The itchiness that comes with hidradenitis suppurativa (HS), or acne inversa, can be one of the condition’s most irritating and debilitating symptoms. An aggravating nuisance throughout the day, it can also deprive you of much-needed sleep at night.

Members of myHSteam often discuss how HS-induced itchiness interferes with their quality of life and solicit tips on how to find itch relief.

“I’m currently having a flare-up as we speak — I’ll be up all night itching and irritated. I’m so sick of going through this,” shared one member.

“Tired of itching all the time because my skin is so dry ... can’t sleep ... again,” lamented another.

Fortunately, there are several techniques you can try to calm HS itchiness. Everyone is different, so a remedy that works for someone else may not work for you. Check with your doctor or dermatologist before trying new treatments or skin care remedies. Remember that even over-the-counter products can have side effects, so it’s important to use them as directed.

What Causes Itching From HS?

Health experts aren’t entirely sure what causes itchiness associated with HS — though they’ve found the symptom affects between 62 percent and 75 percent of people with the condition. HS breakouts on the armpits, groin, and thighs are often the itchiest, according to the American Academy of Dermatology (AAD).

One theory suggests that the itchiness associated with HS may be caused by the release of histamine from mast cells in the nodules, abscesses, and surrounding skin. This histamine release can cause itching and other allergic symptoms.

Additionally, the formation of scars from HS can lead to nerve irritation, and scar tissue itself can be itchy. Although pain is a more common HS symptom, the itch can also be quite bothersome, especially at night, making it difficult to sleep.

“Scratching somewhere, only to realize that that particular bit is itching because it’s a lesion and you’ve just scratched the top off. Oh, the pain is real,” shared a myHSteam member.

Relieving Itch With HS

There’s little to no research on how to relieve itchiness specifically for HS. However, there has been a lot of research into what causes the skin to itch from other health conditions. Thus, there are many dermatologist-recommended techniques to both prevent and soothe itchiness.

Many myHSteam members have also shared the products, techniques, and home remedies that work for them.

1. Wash With Care

Washing regularly can help reduce bacteria on your skin and may prevent or reduce flare-ups of hidradenitis suppurativa. That can help reduce itchiness. Be mindful of what soap or cleansers you use on your skin and how you treat your skin when you wash.

When choosing a soap or bodywash, look for an antimicrobial option. By reducing the amount of bacteria on your skin, you can reduce flare-ups.

Cleveland Clinic recommends avoiding soaps and cleansers that contain:

• Harsh chemicals
• Fragrances
• Dyes
• Exfoliators
• Parabens
• Beta-hydroxy acids
• Rubbing alcohol
• Tree tea oil

Antiseptic cleansers containing benzoyl peroxide, zinc pyrithione, or chlorhexidine may also help. Start by using these just once per week to make sure your skin can tolerate them, as they can dry out the skin. If your skin tolerates the ingredients well and they help your symptoms, move on to daily use.

When choosing a soap or bodywash, look for an antimicrobial option.

One myHSteam member recommended Dr. Organic Bioactive Aloe Vera Body Wash: “I have been testing this stuff out, and it’s got very good results so far. It’s stopped the itching that drives you crazy.”

Another member reported positive experiences with Dial Gold, a type of antibacterial soap. “Yesterday, I bought some Dial Gold. Showered with it, and I haven’t itched since,” they wrote.

Remember, too, that when you’re washing your skin, you’re not sanding a deck. Be gentle with the affected areas to avoid triggering inflammation or causing a lesion to burst. Washcloths, loofahs, and the like can irritate your skin, so don’t use them — let the soap or cleanser do the work.

After washing, gently pat the affected areas with a clean towel to remove excess moisture. Keep the area dry since moisture can worsen HS symptoms.

2. Keep Cool

Topical cooling is a time-tested remedy for relieving itchiness. “Doing cold compresses,” one myHSteam member told another.

The AAD suggests applying a cool, damp cloth or an ice pack to itchy spots for five to 10 minutes. Products containing cooling agents like menthol — which comes from peppermint — or calamine can also help. You can also try cooling your moisturizer of choice in the refrigerator.

Sweating and overheating can make HS symptoms worse. Limit activity when it’s hot or stay indoors — ideally where there’s air-conditioning. Enjoy outdoor time in the morning or late afternoon when the sun isn’t as intense.

3. Take a Warm Bath

Bathing (or showering) in lukewarm water can help prevent itching. Don’t turn the heat up too much though, even if it feels good. Hot water can dry your skin, which can worsen inflammation. Limit your shower or bath to 10 minutes.

In a pinch, a warm compress may relieve swelling and inflammation. To make one, run warm water over a clean washcloth, then wring out excess water and place it where you’re experiencing an itch for about 10 minutes.

In a pinch, a warm compress may relieve swelling and inflammation.

Although a lukewarm bath can provide relief from itchiness, you might find additional relief by adding certain ingredients.

