Abstract
Background
Hidradenitis suppurativa (HS) is a chronic, inflammatory skin condition that substantially reduces patient quality of life. Many HS patients ask their dermatologist about potential lifestyle modifications, such as following particular diets or avoiding specific products, in an attempt to alleviate their symptoms. However, insufficient research has been conducted to support well-informed lifestyle modification counseling, and patients frequently defer to anecdotal endorsements of various interventions found on social media support groups. Therefore, we sought to clarify what lifestyle modifications were capable of improving HS symptoms.
Methods
We conducted a survey-based study to examine modifiable risk factors and their association with the severity of HS. Five hundred and ninety-one patients with HS participated in an online survey detailing the severity of their HS symptoms before and after various lifestyle interventions. Average improvements in both subjective and objective ratings of symptom severity were calculated and statistical differences between the levels of improvement seen among various categories of lifestyle interventions were determined.
Results
Numerous lifestyle interventions including substantial weight loss, smoking cessation, use of gentle skin and depilatory products, and menstrual regulation were associated with both subjective and objective improvements in symptom severity.
Conclusions
Our results suggest that patients affected by HS may experience clinically significant improvement from a variety of lifestyle modifications.
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References
Cosmatos I, Matcho A, Weinstein R, Montgomery MO, Stang P (2013) Analysis of patient claims data to determine the prevalence of hidradenitis suppurativa in the United States. J Am Acad Dermatol 68(3):412–419
Ofenloch RF (2017) Health-related quality of life in hidradenitis suppurativa. Br J Dermatol 176(4):861–862
Danby FW (2015) Diet in the prevention of hidradenitis suppurativa (acne inversa). J Am Acad Dermatol 73(5 Suppl 1):S52-54
Ingram JR, Collier F, Brown D, Burton T, Burton J, Chin MF et al (2019) British Association of Dermatologists guidelines for the management of hidradenitis suppurativa (acne inversa) 2018. Br J Dermatol 180(5):1009–1017
Eiken HC, Holm JG, Thomsen SF (2020) Studies on the role of diet in the management of hidradenitis suppurativa are needed. J Am Acad Dermatol 82(4):e137–e138
Dempsey A, Butt M, Kirby JS (2020) Prevalence and Impact of Dietary Avoidance among Individuals with hidradenitis suppurativa. DRM 236(4):289–295
von der Werth JM, Williams HC (2000) The natural history of hidradenitis suppurativa. J Eur Acad Dermatol Venereol 14(5):389–392
Alikhan A, Lynch PJ, Eisen DB (2009) Hidradenitis suppurativa: a comprehensive review. J Am Acad Dermatol. 60(4):539–561
Revuz JE, Canoui-Poitrine F, Wolkenstein P, Viallette C, Gabison G, Pouget F et al (2008) Prevalence and factors associated with hidradenitis suppurativa: results from two case-control studies. J Am Acad Dermatol 59(4):596–601
Sartorius K, Emtestam L, Jemec GBE, Lapins J (2009) Objective scoring of hidradenitis suppurativa reflecting the role of tobacco smoking and obesity. Br J Dermatol 161(4):831–839
Joseph MA, Jayaseelan E, Ganapathi B, Stephen J (2005) Hidradenitis suppurativa treated with finasteride. J Dermatolog Treat 16(2):75–78
Vazquez BG, Alikhan A, Weaver AL, Wetter DA, Davis MD (2013) Incidence of hidradenitis suppurativa and associated factors: a population-based study of Olmsted County. Minnesota J Invest Dermatol 133(1):97–103
Canoui-Poitrine F, Revuz JE, Wolkenstein P, Viallette C, Gabison G, Pouget F et al (2009) Clinical characteristics of a series of 302 French patients with hidradenitis suppurativa, with an analysis of factors associated with disease severity. J Am Acad Dermatol 61(1):51–57
