Living with hidradenitis suppurativa (HS) has its ups and downs. Some days, your skin may not cause you much trouble, but on others, HS breakouts can make daily life frustrating and even painful. People living with HS often seek tips for managing HS flare-ups.

In this article, we’ll provide you with some practical tips for flare relief. From self-care strategies to medical treatment options, here are ways to navigate HS flares.

Understanding HS Flare-Ups

Hidradenitis suppurativa is an inflammatory skin condition that causes painful bumps, boils, and abscesses. When these symptoms intensify and your skin is at its worst, you may be experiencing a flare-up. A flare-up can strike at any time, and it may be unclear what triggered it. You may have been taking great care of your skin and following all your doctor’s orders, yet a flare began. So, what can you do about it?

Managing HS flare-ups requires a combination of home care, wound care, and medical treatment, if needed. Always remember to get advice from your dermatologist, especially if your symptoms worsen or can’t be managed at home.

Skin Care at Home

When you notice an HS lesion, it’s important to keep the area as clean and protected as possible. Your skin care routine may begin with a gentle cleanser, such as a dermatologist-approved soap and warm water. Avoid harsh scrubs or exfoliators that can worsen irritation and cause lesions to open up.

Follow the skin care guidance from your dermatologist or other health care professional. This may include applying topical prescription medications to the affected areas.

Wound Care

Bandaging your wounds is essential to help prevent exposure to the outside world. Some parts of the body, such as the groin or underarms, may be harder to bandage than others. Do your best to cover the area fully. In general, it’s best to avoid tight dressings or bandages that may further irritate your skin. Breathable, antimicrobial materials can help promote healing without triggering additional symptoms. One member said, “I wear light dressings that I change often.”

Managing Odor From Wounds

If you’re living with HS, you know that wounds sometimes produce an unpleasant odor. This can be an added source of stress and frustration during a flare.

Some ways to reduce odor include:

• Using an antiseptic wash or cleanser recommended by your health care provider to prevent both infection and odor
• Wearing dressings that can absorb discharge or drainage
• Replacing dressings regularly to reduce smells
• Showering or bathing frequently with fragrance-free soap to avoid irritation and kill bacteria

Members of myHSteam have also tried home remedies such as witch hazel. Others have tried to distract from the scent by dabbing essential oil or perfume on their clothing. Make sure to avoid applying products with fragrances, including antiperspirants or deodorants, to affected skin or your HS symptoms may get worse.

How To Manage Pain From an HS Flare

HS can cause pain that makes it hard to get through the day, but you can take steps to feel better.

The American Academy of Dermatology recommends applying a warm compress to ease pain and inflammation and help drain any oozing abscesses. You can try soaking a clean cloth in warm water and applying it to your skin in 15-minute intervals.

“A nice hot compress can be such a lifesaver!” one myHSteam member shared.

Some members prefer cool compresses: “I find cold compresses work much better than heating pads.”

If a compress doesn’t help enough, an over-the-counter pain medicine such as ibuprofen (Advil) or acetaminophen (Tylenol) may provide temporary relief from pain and swelling. Before starting a new medication, talk to your doctor to make sure it’s safe for you.

Finally, avoiding painful, tight fabrics can help reduce pain from friction. Breathable, loose-fitting clothing, such as cotton, can keep you more comfortable during flare-ups.

If the pain is unbearable and not improving with home remedies, make sure to speak with your doctor about other treatment options.

Treatment Options

If you notice an HS flare coming on or have symptoms that aren’t getting better at home, talk to your dermatologist.

Prescription medications for HS flares include antibiotics to kill bacteria and corticosteroids to reduce inflammation. One myHSteam member said, “I've been taking antibiotics for two weeks, and I see an improvement.”

In severe cases, immunosuppressive medications, like biologics, that target your immune system might be used. These options include:

• Adalimumab (Humira)
• Infliximab (Remicade)
• Secukinumab (Cosentyx)
• Ustekinumab (Stelara)

“Started Humira — starting to feel some relief!” one member reported.

What To Avoid

It may be tempting to scrub, exfoliate, pick at, or lance your HS lesions, but doing so can lead to infection, bleeding, and scarring. These actions can also delay healing. If you have a lesion that needs to be drained, your dermatologist can do so in a safe and sterile environment.

Talk With Others Who Understand

On myHSteam, the social network for people with hidradenitis suppurativa and their loved ones, more than 39,000 members come together to ask questions, give advice, and share their stories with others who understand life with hidradenitis suppurativa.

What do you do when you’re experiencing an HS flare? What advice do you have for others living with HS to relieve their symptoms? Share your experience in the comments below, or start a conversation by posting on your Activities page.