Living with hidradenitis suppurativa (HS), also known as acne inversa, may be something you’ve kept to yourself. But confiding in a good friend or two—even if slightly embarrassing—is one of the best and kindest things you can do for yourself. A true friend will support you with understanding and compassion, and may even have suggestions for how to cope. Defining HS HS is a chronic skin condition that develops when the apocrine (sweat) glands become blocked and inflamed. It starts as pimple-like bumps and can lead to boils under the skin that may leak and be difficult to heal. It usually forms under the arms and in the groin/inner thigh area, and is more common in people who have acne and in women, who can also develop it under the breasts. It can be hard for some people to talk about, even with close friends, but there are some ways to make the initial conversation a bit easier. Talking Tips Write it down. Sometimes it helps to prepare what you’re going to say ahead of time. Write down what you want to discuss, and rehearse it first to help you remember all the key points. Send a note. If it’s too hard to broach the subject in person, consider sending your friend an email or text to initiate the conversation. Keep it simple. Find a good time and a comfortable place to talk—someplace quiet where you both feel relaxed. Keep the initial explanation short and to the point. You don’t have to delve into detail about your physical symptoms. If your friend wants to know more and you feel like sharing, it may feel good to divulge the specifics. But if you feel a brief explanation is plenty, leave it there. You can always revisit the topic at another appropriate time. Dispel the myths. Sometimes people react negatively to things before they have all the information. Helping your friend understand what HS is—and what it is not—can help lay the groundwork for a healthy and empathetic conversation. For example, you can explain that HS has nothing to do with poor hygiene and that it’s not contagious. If your friend is interested in learning more, you can always recommend online sources of information about acne inversa. Explain how the condition affects you. Try to be as honest as you can when explaining how living with HS makes you feel. For example, it may make you feel self-conscious, tired, angry or depressed. Sharing these feelings with a trusted friend can be a huge relief. Ask for their support. Friends are often a great source of support in times of struggle, and when you have HS, there are certain lifestyle changes you may want to make to improve your condition and quality of life. Ask your friend to support you in these. For example, smoking can exacerbate HS, so request that your friend not smoke around you. Getting plenty of rest and limiting alcohol is also important to reduce stress, another trigger of HS. Your friends can help by reducing the temptation to party or stay out late. Reassure them that when you are not having a flare-up, there will be time for hanging out and having fun. Get help with goals. Excess weight can also cause HS flare-ups or make them worse, so it’s important to get plenty of exercise and eat a well-balanced diet to maintain your weight. This might be easier with a good friend by your side so you can set goals together and stay motivated to keep them. Opening up about HS can be a challenge, so you are by no means alone. But choosing friends who you can be honest with can make all the difference. Find one or two pals who offer positive feedback and great support, and you will find yourself living easier with HS.