So I use ice for my really bad lesions all the time. Or cold water therapy. It isn't caused because you might have gotten lacks about your hygiene. But what will cause more lesions is shaving or plucking any hair. Because it's not the sweat gland it's the hair follicle that your immune system is attacking. If you can get one of those kind of electric razors , not the ones that pull , but they're just kind of cut the hair you're gonna be better off and won't get as many lesions

Anecdotally I have heard that smoking can make HS worse, especially if nightshades are a trigger for you (they aren't for everyone). Ice could help the pain, warm compresses might help the flares come to the surface and start draining which can also ease the pain.

Not sure if it’s been 2 or 3 yrs; sorry