Loose clothing made with breathable and absorbent fabrics can help reduce skin irritation that contributes to hidradenitis suppurativa flares.
Hidradenitis suppurativa (HS), or acne inversa, is a chronic inflammatory skin condition. It features deep, painful lumps under the skin that can develop into pockets of infection (abscesses).
If left untreated, these abscesses can break open, drain, leave behind scars, or cause deep tunnels within the skin called sinus tracts.
If you’ve been diagnosed with HS, you might not have active lesions all the time. HS can go through periods of active symptoms and periods where symptoms aren’t present. Times of active or worsening symptoms are called “flares,” and they can be caused by triggers that worsen and irritate your skin.
Skin care, medications, and clinical procedures are all used to manage HS, but self-care can help you get the best outcomes from your treatment.
Clothing selection is a part of HS self-care. By selecting HS-friendly fabrics and styles, you can reduce clothing issues that can cause HS to flare, like pressure, rubbing, sweat retention, and the buildup of bacteria and other microbes.
HS can affect everyone differently. Your dermatologist can help you create a self-care plan — including clothing options — that makes sense for your lifestyle and the severity of your HS diagnosis.
General recommendations focus on clothing that reduces the chance of skin irritation throughout the day.
Tightness
Loose clothing promotes airflow, keeping you cool and dry, and limits the chance for skin friction, heat buildup, and moisture retention. A dermatologist-perspective research paper from 2023 recommends swapping classic form-fitting garments like underwear briefs for looser options like boxers.
Other loose-fitting options include:
- relaxed-fit shirts
- pants with wide legs
- bottoms with loose elastic or adjustable, stretchy waistbands
- “flowy” dresses, skirts, and blouses
- stretchy bras without unwires
- camisoles with built-in wireless bra support
You can always opt to buy a size or two above your usual selection if you want to play it safe.
Fabric type
Breathable, absorbent, soft fabrics are less likely to trap moisture, sweat, and heat against your skin or cause irritation from rubbing over time. Moisture and heat can promote the growth of bacteria and other microbes, and rough textures can be abrasive as the day goes on.
Experts recommend people living with HS select clothing made from:
- cellulose-derived fabrics (like Modal or Tencel)
- bamboo fibers
- moisture-wicking cloth
- cotton
- silk
- linen
Not all fabric choices are right for everyone living with HS. Polyester, for example, is a synthetic fabric that is great for wicking moisture. But it can be irritating for some people living with HS because it can trap heat and promote bacterial growth.
Style
In addition to fit and fabric, style can affect HS, too. Tags, buttons, seams, and other irregular textures on clothing can become points of irritation on your skin over time.
Seamless clothes, those without dyes, and items with printed-on labels, rather than loose tags, may be less irritating.
Other style choices to consider include:
- loafers or low-cut slip-on shoes
- shirts with wide armpit holes
- scooped or V-neck tops
- dresses without cinched waists
- billowy tops and pants (wide sleeves and legs)
- shirts with wide shoulder straps to distribute pressure
- boxer-style or seamless undergarments
- items made with only one fabric
If you’re looking to go with a layered outfit (of if you need layers to stay warm), layers should still follow the “loose, breathable, absorbent, soft” recommendations, especially for the layers next to your skin.
Skin irritation can trigger HS flares, and clothing can be a source of irritation through pressure, friction, heat, moisture, and microbial growth.
Tightness
Tight clothes that press against your skin and rub, restrict movement, trap heat, or create areas of pressure can worsen symptoms of HS
Clothes that may be too tight to wear in HS include:
- underwear briefs
- compression garments like shapewear or athletic supports
- body suits
- underwire bras
- compression-style sports bras
- leggings
- form-fitting jeans
- clothing with tight cuffs or narrow arm holes/sleeves
- bodycon dresses
- pants, dresses, or skirts with tight, unadjustable waistbands
- footwear with narrow ankle/leg openings
Fabric type
Fabrics that have a rough texture and aren’t breathable can cause irritation even if they’re loose. Rough clothing can be scratchy against sensitive skin, and when air can’t circulate through your clothing and against your skin, it can promote moisture and heat buildup.
Fabrics you may want to avoid with HS include:
- leather
- vinyl
- wool
- denim
- polyester
- nylon
- lace
Some fabrics are treated with chemical dyes and preservatives that can be irritating.
According to a 2024 review, chemical exposure is one of the top triggers for HS. You can help reduce your exposure to irritating chemicals in clothing by looking for products that use natural fibers, like cotton, or those that carry a certification like the Global Organic Textile Standard (GOTS).
Style
Clothing comes in all shapes and sizes, but some style choices may irritate your skin. Clothing with thin straps, for example, can focus pressure on one area. Or, certain cuts of undergarments might rub along areas prone to HS, like the
Clothing styles to consider avoiding with HS include:
- turtle necks
- shirts with small armpit holes, like tunic tank tops
- halter tops or spaghetti strap tank tops
- bras with thin straps or lace
- thongs
- underwear briefs
- clothing with thick seams
- footwear with tight straps
- tall boots made from unbreathable material
- fuzzy, frilly, or ruffled outfits
Clothing selection is an important part of HS self-care. The right clothes can be comfortable to wear while also reducing the chance of pressure, friction, heat, and other HS triggers.
While HS affects everyone uniquely, general recommendations are to focus on loose clothes made from breathable, absorbent, soft fabrics.