Crowley J, Mekkes J, Zouboulis C, Scheinfeld N, Kimball A, Sundaram M et al (2014) Association of hidradenitis suppurativa disease severity with increased risk for systemic comorbidities. Br J Dermatol 171(6):1561–1565
Schrader AMR, Deckers IE, van der Zee HH, Boer J, Prens EP (2014) Hidradenitis suppurativa: a retrospective study of 846 Dutch patients to identify factors associated with disease severity. J Am Acad Dermatol 71(3):460–467
Shalom G, Freud T, Harman-Boehm I, Polishchuk I, Cohen AD (2015) Hidradenitis suppurativa and metabolic syndrome: a comparative cross-sectional study of 3207 patients. Br J Dermatol 173(2):464–470
Bettoli V, Naldi L, Cazzaniga S, Zauli S, Atzori L, Borghi A et al (2016) Overweight, diabetes and disease duration influence clinical severity in hidradenitis suppurativa-acne inversa: evidence from the national Italian registry. Br J Dermatol 174(1):195–197
Egeberg A, Gislason GH, Hansen PR (2016) Risk of major adverse cardiovascular events and all-cause mortality in patients with hidradenitis suppurativa. JAMA Dermatol 152(4):429–434
Vossen ARJV, van Straalen KR, Prens EP, van der Zee HH (2017) Menses and pregnancy affect symptoms in hidradenitis suppurativa: a cross-sectional study. J Am Acad Dermatol 76(1):155–156
Barth JH, Layton AM, Cunliffe WJ (1996) Endocrine factors in pre- and postmenopausal women with hidradenitis suppurativa. Br J Dermatol 134(6):1057–1059
r/Hidradenitis (2020). reddit. https://www.reddit.com/r/Hidradenitis/. Accessed 7 Aug 2020
HSSA - Hidradenitis Suppurativa Symptom Assessment (2020). https://eprovide.mapi-trust.org/instruments/hidradenitis-suppurativa-symptom-assessment. Accessed 29 Apr 2020
Senthilnathan A, Kolli SS, Cardwell LA, Richardson I, Feldman SR, Pichardo RO (2019) Validation of a hidradenitis suppurativa self-assessment tool. J Cutan Med Surg 23(4):388–390
Cole DW, Fotouhi A, Fakhoury J, Daveluy S (2019) An internet-based survey study of hidradenitis suppurativa patients: use of the internet for disease-related information. J Am Acad Dermatol. https://doi.org/10.1016/j.jaad.2019.12.024
Tavora IG, Bissoli GC, Miot HA, Schmitt JV (2019) Clinical manifestations and quality of life in hidradenitis suppurativa patients: survey of participants from an internet support group. An Bras Dermatol 94(3):298–303
Paleo diet: Eat like a cave man and lose weight? (2020). Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/paleo-diet/art-20111182. Acccessed 31 Jul 2020
Anti-Inflammatory Diet: Road to Good Health? (2020). WebMD. https://www.webmd.com/diet/anti-inflammatory-diet-road-to-good-health. Accessed 31 Jul 2020
Macklis P, Adams KM, Li D, Krispinsky A, Bechtel M, Trinidad J, et al. (2019) The impacts of oral health symptoms, hygiene, and diet on the development and severity of psoriasis. Dermatol Online J. 25(7):1–5
Prens E, Deckers I (2015) Pathophysiology of hidradenitis suppurativa: an update. J Am Acad Dermatol 73(5):S8-11
David Boothe W, Tarbox JA, Tarbox MB (2017) Atopic dermatitis: pathophysiology. Adv Exp Med Biol 1027:21–37
American College of Physicians (2003) Relationship between cigarette smoking and novel risk factors for cardiovascular disease in the United States. Ann Intern Med 138(11):891
Hidradenitis suppurativa: Management-UpToDate (2020). https://www.uptodate.com/contents/hidradenitis-suppurativa-management?search=hidradenitis%20suppurativa&source=search_result&selectedTitle=1~66&usage_type=default&display_rank=1. Accessed 2020 1 Aug
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Macklis, P.C., Tyler, K., Kaffenberger, J. et al. Lifestyle modifications associated with symptom improvement in hidradenitis suppurativa patients. Arch Dermatol Res 314, 293–300 (2022). https://doi.org/10.1007/s00403-021-02233-y
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DOI: https://doi.org/10.1007/s00403-021-02233-y