Treatment & Management of HS (Hidradenitis Suppurativa)

Hidradenitis Suppurativa (HS) is a chronic inflammatory skin condition that causes painful lumps, abscesses, and tunneling wounds in areas where skin rubs together, such as the armpits, groin, and under the breasts. It is a complex disease that varies in severity from person to person, with some experiencing mild, occasional flare-ups and others dealing with widespread, recurring symptoms that significantly impact daily life. While there is no definitive cure for HS, effective treatment and management strategies can help control symptoms, reduce flare-ups, and improve overall quality of life.

The treatment of HS typically involves a combination of medical therapies, lifestyle adjustments, and, in some cases, surgical interventions. Dermatologists and other healthcare providers use a range of approaches to reduce inflammation, prevent infections, and promote healing. Some individuals may respond well to antibiotics or anti-inflammatory medications, while others may require biologic treatments that target the immune system. In more severe cases, surgical procedures, such as drainage, excision, or laser therapy, may be necessary to manage advanced symptoms. The goal of treatment is not just to address current flare-ups but also to prevent new ones and minimize long-term damage to the skin.

Beyond medical treatments, lifestyle changes play an essential role in managing HS. Avoiding common triggers, such as friction, excessive sweating, and certain dietary factors, can help reduce symptom severity. Maintaining a healthy weight, quitting smoking, and practicing good skin care are often recommended to help keep the condition under control. Many people with HS also benefit from emotional support, whether through therapy, support groups, or online communities, as the condition can have a significant impact on mental health.

Because HS is a progressive disease, early intervention is key. The sooner a person seeks medical attention, the better their chances of managing symptoms and preventing complications. However, treatment can be a long process that requires patience and persistence, as what works for one person may not work for another. Understanding the different treatment options available and working closely with a knowledgeable healthcare provider can make a significant difference in controlling the disease.

This article will explore the various approaches to treating and managing HS, including medical treatments, self-care strategies, and lifestyle modifications. By learning how to take an active role in managing HS, individuals with the condition can find ways to minimize discomfort and improve their overall well-being.

Medical Treatments for HS

There are several medical treatments available to help manage Hidradenitis Suppurativa (HS). The choice of treatment depends on the severity of symptoms, frequency of flare-ups, and overall health of the individual. While no cure currently exists, many options can help reduce inflammation, control infections, and minimize pain.

1. Topical and Oral Antibiotics

Used to reduce inflammation and prevent bacterial infections.
Topical clindamycin is commonly prescribed for mild HS.
Oral antibiotics such as tetracyclines, rifampin, and clindamycin are used for moderate cases.
Long-term antibiotic use may be necessary to prevent recurring flare-ups.

2. Anti-Inflammatory Medications

Help control swelling and discomfort caused by HS.
Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can relieve pain.
Corticosteroids may be prescribed to reduce severe inflammation during flare-ups.

3. Biologic Treatments

Used for moderate to severe HS to target the immune system and block inflammation.
Adalimumab (Humira) is the first FDA-approved biologic specifically for HS.
Other biologics like infliximab (Remicade) and secukinumab (Cosentyx) are sometimes used off-label.

4. Hormonal Therapy

Helps individuals whose HS is influenced by hormonal fluctuations.
Spironolactone is often prescribed for women to reduce androgen levels.
Some patients benefit from oral contraceptives that regulate hormones and decrease flare-ups.

5. Surgical and Laser Procedures

Recommended for severe or recurring HS that does not respond to medication.
Incision and drainage provide temporary relief from painful abscesses.
Laser hair removal therapy can help reduce the number of lesions over time.
In extreme cases, wide surgical excision may be necessary to remove damaged tissue permanently.

Medical treatment for HS often requires a combination of therapies to achieve the best results. A dermatologist or specialist can help develop a personalized plan based on the severity of symptoms.

Self-Care Treatments for HS

In addition to medical treatments, self-care strategies play a crucial role in managing Hidradenitis Suppurativa (HS). Proper skincare, lifestyle adjustments, and at-home remedies can help reduce flare-ups, minimize discomfort, and improve healing. Below are some effective self-care treatments that can support overall HS management.

1. Gentle Skincare Routine

Wash affected areas with a mild, fragrance-free cleanser to prevent irritation.
Avoid harsh scrubbing, as this can worsen inflammation.
Pat the skin dry instead of rubbing to reduce friction.
Apply a lightweight, non-comedogenic moisturizer to keep skin hydrated.

2. Warm Compresses

Helps soothe pain and promote drainage of abscesses.
Use a warm (not hot) compress for 10-15 minutes on affected areas.
Soaking in a warm saltwater bath (such as with Epsom salts) may also help.

