What's Happening?
Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that often becomes more challenging to manage in midlife. Dr. Nicole M. Golbari from NYU Grossman Long Island School of Medicine explains that while the disease itself may not change
significantly, the context of midlife—characterized by hormonal shifts, increased responsibilities, and stress—can make symptoms feel more disruptive. Midlife brings hormonal fluctuations, particularly during perimenopause, and metabolic changes like increased insulin resistance, which can amplify HS activity. Stress, both emotional and physiological, further exacerbates the condition, making flares more frequent and harder to manage.
Why It's Important?
The increased difficulty in managing HS during midlife highlights the need for comprehensive and individualized care. As patients juggle careers, family responsibilities, and personal health, the impact of HS can be more profound, affecting work, relationships, and overall quality of life. Understanding the biological and lifestyle factors that contribute to HS flares in midlife can lead to better management strategies and improved patient outcomes. This underscores the importance of not normalizing worsening symptoms as an inevitable part of aging and instead advocating for proactive and tailored treatment plans.
What's Next?
Healthcare providers are encouraged to refine treatment approaches for midlife patients with HS, focusing on long-term disease control and comprehensive care that considers hormonal, metabolic, and inflammatory factors. Patients should be empowered to seek care that addresses the full impact of HS, beyond its appearance on the skin. This may involve earlier use of systemic or biologic therapies and addressing lifestyle factors that contribute to disease severity. The goal is to prevent the normalization of symptoms and ensure that patients receive care that reflects the true impact of the disease.
