When your hidradenitis suppurativa (HS) abscesses break open or leak, you want them to heal as quickly as possible. As this happens, it’s important to keep the area clean, manage drainage, and watch for signs of infection. The healing process is different for everyone with HS, as many myHSteam members have shared.

“I had a flare-up a month ago and still struggle to get rid of the bugger,” one member wrote. Another said, “I have had three more lesions pop up, and the last one to drain is taking twice as long to heal. The pain is unbearable.”

Keep reading to learn about the stages of abscess healing in HS and how to care for your skin after an abscess bursts.

Abscess vs. Wound: What’s the Difference?

It’s important to know the difference between an HS abscess and a wound. HS is a chronic skin condition that causes painful lesions (areas of damaged or inflamed skin) to form under your skin. Lesions are especially likely to develop in areas of the body where the skin rubs together, such as the groin, breasts, buttocks, and armpits, and can turn into pus-filled abscesses. When an abscess ruptures, pus may leak out, sometimes producing an odor.

A burst abscess can cause an open wound. Multiple abscesses may create tunnels, also called sinus tracts, under the skin. The tunnels can also open up and lead to larger wounds. HS lesions do heal, but they leave behind thick, ropelike scars or pitted skin.

Your doctor may also create wounds on your skin if they treat HS with incision and drainage. This procedure isn’t commonly used for this skin condition, but some doctors may still perform it. Although this approach may offer short-term relief from the pain, it’s not considered an effective long-term solution because abscesses often return.

Stages of Healing

Not everyone with HS heals the same way after an abscess bursts and forms a wound. In fact, you may notice that each of your HS nodules heals slightly differently. Still, you can watch out for some general stages of wound healing.

Hemostasis Stage

Immediately after a wound forms, the body enters the early stages of healing. The first stage is called hemostasis when the bleeding stops. A blood clot forms to seal the wound and prevent further bleeding.

Inflammatory Stage

Within 24 hours, the wound site becomes inflamed, causing swelling, leaking fluid, and pain. A scab may also start to form. This stage typically lasts about two weeks but can take longer in some people.

Proliferative Stage

Next comes the proliferative stage, when the abscess wound starts rebuilding the damaged area by growing new tissue. The wound may look pink or red on lighter skin and brown, purple, or darker than the surrounding skin on deeper skin tones. It might also be slightly raised, but it shouldn’t bleed easily anymore.

Maturation (Remodeling) Stage

In the final stage, called maturation or remodeling, the wound begins to close and form a scar. This phase typically starts about 21 days after the wound appears, but it can take up to a year for the newly healed skin to become completely healthy.

Timeline for Abscess Wound Healing

If your abscess ruptures and leaves an open wound, healing may take time. Most wounds heal within four to six weeks, but it may take longer for people with HS. Factors like infection (when bacteria enter the wound), smoking, or chronic conditions can slow the healing process.

Members of myHSteam have described a wide range of timelines, with comments such as:

• “I have an open wound on my armpit. It’s been like this for more than three weeks now.”
• “The flare-up on my breast that refused to go away for seven months finally started to heal this month. After three weeks of promising signs, it came back yesterday.”

How To Tell if an Abscess Is Healing

As your wound heals, you should see less pus coming out. Using warm compresses or gentle pressing with a clean bandage can help the abscess drain faster. The area may swell before healing and could form a scab. Even without a scab, the skin may darken or lighten before settling into its final color. As the wound closes and shrinks, new skin will grow over the area, and a scar may form.

Members of myHSteam often express great relief when they notice their abscesses are finally healing. “My wounds look like they’re healing,” one member wrote. “I even wore a sleeveless dress at work today.”

“No new lesions have popped up,” another member said. “I don’t care that I have a scar. I’m just happy it’s gone.”

When To Call Your Doctor About Abscess Healing

If your abscess doesn’t begin to drain within a few days of bursting, it’s a good idea to check in with your dermatology provider (skin specialist). You should also call a doctor if you notice signs of abscess infection, such as:

• A fever that doesn’t go away
• Skin that stays discolored, warm, swollen, or painful
• Dark streaks spreading outward from the wound

If your pain becomes unbearable, don’t hesitate to reach out for help. Your doctor can recommend treatment options, like oral antibiotics for an infection or biologics for your HS. In severe cases, they may refer you to a plastic surgeon for debulking surgery. Seeing a dermatologist early on is important because they can help you find the best treatment plan for your needs.

Wound Care Best Practices

To avoid infections around abscesses or open wounds, follow these best practices:

• Change your wound dressings frequently to keep the wound free of bacteria.
• Clean the wound with warm water and a gentle soap.
• Keep an eye on the wound to watch for changes.

Contact your dermatologist or another healthcare provider for medical advice if your wound doesn’t seem to be healing, causes you excessive pain, or looks inflamed or infected. Taking care of your skin and seeking timely medical help can make a big difference in managing HS and promoting proper healing.

Find Your Team

On myHSteam, the social network for people with hidradenitis suppurativa and their loved ones, more than 45,000 members come together to ask questions, give advice, and share their stories with others who understand life with hidradenitis suppurativa.

How long do your abscess wounds with HS take to heal? How do you take care of the affected skin? Share your tips in the comments below or by posting on your Activities page.