Hidradenitis suppurativa is a chronic inflammatory skin disease that causes bumps to appear on and under your skin. Little is known about what directly causes hidradenitis suppurativa, but it’s often mistaken for other conditions like pimples or cystic acne.
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“A lot of patients that come in are so embarrassed to even mention this condition that they hide their condition for very long periods of time because they think they’re doing something wrong with their hygiene, but that’s not the case,” explains dermatologist Asfa Akhtar, DO.
If left undiagnosed, hidradenitis can spread or worsen and cause infection. It can also cause quality-of-life issues, like making it difficult to exercise or wear comfortable clothing. Although there isn’t a cure, there are ways to alleviate symptoms, including pain, pus build-up and scarring. Dr. Akhtar walks us through common treatments, as well as at-home remedies you can try temporarily (and some you should avoid).
What is hidradenitis suppurativa?
Hidradenitis suppurativa, also known as acne inversa, appears on parts of your body where your skin rubs against other skin. These areas can include:
- Inner thighs.
- Under or on breasts.
This condition can start happening around puberty and is often mistaken for common acne. It develops in three stages:
- Stage one: Sweat glands in the parts of your body where you have hair become inflamed and the opening for your hair follicles get clogged. This causes cysts to form on or under the surface of your skin.
- Stage two: Your cysts start connecting with each other through deep tunnels under your skin that fill with fluid. Your cysts become painful to the touch.
- Stage three: Your cysts break open, producing a foul-smelling discharge or pus. These open wounds may or may not heal completely and can leave irreversible scars.
“Hidradenitis is the most severe form of inverse acne,” says Dr. Akhtar. “It progresses over time and delivers irreversible damage.”
The best treatment plan for hidradenitis suppurativa
If you’re showing early signs of hidradenitis suppurativa, you should see your healthcare provider or board-certified dermatologist as early as possible to avoid worsening symptoms.
“As soon as you feel that you are getting any kind of pimples in your underarms or groin area, and acne treatments you might have done at home aren’t working, you should go see a board-certified dermatologist,” advises Dr. Akhtar.
For moderate to severe hidradenitis, adalimumab (Humira®) is often used as an injection to help reduce inflammation. This drug is also used to help treat other inflammatory diseases like plaque psoriasis, ankylosing spondylitis and Crohn’s disease.
For mild or early-stage hidradenitis, antibiotics can also be helpful.
Natural and at-home remedies for hidradenitis suppurativa
There are some temporary solutions you can turn to at home that can help alleviate symptoms until you’re able to get medical treatment.
Aloe vera can soothe your pain
Aloe vera is often used to soothe itchy or irritated skin (especially sunburns). Because it’s a moisturizer, it can help with pain and inflammation, but it won’t heal your cysts or open wounds.
Warm compresses can help drain your cysts
You should never pick at or cut open your cysts because this can lead to infection. Instead, using a warm compress (or letting warm water from a shower hit the affected area) can help your cysts drain in a cleaner way.
Adjust your diet
“Foods rich in dairy products, complex carbohydrates or high fatty foods tend to worsen hidradenitis,” notes Dr. Akhtar. The Mediterranean diet, which is high in anti-inflammatory foods, is better suited for anyone who has hidradenitis.
Obesity can add its own set of complications, too. People who have obesity have higher levels of insulin-like growth factors (IFG) — hormones that stimulate growth but decrease blood glucose levels. High levels of IFGs can lead to larger cysts in greater volumes, so adjusting your diet to reduce those levels can be helpful.
Turmeric can help with inflammation
Turmeric, which contains a natural anti-inflammatory compound called curcumin, has been studied for its antimicrobial properties and presents a number of health benefits. Although you can make a paste with turmeric and apply it directly to the skin, Dr. Akhtar suggests adding it to your diet instead.
“Just a pinch of turmeric in your daily diet would be enough to help give you the anti-inflammatory properties you need,” says Dr. Akhtar.
Increase zinc and vitamin D intake
A 2018 study showed that people who had hidradenitis were more likely to have low levels of zinc and these lower levels could add to an increase in severe symptoms. Dr. Akhtar says both zinc and vitamin D have been shown to alleviate symptoms. But high levels of zinc could interfere with your body’s ability to absorb copper through your intestines, which can lead to a variety of issues, including nausea, vomiting and diarrhea.
“If someone starts to take high levels of zinc, they need to make sure that they are taking a multivitamin with copper as well,” says Dr. Akhtar.
Wear loose-fitting clothing
Because of where hidradenitis symptoms occur, you want to try and reduce as much friction as possible. Wear comfortable, loose-fitting clothing until your flare-up is treated. Otherwise, you run the risk of irritating your skin further and causing your cysts to burst.
Things you should avoid if you have hidradenitis suppurativa
Here are a few things you should never do because they could worsen your condition.
Don’t use tea tree oil
Tea tree oil has been shown to have anti-inflammatory and antifungal properties, but you should avoid using this at-home remedy if you have hidradenitis.
“Oils clog pores, and you don’t want your pores to get more clogged,” says Dr. Akhtar. Clogged pores could lead to an increase in pus production, which can be painful and cause further infection.
Don’t use rubbing alcohol
Where aloe vera moisturizes, rubbing alcohol does the opposite and dries out your skin. Dr. Akhtar suggests only using rubbing alcohol to clean an infected cyst. You should not use it routinely as a form of treatment. Dry skin can lead to worsening problems in the future and cause other cysts to rupture when your skin gets too dry.
Bleach baths aren’t a good idea
If you have eczema, a condition that makes your skin red and itchy all over, a bleach bath can be effective because it kills bacteria associated with skin infections. However, the bacteria associated with hidradenitis is different and so deeply embedded in your skin that a bleach bath never reaches the infection.
While you can soothe your symptoms with these at-home remedies, they won’t cure the condition. The best thing you can do for hidradenitis suppurativa is see your doctor as soon as possible. They’ll get you on the right course of treatment.