Appendix C
Fabric, Sweat & Friction Guide
Friction and heat are two of the most consistent external HS triggers. Managing these is not optional — it is part of remission maintenance.
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While friction and heat do not cause HS, they reliably worsen active lesions and can initiate new flares in susceptible areas. Most patients see a measurable reduction in flare frequency within two to four weeks of consistent application.
Recommended Fabrics
Wear These
- Soft cotton — primary choice for daily wear
- Bamboo cotton — breathable and gentle on skin
- Linen — especially in warm weather
- Moisture-wicking athletic wear during exercise only
- Loose, non-binding fits in affected areas
- Seamless underwear in groin and underarm areas
Fabrics to Avoid
Avoid These
- Nylon — traps heat and moisture
- Polyester — increases friction and sweating
- Tight elastic bands around affected areas
- Rough seams near groin, underarm, or breast fold
- Dark colours during active flares — retain more heat
- Spandex blends in areas prone to lesions
Sweat Management
Daily Practice
- Shower promptly after heavy sweating
- Keep affected areas dry using soft cloth pads
- Use anti-friction powders sparingly — only on dry skin
- Avoid antiperspirant deodorants during open lesions
- Change clothing if significantly damp
- Pat dry gently — never rub affected areas with towel
Situation-Specific Guidance
During Active Flares
- →Wear the loosest cotton possible in affected areas
- →Avoid any tight waistbands, bra underwires, or tight thigh bands
- →Change clothing at least twice daily if sweating
- →Use gentle, unscented cleansing — no harsh soaps on active lesions
- →Cool (not cold) water for washing — hot water increases inflammation
During Exercise
- ✓Moisture-wicking fabrics only — change immediately after
- ✓Avoid exercises that cause direct friction on affected areas
- ✓Swimming pools: rinse immediately after; chlorine can irritate
- ✓Light walking and yoga preferred during active flares
- ✓Exercise in cooler parts of the day — early morning or evening
At Work or in Hot Environments
- →Carry a clean cotton change of clothes if working outdoors or in warm spaces
- →Use a small fan if desk-based — keep the groin and underarm areas cooler
- →Avoid prolonged sitting on non-breathable surfaces during gluteal or groin flares
Sleep & Nighttime
- ✓Soft cotton or bamboo sleepwear — loose fit, no elastic near lesion areas
- ✓Cotton or bamboo bed sheets — changed frequently during active flares
- ✓Sleep position: avoid direct pressure on active lesion areas where possible
- ✓Keep the bedroom cool — excess heat disrupts the body's healing processes
External Management Is One Layer
Friction and heat management reduces external triggers — but HS is driven from within. A personalised evaluation maps your internal drivers and determines the appropriate correction sequence.