HS Exercise Guide: Staying Active with Hidradenitis Suppurativa
Exercise is one of the most powerful tools for managing HS - but friction, sweat, and heat can trigger flares. This guide shows you how to stay active while protecting your skin.
Medical Disclaimer: This article is for educational purposes only. Always consult your physician before starting a new exercise program, especially if you have active HS lesions or other medical conditions. Read full disclaimer.
Many people with hidradenitis suppurativa avoid exercise out of fear that it will worsen their condition. This is understandable - friction, heat, and sweating can trigger HS flares. But avoiding physical activity entirely is not the answer. Regular exercise is one of the most evidence-supported lifestyle interventions for HS, with benefits that extend far beyond weight management. Combining exercise with an anti-inflammatory diet and proper post-workout hygiene creates a powerful foundation for HS management.
Reduces Inflammation
Regular moderate exercise lowers systemic inflammatory markers including CRP, IL-6, and TNF-alpha - the same cytokines that drive HS.
Improves Metabolic Health
Exercise improves insulin sensitivity and supports weight management, both of which are associated with less severe HS.
Mental Health Benefits
Physical activity reduces depression and anxiety, which are highly prevalent in HS patients and can worsen disease perception.
Exercise Options for HS Patients
The following ratings are based on friction risk, heat generation, and impact on HS-affected areas. Individual experiences vary - what works for one person may not work for another.
Swimming
ExcellentNon-friction, low-impact, cooling effect on skin. Chlorinated water may have mild antiseptic benefit. Ideal during flares.
Tip: Shower immediately after to remove chlorine; dry skin folds thoroughly.
Walking
ExcellentLow friction, adaptable pace, no special equipment needed. Can be done in loose, breathable clothing.
Tip: Use anti-chafe products on inner thighs; wear moisture-wicking socks.
Cycling (stationary)
GoodLow-impact, no leg friction. Stationary cycling avoids road vibration and allows controlled intensity.
Tip: Use padded cycling shorts; avoid tight waistbands over abdominal HS lesions.
Yoga / Pilates
GoodImproves flexibility, reduces stress (a known HS trigger), and can be adapted to avoid pressure on lesions.
Tip: Avoid poses that press directly on active lesions; use a clean mat.
Resistance Training
GoodBuilds muscle, improves metabolic health, and can be done with minimal friction if clothing is appropriate.
Tip: Wear loose-fitting gym clothes; avoid exercises that cause friction in affected areas.
Running / Jogging
ModerateCardiovascular benefits are significant, but inner thigh and groin friction is a concern.
Tip: Use anti-chafe products liberally; wear compression shorts with smooth seams; avoid during active flares in groin/thigh.
Contact Sports
CautionPhysical contact, friction, and impact can aggravate HS lesions.
Tip: Avoid during active flares; use protective padding over lesion areas when participating.
Hot Yoga / Bikram
CautionExcessive sweating and heat are known HS triggers.
Tip: May worsen flares; consider standard yoga instead.
Exercise Protocol for HS Patients
Before Exercise
- -Apply zinc oxide paste or anti-chafe balm (e.g., Body Glide) to inner thighs, groin, and underarms
- -Choose moisture-wicking, seamless, loose-fitting clothing - avoid tight waistbands over active lesions
- -If you have active open lesions, cover them with a non-stick dressing to prevent friction and contamination
- -Choose a cooler time of day or an air-conditioned environment when possible
During Exercise
- -Stop if you experience sharp pain at a lesion site - this may indicate a flare developing
- -Stay hydrated; dehydration can concentrate sweat and increase skin irritation
- -Modify exercises that cause friction in affected areas - for example, use a recumbent bike instead of an upright bike if you have gluteal HS
- -Keep intensity moderate during active flares; reduce duration and intensity as needed
After Exercise
- -Shower promptly - within 30 minutes of finishing exercise
- -Use a gentle, fragrance-free, antibacterial cleanser (e.g., Hibiclens diluted, or chlorhexidine wash) in affected areas
- -Pat skin dry - do not rub; use a clean, soft towel
- -Apply any prescribed topical treatments after showering
- -Change into clean, dry, loose-fitting clothing immediately
Modifying Exercise During Active Flares
During active flares, the goal is to maintain some level of physical activity while avoiding further irritation to affected areas. Complete rest is rarely necessary and may worsen metabolic and mental health.
Axillary (Armpit) Flares
Avoid overhead pressing, pull-ups, and exercises that require arm-to-body contact. Swimming with modified stroke, walking, and lower body exercises are typically well-tolerated.
Groin / Inner Thigh Flares
Avoid running, cycling, and exercises requiring leg abduction. Swimming (breaststroke may cause friction - use freestyle), upper body resistance training, and seated exercises are good alternatives.
Gluteal / Perianal Flares
Avoid seated exercises and cycling. Standing exercises, swimming, and walking are typically well-tolerated. Use a donut cushion if sitting is required.
Chest / Submammary Flares
Avoid exercises that cause breast movement or friction. Supportive, seamless sports bras or no-bra options during exercise may help. Swimming and lower body exercises are usually feasible.