Having a chronic skin condition like hidradenitis suppurativa can sometimes feel overwhelming, especially when you’re left standing in the health and beauty aisle wondering, Which, if any, of these products are going to help me?
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Dermatologist Michelle Kerns, MD, cuts through some of the confusion by sharing a shopping list of ingredients and products you want to look for if you have hidradenitis suppurativa, along with some ingredients you should avoid.
Hidradenitis suppurativa (HS) is an auto-inflammatory skin condition caused by clogged hair follicles that rupture deep beneath the surface of your skin. Not to be confused with acne, which is much closer to the surface of your skin, HS usually presents with recurring boils in your armpits, groin, buttocks and under your breasts. It’s also associated with drainage or pus and has an unpleasant odor.
“You can have an overgrowth of bacteria that contributes to odor and drainage,” says Dr. Kerns. “But HS isn’t infectious and it’s not caused by poor hygiene. It’s an autoinflammatory disease that’s triggered by the rupturing of those clogged hair follicles deep down in the skin.”
Because of its autoinflammatory nature, HS is best treated and managed with anti-inflammatory ingredients and antibacterial products that help with inflammation and reduce drainage and odor. Some popular products and ingredients that work best include the following:
Because of increased bacterial activity associated with HS, antibacterial soaps and washes, like Hibiclens®, contain helpful ingredients like chlorhexidine or benzoyl peroxide. Chlorhexidine is used to disinfect skin and sterilize surgical instruments before surgery, and benzoyl peroxide is an antiseptic used often in preventing acne-causing bacteria from multiplying.
“These products will decrease the bacterial load, but it’s gentle enough for the skin of people with HS,” says Dr. Kerns. “A lot of over-the-counter antibacterial body washes have fragrances, dyes and a lot of other unnecessary ingredients. But products like Hibiclens are used in preparation for surgery. They’re less likely to cause irritation and allergic reactions.”
Your immune system kickstarts an inflammatory response in an effort to get rid of foreign invaders like bacteria associated with HS. But when that inflammatory response is in overdrive, you’ll be tempted to itch, scratch or break open those clogged hair follicles which could lead to more trouble.
“With HS, your hair follicle ruptures deep in the skin,” explains Dr. Kerns. “When you scratch, pop or irritate the area, you’re just creating damage to the upper layers of your skin and you can end up having more clogging.”
If you’re experiencing flare-ups or have itchy skin, creams and lotions like CeraVe®, Cetaphil®, Vanicream® and Aveeno® can help because of their anti-inflammatory ingredients.
Trying out new products can be a big pain for people with sensitive skin or allergies. In those cases, some natural home remedies, like zinc, can provide relief.
One solution involves combining 1 tablespoon turmeric powder with 1/2 tablespoon coconut oil to create a salve that you can then rub onto affected areas for relief. The coconut oil helps your skin absorb the turmeric, which has anti-inflammatory properties.
“You can use this combination when you’re experiencing flare-ups or for keeping up with daily maintenance,” says Dr. Kerns.
Honey-infused dressings are another solution that helps provide relief and reduce the likelihood of scarring.
“When draining boils, wound care is a huge part of the struggle with HS, so we want to have dressings that help promote wound healing, as well as avoid causing more damage by ripping the skin or tearing the skin,” advises Dr. Kerns. “Even just applying honey to non-adhesive dressings and covering your open wounds can help.”
So, what’s the best way to use soap and body washes for hidradenitis suppurativa? Well, the goal is to keep your skin hydrated without causing more irritation by using gentle skin care products every day. At the very least, your daily skin care routine should include the following:
“Different topical regimens are really important,” says Dr. Kerns. “The general recommendation is to rely on gentle skin care.”
You want to avoid products or ingredients that can dry out or strip your skin of water, cause an allergic reaction or cause more clogging in your hair follicles. Some ingredients to avoid are:
“When you’re developing boils and drainage, you’re going to want to try many things. But scrubs, loofahs and exfoliators are all things that should be avoided,” stresses Dr. Kerns. “Body scrubs irritate your skin and cause more damage.”
But we can all agree, having those boils can be a real pain, and no one wants them to stick around longer than they have to. Instead of using exfoliators or popping and/or scratching the affected areas, use a warm compress to help alleviate any itching or pain and speed along the process of draining the boil. Anti-inflammatory products, like African black soap, can’t hurt either, as long as it doesn’t cause or worsen flare-ups.
“When you try to push things out, even for pimples or cysts, they can end up going deeper down and create more clogging in your hair follicle,” cautions Dr. Kerns.
And drying out your skin might seem like a good solution on the surface, but that’s exactly where that solution stops being helpful — on the surface. The roots of HS boils are much farther down than rubbing alcohol and beta-hydroxy acids can reach.
“A lot of treatments for acne will strip the skin, but our goal is to restore the balance to your skin,” she adds.