When you have hidradenitis suppurativa (HS), an auto-inflammatory illness that causes painful boils and skin abscesses that occasionally exude foul-smelling pus, it can be difficult to feel comfortable in your own skin, both literally and metaphorically. This chronic illness affects between 1% and 4% of the population in India and can manifest as early as adolescence. Exercise can be painful for some people with HS, resulting in unnecessary weight gain and aggravating symptoms. Here’s what we know about the HS-obesity link.
Obesity is a significant risk factor, but it is not the only one.
Excess weight is a key risk factor for HS, however it does not cause the disease and is not the only one. In reality, some HS patients are thin. This illness is most typically diagnosed in women between the ages of 18 and 29. Cigarette smoking might also raise your chances of acquiring HS. Furthermore, for some people, having malfunctioning sweat glands can play a role as well.
Family History Should Be Considered As Well
While being overweight is frequently related with acne inversa (also known as HS), acquiring this condition may have as much to do with your family’s genetic background, according to Dr Adil. According to research, a mutation in the gene responsible for the division of hair follicles and other skin cells may have a role in initiating symptoms. “There are several common genes, and each one adds a little increased risk” for HS, he says, adding that obesity, which commonly precedes HS by 5 to 10 years, raises the risk even more.
Being overweight might aggravate flares.
Having a BMI of 30 or more is still cause for caution when it comes to HS. According to 2020 research published in SKIN persons with this problem are 17 times more likely to be fat than the general population. Obesity can also make it more difficult to regulate the disease, according to Dr Adil. “A higher BMI contributes to hormonal imbalances as well as increased skin friction, exacerbating the disease,” he notes.
Friction is increased when the number of skin folds increases.
Obesity and HS are frequently related due to more skin folds caused by increased weight, which are commonly observed in the upper body. Clogged sweat glands can result in the formation of painful nodules, boil-like lumps, blackheads, and cysts, as well as the formation of channels beneath the skin in the armpits and groin, under the breasts, and on the buttocks and inner thighs in later stages. Abscesses can eventually rupture and emit an unpleasant odor. To make matters worse, this can result in lifelong scarring.
The Bacterial Balance of the Skin Could Be Off
Then there are the heated, damp spaces between folds that serve as a breeding ground for bacteria, either causing an HS outbreak or worsening the chronic skin condition. “In the armpit and groin, we have a very intricate balance between [good] bacteria and foreign pathogens,” adds Dr Adil. “Beneficial bacteria help to keep bad bacteria at bay, but when we have a humid environment with inflammation and friction, it creates an imbalance that encourages bacterial growth.” Antibiotics that kill bacteria are frequently used to treat HS. Losing weight reduces extra skin, giving germs less sites to colonize.
Extra weight promotes inflammation.
Inflammation appears to have a role in HS, as it does in other skin illnesses such as psoriasis and eczema, where persistent inflammation drives the immune system to induce skin alterations at the cellular level. Obesity causes chronic low-grade inflammation, which can exacerbate HS symptoms, he claims, citing 2019 research that links higher inflammation to worse disease outcomes. “We tend to think that this chronic overweight condition is associated with low-grade systemic inflammation, which leads to inflammatory changes in the skin and promotes these abscesses,” he continues.
Flares may be reduced if you lose weight.
A 2020 study found that overweight children who dropped weight before puberty had a lower probability of developing HS later in life. Losing at least 15% of one’s body weight is connected with significant reductions in HS symptoms in adults. While the lesions make exercise uncomfortable, losing weight can have a substantial favorable impact on the condition. “HS is a disease in which consistency of exercise is more important than speed,” explains Dr Adil. “Start small and gradually increase your exercise capacity to develop a routine you can stick to.”
Working Out With HS Can Be Difficult
It may be tempting to forego a workout to minimize skin-fold friction and sweat-clogged pores, but doing so may result in further weight gain and severe symptoms. Wear form-fitting training clothes made of moisture-wicking fibers instead to keep your skin from rubbing together and troublesome sweat at bay. According to Dr Adil, a simple clothing alteration like this may make exercise more pleasant, if not possible.
Begin slowly, consider swimming.
Set minor objectives. To begin, try losing just 5% of your body weight and see how you feel. Allow your body to heal if you’re in a flare and even brisk walking is difficult. Put the trainers back on and try again when the agony subsides. Swim some laps instead. “Water workouts are very good,” Dr Adil says, because water lubricates the skin and reduces friction. If you require additional assistance, weight loss applications such as Noom or Weight Watchers can assist you. You may notice an improvement in your HS symptoms as you lose weight—and feel better than ever in your own skin.
Other forms of self-care are also important.
Losing weight should not be your exclusive goal. Your doctor may also advise you to take drugs to relieve symptoms and, in some cases, have surgery to remove inflamed nodules, lesions, or damaged tissue. Dr Adil emphasizes the importance of diet. HS flares can be reduced by avoiding or reducing dairy, sugar, simple carbs, nightshade plants like tomato and aubergine, as well as bread, fermented cheese, black tea and beer. Trying a Paleo or autoinflammatory diet may also be beneficial. “Whether the diet is truly anti-inflammatory or just results in weight loss, either way, it could be beneficial,” he adds.
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According to Ayurveda, hidradenitis suppurativa is a cause of Kapha and Pitta dosha. When the digestive fire (Agni), or Pitta, is out of balance, the Kapha Dosha becomes vitiated, which slows down metabolism. Due to the disruption of fat molecules, they start to build up in muscles and impede bodily passageways, causing painful, swollen sores in the groin, buttocks, thighs, and armpits.
In Ayurveda, hidradenitis suppurativa Treatment is to restore the body’s natural equilibrium by detoxifying it with potent herbal therapies.
The treatment for Hidradenitis Suppurativa at Elite Ayurveda comprises balancing the Kapha and Pitta doshas, as well as providing harmony to the metabolism. The treatment comprises body detoxification, internal drugs to balance doshas, and external applications to heal scars.
The treatment involves combinations of herbs created based on individual Prakruti and Vikruti analysis. Visit our website to know more
Connect with us to get our patient testimonials and also to speak with our patients directly about their experience in getting their disease treated by us and by Ayurveda as a whole.
Medically reviewed by Dr Adil Moulanchikkal, Lead Ayurveda Specialist at EliteAyurveda Clinics. With over 15 years of experience in treating Neurological, Skin & Autoimmune Diseases.