It’s gone midnight on a Sunday in October. Both armpits, my belly button, my groin, my perineum and my tailbone are all flaring at once. I’ve got a laptop on a cushion, a fresh dressing that won’t last till morning, and a data protection policy open in another tab. Joyous.
I’m Gaz. I’ve had HS for close to 20 years, I’m Stage 3, and I’ve been on a biologic injection since the beginning of 2025, adalimumab to be specific, sometimes called Humira (brand name). Since the beginning of this year I’ve been full-time and unpaid on the CIC. And for the last three months my skin has been the worst it’s been in a long while.
I want to talk about whether those two things are connected.
Does stress trigger HS?
First, the honest bit. Nobody knows exactly what causes HS. The NHS page on hidradenitis suppurativa says the exact cause is unknown. Stress doesn’t give you HS. I’ll say that twice, because it matters: stress doesn’t give you HS.
What it might do is poke the bear. Loads of us say our flares follow the stressful stretches, and the British Association of Dermatologists’ patient information on HS includes “try to reduce anxiety and stress levels” in its list of self-care measures that may help. If you’re newer to all this, What is HS? covers the basics.
What the last six months have done to my skin
Here’s what my diary looks like since Living Life With HS became a Community Interest Company on 24 March.
A board. Volunteers. Quarterly board meetings. Professional subscriptions that cost a bomb. A full rebuild of the website, with a shop, Your Stories, weekly blog and a monthly newsletter. Building our own community app from scratch, so our community has a proper, safe home instead of WhatsApp groups. Privacy, data protection and safeguarding policies, written line by line with our volunteer data protection officer, because if people trust us with their health, their data gets handled properly. Three grant bids sent in August and September, and now the wait. A first year of accounts to pay for that nobody budgeted for, roughly £700. Advocacy work too: a patient group with dermatologists, a research project, sitting in a room as a patient voice, meeting a local charity.
And the skin? Twelve rough weeks of being properly ill. It ended with an abscess in my belly button. That’s not a sentence I ever expected to type on a public website, but there it is. Well, I say it ended, but you know this won’t be the end of the war, maybe just the end of this battle, or maybe not.
Can stress make HS flares worse?
I can’t prove anything. I’m one bloke with one body, not a study.
But I know what it feels like from the inside. The busiest stretches of this year have lined up with the worst stretches for my skin. The late nights and early hours at the laptop, flaring, are the ones I pay for afterwards. Every new abscess feels like kicking the can a bit further down the road, and somewhere down that road is my biggest fear: surgery. That’s a fear, not a forecast. I am in the lap of the HS gods as we speak and it’s not a very comfy place to be, I’ll tell you that for free!
Winter’s always been my worst season. This year I’m walking into it already running on empty. The signs don’t look good for me this Christmas time.
Why keep going, then?
Because twenty years ago I’d have given anything for a place like this.
When I was first diagnosed there was no group, no blog, nobody who sounded like me. Men especially go quiet with HS. I wrote about that in the HS gender gap. Me writing this, flaring, at midnight, is part of the job. Somebody has to say it out loud. If a bloke with twenty years of this won’t, why would anyone newly diagnosed?
If those grant bids come in, there’ll be HS coffee mornings to run this winter. I’m already dreading delivering them through the winter, and I already know what my skin will think of it.
So is that a fair trade? I don’t know. I just know the support needs building, and it’s getting built irrespective of my health concerns.
How do you balance pushing forward with looking after yourself?
I haven’t cracked it. I’m not even close. But here’s what I’m going to try this winter.
Slow down a bit. Not stop, slow. Say “next week” more often. Lean on the team and the volunteers, because that’s why we’ve got them. And keep talking about it, here, in the fantastic community we’ve built on our app and with my own GP and dermatology team, rather than gritting my teeth through another twelve weeks.
If your flares are getting worse, or more frequent, please speak to your GP or dermatology team. This post is my experience, not medical advice. If you want help getting the most out of that appointment, I wrote up how to get a good GP appointment for HS.
Quick answers
Does stress cause HS?
No. The exact cause of HS is unknown. Many people with HS say stress can set off or worsen a flare, but that’s a possible trigger, not a cause.
Can stress make an HS flare worse?
It can for some people. Many of us notice flares following stressful periods, and the British Association of Dermatologists lists reducing anxiety and stress among self-care measures that may help. Everyone’s triggers are different.
What should I do if my HS flares keep getting worse?
Speak to your GP or dermatology team. Keeping a note of when flares happen, and what was going on at the time, can help that conversation.
Is it normal to feel worn down by HS?
Yes, it’s common. Lots of people with HS say it takes a toll mentally as well as physically. You’re not on your own, and talking about it, to your GP or to people who get it, can help.
Over to you
Have you noticed stress setting off your flares? Work, money, family, a big push on something you care about? Let us know in the comments. I genuinely want to know if it’s just me.
If you’ve got a longer story, share it through Your Stories. If you want the blog and news in your inbox each month, join the mailing list.
And one more thing: we’re currently testing our own community app, hoped for in the new year. More on that when it’s ready.
Together we cut the HS silence.
Gaz