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If you have HS, you may have noticed an unpleasant odor during flare-ups. But what causes the smell, and how can you manage it? Let's break it down.
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What causes the smell? HS lesions filled with pus, a mix of dead skin cells, white blood cells, and bacteria. When they burst and drain, the odor can be strong and unpleasant. What does HS smell like? People describe it as foul or pungent. The smell can be embarrassing, and it can affect your daily life and confidence. How to manage HS odor?
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Number one, clean gently. Use a fragrance-free, antibacterial wash to help remove bacteria that contribute to the smell. Harsh soaps can make HS worse. Number two, use absorbent dressings. HS lesions leak fluid. Nonirritating, absorbent pads help control the odor and keep skin dry. Number three, wear breathable fabrics. Loose-fitting cotton or bamboo clothing helps reduce the sweating, friction, and irritation that can make HS worse.
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Number four, choose the right deodorant. Alcohol-free, fragrance-free sprays can help manage odor without triggering flare-ups. Number five, talk to a doctor. If HS odor is affecting your mental health or daily life, a dermatologist can help. HS odor can be challenging, but you're not alone. Have tips that work for you? Share in the comments. Learn more and connect at myHSteam.com.
Unpleasant odors from hidradenitis suppurativa (HS) flares can be a source of stress and frustration for myHSteam members. “Nothing has seemed to help with the odor,” one member commented.
If you need help with managing odors from leaking wounds, you can try a few techniques to reduce the smell and stress that come with it. Read on to learn what causes the HS smell and ways you can curb it.
Hidradenitis suppurativa, also known as acne inversa, is caused by long-term inflammation of the hair follicles. In this skin condition, hair follicles get clogged with keratin (a protein in skin, hair, and nails), sweat, and bacteria. This blockage causes abscesses to form, filling with pus — a mixture of dead white blood cells, skin cells, and bacteria or fungi. If these lesions burst, pus can drain from the open wound and cause an odor.
HS lesions most often form near the sweat glands, such as the armpits, groin, and inner thighs. People who notice a smell coming from HS lesions often describe it as a strong foul odor. “I used to have the smell of blood or sweat that would make me want to dig a hole and stick my head in it,” wrote one myHSteam member.
“It’s awful,” another member said about their hidradenitis suppurativa odor. “It stops me in my tracks when I catch a whiff of myself. It’s a very real and pungent smell.”
The smell coming from HS lesions may cause embarrassment and anxiety, negatively affecting your quality of life. People with HS may experience loneliness, depression, low self-esteem, and social isolation that can make forming personal relationships and participating in social activities difficult. What’s more, the stress caused by worrying about the odor can trigger HS breakouts.
HS usually occurs in cycles, with lesions healing and then becoming inflamed again when something triggers a flare. As with other symptoms of HS, the related smell becomes more intense during an outbreak.
In severe cases of HS, many abscesses deep under the skin connect and form tunnels (also called sinus tracts) that contain pus. When these pus-filled tunnels drain, it results in a strong smell that some people with HS experience during flare-ups. HS symptoms, including the smell, sometimes get worse before menstrual periods.
Many members of myHSteam have asked how to get rid of the abscess smell that may accompany HS. Although you can’t prevent an odor from HS lesions, you can take several steps to curb it. Cleansing skin gently, applying effective dressings, and avoiding HS flares are key parts of a plan to reduce or stop odor from hidradenitis suppurativa.
HS typically affects areas of the body with skin folds where sweat can get trapped and bacteria can grow. This buildup may cause odor and skin irritation, possibly triggering an outbreak.
Keeping the affected areas clean with regular washing can help manage the HS smell. Avoid scrubbing and using harsh, scented soaps, which can irritate the skin and lead to flare-ups. Instead, use a gentle cleanser — many of the best options can be purchased over the counter.
Cleansing the affected areas with antiseptic wash daily helps reduce the growth of bacteria on your skin’s surface that can contribute to odor. An acne cleanser that contains salicylic acid, benzoyl peroxide, or zinc pyrithione can be part of your skin care routine. Or you could try an antibacterial soap such as Hibiclens or Hibiscrub. Applying diluted white vinegar to HS lesions before dressing them can also help reduce the odor.
Many members of myHSteam affirmed the effectiveness of a good cleansing routine, sharing comments such as these:
Placing absorbent pads in affected areas to catch the pus draining from abscesses and tunnels can reduce the strong smell caused by HS. Absorbent dressings come in different strengths, and menstrual pads can be used effectively for this purpose. However, avoid dressings with strong adhesive borders, which can irritate the skin around HS lesions.
Members of myHSteam have discussed the importance of covering HS lesions to control the smell. “The odor was from when an abscess is opened and needs to drain. The pus does have an odor. In fact, when I went and got one lanced last week, I actually had to ask the doctor what that smell was,” one member wrote. “The thing that helped with the smell was to keep it clean and covered. Once it drained entirely, the smell went away and the wound healed itself.”
Friction caused by tight clothing can cause irritation and the rupture of HS abscesses, leading to draining. Synthetic fabrics also trap sweat more than natural fabrics, which are more absorbent. Wearing loose-fitting clothes made of a natural fabric can help reduce HS lesion irritation and odor.
Deodorants and antiperspirants can help control HS smell and body odor from underarm perspiration. However, some chemicals and fragrances in these products can trigger a flare-up. Avoid products that contain alcohol, baking soda, parabens, dyes, or fragrances. Spray deodorants are recommended because they tend to be less irritating than solid sticks.
Symptoms of HS, including odor, can worsen during a flare-up, so avoiding triggers that bring on outbreaks is an important part of managing HS and its odor. The following lifestyle-related tips can help you avoid HS triggers:
Topical antibiotics such as clindamycin are applied directly to the skin. They can help treat HS sores and prevent infections that might cause more pus and draining. In some cases, an oral antibiotic such as doxycycline, minocycline, or tetracycline, or a combination of topical and oral antibiotics, can be used.
If a strong smell coming from your HS lesions begins to affect your daily activities and mental health, reach out to a dermatologist who can help you understand your treatment options. Your healthcare provider can guide you to the most effective treatment plan, helping you minimize HS odor and regain your confidence in daily activities and social situations.
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 do you reduce odor from hidradenitis suppurativa? What treatments or strategies have helped you get rid of the abscess smell? Share your experience in the comments below, or start a conversation by posting on your Activities page.
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