Oatmeal

One option is colloidal oatmeal — that is, finely ground oatmeal. Researchers have found that colloidal oatmeal can help with chronic, itchy skin caused by skin conditions like eczema or psoriasis. It also has moisturizing and cleansing properties.

To prepare an oatmeal bath, finely grind about a cup of oatmeal and add it to a tub of lukewarm water. Soak for about 15 minutes. You can also buy over-the-counter oatmeal bath treatments.

Epsom Salts

Some myHSteam members have found that Epsom salts baths provide relief. Epsom salts are magnesium sulfate — magnesium is considered the active ingredient. The International Association of Hidradenitis Suppurativa Network recommends a warm bath with Epsom salts to relieve itchiness.

“Epsom salt baths help with inflammation and are especially relaxing before bed,” one member shared.

4. Try a Topical Treatment

Some over-the-counter anti-itch creams, ointments, wipes, and pads may help bring relief. In addition to menthol and calamine, other potentially helpful ingredients include:

• Aloe — This moisturizing extract from the aloe plant has anti-inflammatory properties and is sometimes used to soothe itchy skin. “Aloe plant has soothed my skin and taken away so much of the rawness and redness. I highly recommend it,” a member shared.
• Antihistamines — This class of drugs is often used to treat allergy symptoms, including itchiness. Members of myHSteam have mentioned success with creams containing antihistamines, like Benadryl and Preparation H.
• Hydrocortisone — This is a steroid used to treat inflammation and itching in skin conditions, available in over-the-counter and prescription products. “I have HS in the groin area and when I’m having a flare, I use hydrocortisone 2.5 percent for the swelling, itching, and irritation,” one member shared.
• Pramoxine — This is a topical anesthetic that can stop nerves from transmitting pain signals. One myHSteam member said that their itching “seems to go away MOST times with Neosporin ointment,” which contains pramoxine.
• Witch hazel — This botanical astringent from the Hamamelis virginiana plant can relieve minor pain, itchiness, and irritation. “Witch hazel works for the itching and swelling,” one member wrote. When using witch hazel, be careful not to dry out the skin too much.

Natural ingredients and over-the-counter medications may cause side effects or interfere with your current treatments. Check with your doctor before adding a new treatment to your regimen, and make sure to read the directions carefully.

5. Dress for Comfort

Tight clothing — especially made from rough fabrics like wool or denim — can cause itchiness as it rubs against your skin. Look for loose clothing made from breathable, moisture-wicking fabrics, which draw wetness away from your body.

Cotton can be a good choice. According to one study, clothing made from bamboo fibers is a better option. Bamboo is absorbent, hypoallergenic (unlikely to cause an allergic reaction or contact dermatitis), and less irritating to the skin.

Look for loose clothing made from breathable, moisture-wicking fabrics, which draw wetness away from your body.

One member said they further reduce irritation using liners. “I use panty liners. I stick about three to four of them on my panties. They help with friction, absorb the drainage, and don’t irritate my skin like the bandages do,” they wrote.

6. Strive for Less Stress

Pain and itchiness from HS can be stressful — and unfortunately, stress can worsen your itchiness, according to the AAD. Consider stress-relieving activities to put your mind at ease, which may provide some physical relief.

Techniques that may help reduce stress include:

• Practicing meditation
• Trying deep breathing
• Empowering yourself with daily affirmations
• Engaging in physical activities such as yoga, tai chi, or walks through nature
• Trying acupuncture

One member shared how reducing stress has helped them feel better physically and mentally. “I have made changes to my diet and also more lifestyle changes, which include very low stress. I have even had to cut out some people in my life who are stress triggers, and it was hard at first, but it was worth it for MY health and well-being,“ they wrote.

You can also speak with your doctor about counseling or medication if you suspect you have anxiety or depression.

7. Work With Your Doctor To Control Your HS

Itchiness is a symptom of HS, so an effective medical treatment to control your overall condition will go a long way in helping free you of that itch. Discuss HS treatment options with your healthcare provider, such as antibiotics, biologics, corticosteroid injections, and retinoids.

They may also recommend lifestyle changes, such as adopting an anti-inflammatory diet or quitting smoking. Follow your treatment plan, and if something’s not working, let your doctor know.

If you feel like your doctor isn’t a good fit for you, you can always look for another doctor who specializes in HS. A specialist familiar with HS can provide you with valuable insights, guidance, and appropriate treatment options. They may have a deeper understanding of the condition and are more likely to be up-to-date on recent HS research and treatments. This can greatly benefit how your condition is managed and potentially lead to better outcomes.

There are also promising new HS treatments on the horizon that are expected to receive approval soon from the U.S. Food and Drug Administration (FDA).

Talk With Others Who Understand

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.

Have you discovered any effective strategies for reducing itchiness associated with HS? Share your tips and experiences in a comment below, or start a conversation by posting on your Activities page.