It isn’t easy to quit smoking. But if you’re living with hidradenitis suppurativa (HS), smoking harms both your HS and your overall health. Smoking not only increases the risk of developing HS, it can also make the condition worse, leading to more painful nodules and abscesses.

“I quit smoking almost a year ago, and it’s helped with my healing process as a whole when I have flares,” a member of myHSteam shared.

Here’s more about how smoking cigarettes and vaping can affect people with HS, also known as acne inversa. If you’ve struggled to quit smoking, talk to your family doctor or dermatologist and ask for help. Your healthcare team can offer support and resources to help you stop smoking.

What’s the Relationship Between HS and Smoking?

The link between hidradenitis suppurativa and smoking has been well studied. People who smoke have almost double the risk of HS compared to those who have never smoked.

Tobacco smoke contains thousands of toxic chemicals, such as nicotine and hydrocarbons. These compounds are known to damage skin, cause early skin aging, slow wound healing, and increase the risk of skin infections. Skin diseases such as HS, psoriasis, and cutaneous lupus erythematosus can all worsen with cigarette smoking.

Smoking also causes blood vessels to narrow, which reduces the amount of oxygen that reaches the skin. It can slow the production of new skin cells and collagen, a protein that helps keep skin strong. In people with HS, smoking is believed to damage hair follicles, where HS first starts. Smoking can also disrupt how your immune system works. When the immune system becomes overactive, it can attack healthy cells and cause inflammation. Immune dysfunction is believed to be one of the main causes of HS. Other risk factors include a family history of HS, higher body weight, and other inflammatory conditions.

The ill effects of smoking have been found to be a triggering factor for people with HS. Smoking can also lead to greater disease severity. People who smoke may have HS in more areas of the body and may not respond as well to treatment.

There’s a high incidence of smoking among people with HS. Studies estimate that 40 percent to 89 percent of people with HS smoke tobacco. This high rate may be linked to depression, which is common in people living with chronic conditions such as HS. For some people, smoking is a way to cope with emotional and psychological stress. This may help explain the high prevalence of smoking among people with HS.

Stopping smoking also lowers the risk of HS. It may also help prevent the development of HS if a person who used to smoke does not start smoking again. Research shows that people who quit smoking were 33 percent less likely to develop HS than people who were currently smoking. The benefits of quitting were seen after about three years of not smoking.

Can Vaping Cause HS?

In recent years, vaping devices — also called electronic cigarettes or e-cigarettes — have grown in popularity as an alternative to smoking cigarettes. Some myHSteam members have asked if vaping is safer for people with HS than smoking cigarettes.

“Does anyone know if vaping triggers HS? I’ve quit smoking and using a vape but it doesn’t seem to be helping,” one team member asked.

Another member replied, “I smoked for eight years, and it’s about two years since I changed to vapes. Nothing changes.”

Research on vaping and HS is still limited. However, studies show that vaping is damaging to lung health, heart health, and brain and nervous system health.

Like cigarettes, vaping releases chemicals such as nicotine and other harmful substances. These substances can damage cells throughout the body. All tobacco products, including vaping devices, are considered unsafe and are linked to increased HS severity.

Vaping has also been found to have harmful effects on the skin. Some studies have linked it to the development of prediabetes. People living with HS already have a higher risk of other health conditions (comorbidities), such as diabetes and cardiovascular disease, because of chronic inflammation. Vaping may further increase those risks.

How Does Smoking Affect HS Treatment and Remission?

There is no cure for HS. Treatment focuses on reducing symptoms and, when possible, helping people achieve longer periods of remission, when symptoms improve or go away for a while. Smoking has been shown to lower remission rates in people with HS.

First-line treatments — such as oral and topical antibiotics, corticosteroids, and antibacterial lotions and washes — have been found to be less effective in people with HS who smoke. The pro-inflammatory effects of smoking can lead to a poorer response to treatment.

Will Stopping Smoking Improve HS?

Smoking cessation (quitting smoking) has been shown to improve symptoms in many people with HS, according to a systematic review published in the Journal of Integrative Dermatology.

Stopping smoking has many other benefits. These include better quality of life, lower risk of cancer and other life-threatening diseases, and a longer life expectancy.

Many myHSteam members have discussed the benefits of quitting smoking. “I haven’t had such a long period without a flare in years. If I’m in remission, I feel I could mainly attribute it to stopping smoking,” one member said.

Another member shared, “Feeling a lot better about the summer this year than the last three years. Stopped smoking and lost a few pounds.”

Even if some people don’t see improvement in HS symptoms after they quit smoking, they might still see other benefits. “I feel better for stopping smoking one year later, but it has not helped my HS in the least,” wrote one myHSteam member. Another said, “I quit two years and four months ago. Unfortunately, my HS didn’t improve, and I have had some of the worst flares of my life since quitting. I’m still happy I quit, though, if just for the cost savings. I save around $5,000 a year.”

Secondhand Smoke Can Be Harmful, Too

Avoiding secondhand smoke — which is also unhealthy — is another challenge if family members and friends smoke cigarettes. “My friend came to visit, and against my protest and begging him not to, he insisted on smoking in my vehicle,” shared a myHSteam member. “That’s one of my worst triggers. Now I’m broken out everywhere.”

If you’re living with HS, it may help to talk to your family and friends about the importance of a smoke-free environment.

Ask for Support To Stop Smoking

If you’re living with HS and currently smoke, talk to your healthcare team about resources that may be available to you. There are medications and support services that can help you stop smoking. Quitting can be difficult, but it’s an important step for improving your health and well-being. Be sure to ask for help if you need it.

Many people struggle with their smoking habits. “I do smoke, which I heard can make HS worse — definitely on the road to quitting. It’s just been difficult with all this stress lately,” a myHSteam member wrote.

Members often encourage one another to make healthy lifestyle choices and to quit smoking. “Please don’t get discouraged! Smoking is not good for you — not just your HS, but for you,” one member told another. “If you can beat that battle with smoking, you can definitely fight HS back. We’re here for you.”

Another myHSteam member shared their words of encouragement about quitting smoking: “I know that I can control this. It won’t control me anymore!”

Join the Conversation

On myHSteam, people share their experiences with hidradenitis suppurativa, get advice, and find support from others who understand.

Has quitting smoking or vaping improved your HS symptoms? Let others know in the comments below.