3. Wear Loose, Breathable Clothing

Tight clothing increases friction and sweating, which can trigger flare-ups.
Opt for soft, cotton fabrics to allow airflow and reduce irritation.
Avoid synthetic materials that trap moisture against the skin.

4. Maintain a Healthy Diet

Some individuals find that reducing dairy, processed foods, and sugar helps with symptom management.
Focus on anti-inflammatory foods like fruits, vegetables, lean proteins, and healthy fats.
Staying hydrated can also help with skin health and overall well-being.

5. Manage Stress and Get Enough Rest

High stress levels can contribute to increased inflammation and more frequent flare-ups.
Practice relaxation techniques like meditation, deep breathing, or gentle yoga.
Ensure adequate sleep to allow the body time to heal and recover.

By incorporating self-care treatments into daily life, individuals with HS can reduce symptoms, improve comfort, and support medical treatments. Small changes can make a big difference in managing this chronic condition effectively.

Lifestyle Modifications to Help with HS

Managing Hidradenitis Suppurativa (HS) often requires lifestyle adjustments in addition to medical treatments. Certain habits and environmental factors can either worsen or improve symptoms, making lifestyle changes an important part of HS management. While these modifications won’t cure HS, they can help reduce flare-ups, manage pain, and improve overall skin health.

1. Wear Loose, Breathable Clothing

Tight clothing creates friction and irritation, which can worsen HS lesions.
Choose soft, cotton fabrics instead of synthetic materials that trap moisture.
Avoid undergarments or belts that put pressure on sensitive areas.
Some people benefit from moisture-wicking fabrics that keep the skin dry.

2. Follow a Skin-Friendly Diet

While no single diet works for everyone, many people with HS notice triggers from certain foods.
Reducing dairy, sugar, and processed foods may help some individuals manage symptoms.
Focus on anti-inflammatory foods, such as fruits, vegetables, lean proteins, and whole grains.
Hydration is key—drinking enough water supports skin health and reduces inflammation.

3. Stop Smoking or Avoid Tobacco Products

Research shows a strong link between smoking and HS severity.
Smoking can increase inflammation and block hair follicles, leading to more flare-ups.
Quitting or reducing tobacco use may improve symptoms and boost the effectiveness of medical treatments.

4. Maintain a Healthy Weight

While HS can affect people of all sizes, excess weight can contribute to friction, sweating, and inflammation.
Losing weight (if applicable) may help some individuals experience fewer flare-ups and less discomfort.
Engaging in low-impact exercises, like walking or swimming, can be beneficial without irritating affected areas.

5. Manage Stress Levels

Chronic stress can worsen inflammation and trigger HS flare-ups.
Practicing stress-reducing activities such as yoga, meditation, deep breathing, or journaling may help.
Maintaining a consistent sleep schedule is also important for immune function and skin healing.

6. Improve Personal Hygiene Without Over-Irritating Skin

Use fragrance-free, gentle cleansers to clean affected areas without causing irritation.
Avoid harsh scrubbing or exfoliants that may worsen inflammation.
Keep areas prone to HS dry and clean to prevent bacterial growth.
Consider using absorbent dressings if lesions drain frequently to protect the skin.

7. Adjust Your Hair Removal Methods

Shaving can irritate the skin and increase the risk of ingrown hairs, which may trigger flare-ups.
If hair removal is necessary, opt for electric trimmers instead of razors.
Some individuals benefit from laser hair removal, which may help reduce lesions over time.

Conclusion: Finding the Right Treatment for HS

Managing Hidradenitis Suppurativa (HS) requires a combination of medical treatments, self-care strategies, and lifestyle modifications. Because HS is a chronic and progressive condition, early intervention and a personalized treatment plan can make a significant difference in controlling symptoms and improving quality of life. While there is no single cure, many individuals find relief through a mix of medications, skincare routines, and surgical options when necessary.

Medical treatments such as antibiotics, biologics, and anti-inflammatory medications can help reduce flare-ups and slow disease progression. In more severe cases, surgical procedures may be required to remove affected tissue and prevent further complications. Alongside these medical interventions, self-care practices like gentle skincare, warm compresses, and stress management play an important role in symptom relief.

Lifestyle changes, such as wearing loose clothing, maintaining a balanced diet, and quitting smoking, can also help minimize triggers and improve overall skin health. Since HS affects each person differently, working closely with a dermatologist or healthcare provider is essential in finding the right combination of treatments that work for individual needs.

Living with HS can be physically and emotionally challenging, but ongoing research and treatment advancements continue to offer hope. By staying informed, seeking medical guidance, and making small but effective lifestyle adjustments, individuals with HS can take proactive steps toward managing symptoms and leading a more comfortable, fulfilling life.