It's so much easier said than done, but I would just be fully honest with them about it. This is a disease that isn't your fault and you can't control it. The right person will understand and care.
There's a quote from the 1940s that's like, "Be who you are and say what you feel, because those who mind don't matter, and those who matter don't mind."
Those that matter will understand about your HS and the people that don't understand don't matter!
I'm so sorry you have to go through HS and I hope you're feeling okay!