defense for HS-prone areas. The problem is, many tight, synthetic fabrics like polyester or nylon can trap heat and moisture. When this happens, they create a breeding ground for bacteria that worsens HS.
So go for breathable, absorbent fabrics instead. Cotton, bamboo, and modal reduce microbial colonization and irritation. Seamless designs are specifically beneficial, mainly because they get rid of rough edges that can disturb sensitive skin further.
But where do you begin?
For starters, look into cotton and bamboo brands from Saalt. This company offers leakproof boyshorts made from modal, a beechwood-derived fiber that’s 50 percent more absorbent than cotton. This is particularly useful for people who have HS flare-ups in the groin area. The best part is, there’s no need for tight elastic bands that dig into the skin.
Saalt’s seamless line is also machine-washable and durable, which is great for daily wear.
Then there are feminine options. Many underwire bras can aggravate HS under the breasts or in the armpits. Instead, opt for wireless bras with wide straps or bralettes. Torrid’s 360° Back Smoothing Wire-Free Bra is a perfect item for this purpose. It has wide straps and full coverage, minimizes irritation, and can reduce friction under the bust.
For extra protection, cotton bra liners can wick away sweat and absorb drainage, another top option for HS sufferers.
If you’re struggling to find seamless options right for you, you can make some DIY alterations yourself. It may sound odd, but try wearing underwear inside out to avoid seam friction, and for bras, add soft fabric patches to straps or bands to reduce pressure points.
Hey, you won’t know if you don’t try!
Flowy Tops
Ready to look stylish and feel good at the same time?
Tops that are loose and breathable are ideal for HS, especially for underarm or chest lesions. In fact, tight clothing can exacerbate flares by increasing friction and heat, as noted in a 2023 International Journal of Women’s Dermatology study. Flowy tops are best when made from natural fibers like linen, organic cotton, or Tencel (a sustainable lyocell fabric). These offer both comfort and style, making them perfect, whether it’s for date nights, office settings, or vacations.
When it comes to going out for a night on the town, the first thing you want is to look chic yet comfortable. Don’t know how to do this? Try ADAY’s Tencel-based flowy blouses. These fashionable wardrobe pieces are lightweight, packable, and gentle on sensitive skin. Because of their billowy structure, they won’t rub, and when paired with high-waisted, loose-fit trousers, they also won’t irritate your groin!
Want to embrace a clothing style for the workplace, or looking to enjoy some vacation vibes? In these cases, a lightweight linen blazer over a loose cotton camisole is the perfect professional look for the office. Brands like Everlane even offer 100% cotton dresses with relaxed fits, and can be layered with a soft cardigan for added coverage that doesn’t constrict.
And finally, for the vacation destination, consider flowy dresses or skirts in bamboo or linen. They’re great for warm climates, and you can always wear moisture-wicking bike shorts underneath.
HidraWear is one brand that provides HS-specific garments, ideal for travel when flares are unpredictable.
Bottoms and Outerwear
We’ve all experienced discomfort from tight jeans or leggings, and they’re particularly bad for people with HS groin and thigh lesions. Fortunately, loose, breathable options like joggers or wide-leg pants can help. For women, high-waisted, seamless pants are a great way to avoid waistband pressure. For outerwear, avoid heavy, scratchy materials like wool, which are notorious for trapping heat.
If you’re not sure where to begin, look into Everlane’s 100% cotton joggers. They’re dermatologist-approved for their breathability and loose fit, and are well-suited for casual office days and travel. If you crave a trendier look, palazzo pants in linen or cotton will give you the polished feel you want.
And finally, when it comes to outerwear, nothing beats some lightweight kimonos or cotton cardigans. Not only do they add style without weighing down your skin, but they also steer clear of synthetic jackets that trap heat. Patagonia’s organic cotton line is one offering to definitely check out.
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Footwear and Accessories
Footwear is critical. Why? Because for HS patients, groin or thigh pain can alter posture and walking. Fortunately, breathable, supportive shoes like cotton-lined sneakers from Brother Vellies can help. One of the main ways they do this is by preventing sweaty feet, which can indirectly worsen HS by boosting overall body heat.
Additionally, accessories like loose silk scarves or cotton hats can add flair while protecting sensitive areas. And if you’re feeling inventive, you have some DIY options as well. For instance, you can line tight shoe interiors with cotton padding. Open-toe sandals in the summertime are also stylish and help to enhance airflow.
Whatever you do, prioritize natural fabrics. Stick with cotton, bamboo, linen, or Tencel for their breathability and low friction. Stay away from most polyester products, unless they’re moisture-wicking activewear.
When testing the fit, try on clothes during an actual flare-up. This will help to determine if they irritate active lesions. And don’t forget to get out in the community! Platforms like myHSteam provide peer recommendations, so you’ll never run out of ideas for HS-friendly clothing.
Last but not least, consult a dermatologist. Your doctor may recommend specific brands or fabrics tailored to your HS severity. At the end of the day, a personalized approach will go a long way in reducing your symptoms time and time again.
