Simple Home Remedies to Soothe HSby Benedict Cosgrove Health Writer
We’re going to be straight with you. Hidradenitis suppurativa can make life miserable. It's a chronic, inflammatory condition that affects at least 1% of the population, and its symptoms range from irritating to life-altering. “This is a painful, painful condition with patients [at later stages] suffering large, inflamed boils and abscesses in areas like the armpits, groin, buttocks, and breasts,” says Rashmi Unwala, M.D., a dermatologist at the Cleveland Clinic in Ohio. “Drainage from these abscesses can also smell quite bad, which of course can be devastating to self-esteem.”
And what do you need when things are really, really hard? Lots of TLC.
We asked doctors and patients to share their favorite soothing strategies. But here are the ground rules: None is intended to replace your regular treatment plan—keep using all your medication as directed! Second, you must talk to your doctor before trying any of the topical remedies. She'll probably be more open than you think: “I believe in Western medicine,” says Haley Naik, M.D., an assistant professor of medicine at the University of California, San Francisco, who runs an HS clinic. “But if we know they’re not harmful or won’t interfere with established treatments, then I’m open to discussing at-home options that relieve pain and discomfort.”
Fair enough? Let’s go!
Wash With Soap
Keeping affected areas clean helps set the stage for soothers to work—and it helps keep flares from worsening or spreading. Think of it as step one. Freelance graphic artist and #HSwarrior Selina Ferragamo, 24, swears by antibacterial soap in body wash or bar form. The American Osteopathic College of Dermatology backs her up and says this kind of soap can even help reduce HS-related odor. Not all docs are down with antibacterials though (they may contribute to antibiotic resistance), so ask yours what he recommends.
Swipe With Alcohol
For Ferragamo, who has dealt with HS since her teens, one reliable soother is a simple alcohol swab, or prep pad. “If I’m sweating too much during the day, I use a swab under my arms,” she says. “It cleans away perspiration, and the alcohol evaporates right away,” which helps keep her underarms feeling cool and dry—and that’s a good thing. When the skin is damp for too long, the area can get more irritated, she finds. Sometimes she swabs areas with open sores, but sparingly—and only after diluting the pad with a bit of water. After all, "it can really, really sting,” she says.
Try Warm Compresses
One of the most effective HS soothers is a compress in the form of a washcloth soaked with very warm water. Put it on affected areas (10 minutes at a time) where pus has built up beneath the skin, says Dr. Unwala. The heat helps pus release all at once, rather than over a longer period. Selina Ferragamo agrees. “I’m a fan of compresses because they relieve pressure and can help boils open. I know that might sound kind of gross, but the relief you feel when a compress works can be wonderful,” she says.
Dab on Aloe Vera
People have been using the gel from the cactus-like aloe vera plant for thousands of years to soothe burns, cuts, and other skin problems. And research has shown that it does have antibacterial and anti-inflammatory properties. Plus, there’s a soothing cooling sensation when it’s applied, welcome relief to angry hot bumps. Apply a dab, preferably cut straight from the aloe leaf, directly to affected areas with clean fingers or a cotton swab. If you prefer to use store-bought, just make sure it’s 100% aloe gel with zero additives.
Try Bleach Baths
The phrase “bleach bath” might sound dramatic, but the bleach in this at-home HS treatment is heavily diluted—a quarter-cup in a whole tub (about 40 gallons). The benefit? It can reduce levels of bacteria on your skin, says Dr. Naik. Be sure to ask your dermatologist if a bleach bath might soothe your HS before you dip in. If she thinks it will help, she’ll provide you with details about how to do it safely.
Smear on Some Honey
Honey is remarkable stuff. A 2018 study notes that it “exhibits strong wound healing, antibacterial, [and] anti-inflammatory effects,” and some people with HS have found that applying honey-coated gauze to a wound—for example, a surgical incision to drain pus—appears to promote healing. That said, it can be irritating for some so definitely discuss with your doc first.
“My goal when I have an HS flare is to get the pus out from under my skin,” Ferragamo says. “I know that sounds disgusting, but the relief is worth it. And my all-time favorite thing to use is Vicks VapoRub.” A thin film applied to an affected area soothes the itching and irritation that come with HS, she says, while also encouraging recurring abscesses to rupture and drain. Ferragamo never uses Vicks on open sores, though. (While this is a popular remedy among HS patients, keep in mind that its manufacturer expressly warns against using VapoRub on wounds or damaged skin. So again: Ask your M.D.)
Eat Anti-Inflammatory Foods
While your diet may not bring instant relief to a flare, sticking to anti-inflammatory foods as much as possible may reduce them overall. Many patients say limiting gluten, processed foods and sugary foods help. Following an anti-inflammatory diet isn’t just about restriction though: Load up on berries, broccoli, tomatoes, leafy green veggies, and certain nuts, like walnuts and pecans and fish like salmon, tuna, and mackerel, all of which are high in inflammation-fighting omega-3 fatty acids.