Hidradenitis Suppurativa (HS) is a chronic inflammatory skin condition that causes painful, deep-seated lumps, abscesses, and tunnels to form beneath the skin. These lesions primarily appear in areas where skin rubs together, such as the armpits, groin, and under the breasts. HS results from a blockage and rupture of hair follicles, leading to inflammation and often secondary infection. While home treatments cannot cure HS, they are important for managing symptoms, reducing discomfort, and preventing further progression alongside medical treatment. Self-care focuses on topical relief during flare-ups, daily hygiene, minimizing physical irritants, and adopting broader systemic changes.
Managing Acute Flare-Ups
When a new lesion or flare-up begins to form or becomes painful, immediate topical measures can provide localized relief. Applying a warm compress is a common home technique, as the heat helps reduce pain and encourages the lesion to drain hygienically. Use a clean washcloth soaked in warm water or a dry heating pad several times daily for about ten minutes.
Conversely, a cool compress or an ice pack wrapped in a cloth can temporarily reduce acute pain and swelling in the affected area. The choice between warm and cool depends on which provides greater comfort for the individual lesion. For systemic discomfort, over-the-counter pain relievers such as ibuprofen or acetaminophen help manage the aches associated with an active flare-up. Crucially, avoid attempting to lance or squeeze the lesions, as this significantly increases the risk of infection, worsening inflammation, and promoting scar formation.
Daily Cleansing and Wound Care
A consistent, gentle hygiene routine is central to managing HS and preventing secondary bacterial infections. Affected skin areas should be cleansed daily using mild, non-irritating, non-soap cleansers that will not strip the skin’s natural barrier. Dermatologists often recommend using over-the-counter antiseptic washes, such as those containing chlorhexidine or benzoyl peroxide, in the affected areas. These ingredients help reduce the bacterial load on the skin surface, which can exacerbate HS lesions.
After cleansing, the skin must be dried completely by gently patting the area with a clean, soft towel rather than rubbing, which causes irritation and friction. For draining lesions, using non-adhesive dressings is necessary to protect the area and absorb discharge without causing trauma upon removal. Hydrocolloid or foam dressings are often preferred because they maintain a moist wound environment, promoting healing without sticking to the open wound surface. Proper wound care includes changing these dressings daily or whenever they become saturated to keep the area clean and minimize secondary infections.
Reducing Friction and Irritation
Physical friction is a significant trigger for new HS lesions and can worsen existing ones, making minimizing skin trauma an effective home strategy. Wearing loose-fitting clothing made from breathable natural fibers, like cotton, helps reduce rubbing and allows air to circulate, keeping the skin cooler and drier. Avoid tight garments that create pressure points, such as restrictive waistbands, underwire bras, or overly snug underwear in affected regions.
Shaving in HS-prone areas should be avoided entirely, as the resulting micro-trauma to the hair follicle can initiate a new flare-up. If hair removal is necessary, using an electric trimmer to closely clip the hair is a safer alternative to shaving with a razor. Using deodorants or antiperspirants that are free of alcohol, parabens, and fragrances can prevent chemical irritation that might aggravate sensitive skin. Barrier creams or specialized powders can also be applied in skin folds to reduce skin-on-skin rubbing and moisture accumulation.
Systemic Lifestyle Adjustments
Beyond topical care, long-term systemic adjustments can profoundly impact the frequency and severity of HS flare-ups by addressing underlying inflammatory drivers. Smoking cessation is strongly advised, as tobacco use, specifically nicotine, is closely linked to a higher prevalence and greater severity of HS. Quitting smoking can lead to significant clinical improvement and is considered one of the most effective lifestyle changes.
Weight management is also a factor, particularly for individuals with excess weight, because adipose tissue increases systemic inflammation and creates more skin-on-skin friction in intertriginous areas. Studies suggest that achieving a weight loss of fifteen percent or more can lead to a noticeable reduction in disease severity. Stress is another known trigger for flares, likely due to its impact on the body’s inflammatory response, making consistent stress management techniques, like mindfulness or gentle exercise, beneficial for symptom control.
Dietary modifications are increasingly recognized as a supportive measure, focusing on reducing internal inflammation. While no single diet is universal, some patients find improvement by reducing or eliminating foods that act as triggers, such as dairy products, which contain hormones that may influence HS. High glycemic index foods and products containing brewer’s yeast are other potential triggers that some individuals may choose to eliminate to see if symptoms improve.