Hidradenitis Suppurativa is a skin condition that affects more than just the skin. It affects our mental health too! Mental health is a key part of Hidradenitis Suppurativa treatment. Our mental health affects our physical health and our physical health affects our mental health.
HS is a serious disease that affects quality of life. Anyone who’s had to fill out a quality of life assessment at their dermatologist knows this. I have taken several quality of life assessments from my dermatologists but none have referred me to a mental health specialist or offered me further support. Which is so frustrating to me – mental health is a significant part of treating HS. Let’s prioritize it!

HS can affect mental health in the following ways:
Depression – a significant percentage of people with HS also suffer from depression, with reported prevalence reaching 43% of HS patients. Studies suggest that depression is more common in patients with HS than with other dermatological conditions.
Anxiety – Anxiety is also higher in patients with HS than with other dermatological conditions. People with HS may experience anxiety due to the life-changing effects of HS. People with HS can worry about financial distress, they can feel anxious about sharing their needs, and/or feel anxious about the unpredictable nature of HS.
Helplessness – The unpredictable nature of HS can make people feel helpless as well. We have no control over what happens to our bodies. This means we feel like we have no control over external things as well – like socializing. No control can make people feel very helpless.
Stress- The burden of HS is extremely stressful. This stress is ironically a trigger to make HS worse. Financial worries, social isolation, remembering medication, and the burden of managing HS disease are all stressful.
Low Self-Esteem- HS is not a pretty disease. The abscesses and scars are unappealing. They discharge pus and blood, which is fairly gross. The pain and discomfort of HS can make mobility difficult. All of this and more can lead to low self-esteem and low confidence in people with HS.
Social Isolation – In response to the stigma and negative attitudes of people viewing HS (or any chronic illness/disability, really), people with HS often choose to socially isolate. This can feel like a safer choice but be detrimental to our mental health. Everyone needs a social support system.
Hopelessness- As there is no cure for HS, many who suffer from it end up feeling hopeless. The limited options for treatment compounds this feeling.
Guilt- People with HS have unique demands on their time and demands on their friends and family. This can make us feel very guilty.
Shame – The stigma of HS can lead to shame in many people. HS can make you feel unworthy, dirty, and unreliable.
Grief – Grief is a common symptom for people with chronic illness – we mourn the life we lost and/or could have had. Any new or worsening symptoms can renew grief and the cycle of mourning.
Anger- Who else rages about HS? I do ALL THE TIME. I feel angry that this is my fortune in life. I feel angry that I feel so helpless. I feel angry that I have to worry about it all the time. I feel angry at my doctors and insurance and medical appointments. Anger is an okay feeling as long as we deal with it in healthy ways.
If you are having any of these symptoms and you feel like you are not coping with them in a healthy way, please reach out, You can reach out to your doctor, to your friends and family, to a mental health professional, and/or to an HS support group.
** If you are having thoughts of self-harm, please seek help immediately. The U.S. National Suicide Hotline is available 24/7 at 1-800-273-8255 or you can text the crisis line at 741741 (in the US).**