Hidradenitis Suppurativa (HS) is a long-term inflammatory skin condition that causes painful lumps, abscesses, and tunnels to form deep under the skin, primarily in areas where skin rubs together, such as the armpits, groin, and inner thighs. HS is not contagious and is not caused by poor hygiene, but rather involves a complex blockage and rupture of hair follicles. While medical treatment is necessary for long-term management, at-home care is an important complement to professional guidance. These strategies help soothe symptoms, reduce the frequency of flares, and improve daily comfort.
Daily Skincare and Hygiene Practices
A gentle and consistent hygiene routine is foundational for managing existing lesions and preventing new ones. The goal is to keep the skin clean without causing irritation or further trauma to the sensitive hair follicles. Use a mild, pH-neutral, and fragrance-free cleanser during bathing, avoiding harsh soaps or vigorous scrubbing that can aggravate affected areas.
Some dermatologists may recommend incorporating an antiseptic wash, such as a chlorhexidine or benzoyl peroxide cleanser, for use on areas prone to flares. These products help reduce the bacterial load on the skin surface, but consultation with a healthcare provider is necessary before regular use. After washing, gently pat the skin dry with a clean towel instead of rubbing, which minimizes friction and prevents micro-abrasions that can trigger a flare.
Properly caring for draining lesions is essential to prevent secondary infection and protect clothing. Use non-adherent wound dressings or sterile gauze pads to cover open wounds, ensuring the material does not stick to the skin. Dressings should be changed frequently to keep the area dry and clean. Never attempt to forcefully pop or squeeze any lump, as this can push inflammation deeper into the skin and lead to the formation of painful tunnels and scarring.
Managing Pain and Inflammation During Flare-Ups
When a painful flare-up occurs, immediate home remedies can offer significant relief and help the lesion resolve more quickly. Applying a warm compress to an inflamed lump for 10 to 15 minutes several times a day can help reduce swelling and may encourage natural drainage. The gentle heat increases blood flow to the area, which can be soothing and promotes the body’s natural healing response.
Alternatively, cold therapy is highly effective for acute pain management, especially if the lesion is not yet ready to drain. An ice pack or cold compress applied briefly to the site helps numb the area and reduce local inflammation, providing immediate comfort. Patients may find alternating between warm and cold applications provides the best results for both discomfort and resolution.
Over-the-counter pain medications manage systemic discomfort and inflammation associated with a flare. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, are often preferred because they address both pain and underlying inflammation. Acetaminophen can also be used for pain relief, but it does not offer the same anti-inflammatory benefits of NSAIDs. Always adhere strictly to the recommended dosage limits to prevent potential side effects.
Reducing Triggers Through Lifestyle Adjustments
Long-term management of HS involves systemic changes to reduce the frequency and severity of inflammatory episodes.
Clothing and Friction Reduction
One of the most impactful adjustments involves clothing choices, as friction is a major mechanical trigger for flares. Opt for loose-fitting garments made from soft, breathable, natural fibers like cotton, which minimize rubbing in high-risk areas like the armpits and groin. Avoid tight waistbands, restrictive undergarments, and synthetic fabrics that trap heat and moisture against the skin.
Weight Management
Maintaining a healthy weight is strongly correlated with reduced disease severity. Excess body fat and skin folds increase friction and can amplify the body’s inflammatory signals. Even a moderate reduction in weight can lead to a noticeable decrease in the number and severity of lesions.
Dietary Modifications
Dietary modifications are another important avenue for reducing systemic inflammation that contributes to HS. While no single diet is effective for everyone, many people report specific triggers, including dairy products, refined sugars, and foods containing brewer’s yeast. A systematic elimination diet, where suspected triggers are removed and then gradually reintroduced, can help identify individual dietary sensitivities.
Smoking Cessation
Quitting smoking is a particularly significant home treatment step, as tobacco use is a well-established and powerful trigger for HS that correlates with more severe disease. Smoking cessation can drastically improve the condition’s severity and the effectiveness of other treatments.
Knowing When to Seek Professional Help
While home care is a powerful tool for daily management, it is crucial to recognize when symptoms require medical intervention. Seek professional guidance if the pain becomes severe and is not adequately managed by over-the-counter medications and home remedies. A rapid worsening of lesions, or if the number of affected areas is quickly increasing, warrants a consultation with a dermatologist.
Signs of a serious secondary infection require immediate medical attention. These include a high fever, shaking chills, or redness that spreads quickly beyond the lesion. Other warning signs include deep or large abscesses that fail to drain or heal, or if a lesion is accompanied by signs of systemic illness, such as body aches or persistent fatigue. Consistent communication with a healthcare provider ensures home care complements a comprehensive medical treatment plan and addresses all aspects of the condition.