Living with Hidradenitis Suppurativa (HS) often involves managing abscesses and wounds, which can vary significantly in healing time and severity. This guide provides detailed tips for handling typical HS wounds—not surgical or deep wounds—while offering product recommendations, home remedies, and insights to help you heal effectively.

ATTENTION: This article does NOT apply to surgical wounds or large, deep wounds. Please follow your physician’s instructions for those types of wounds. This guide is intended for typical HS wounds. Adults should supervise their children when tending to wounds, as their skin can be more sensitive. Always test products on a small area of skin first to ensure there is no adverse reaction.

The content provided here is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with your physician or a qualified health provider for any questions regarding a medical condition. Never disregard professional medical advice or delay seeking it based on information from this article.

If you suspect a medical emergency, contact your doctor, go to the emergency department, or call emergency services immediately.

Encouraging an Abscess to Drain

When an abscess is close to draining:

  1. Use Warm Compresses: Moist, warm compresses soften the skin and encourage drainage.
  2. Natural Moist Packs: Options include:
    • Basil, witch hazel, or turmeric
    • Medi-honey or regular honey
    • Bread soaked in milk
  3. Bath Soaks: Try Epsom salt or apple cider vinegar baths. Learn more about bath options here.

If an abscess isn’t ready to drain, avoid applying heat, as it may worsen inflammation. For further guidance, explore more on heat and inflammation here.

Managing Abscesses Not Ready to Drain

  • Cold Therapy: Ice packs can reduce swelling and pain. Use a towel or washcloth as a barrier to prevent ice burns.
  • Over-the-Counter Relief: Ibuprofen or acetaminophen can help control inflammation and discomfort.

When dealing with deep abscesses, avoid poking or prodding them. Instead, give them time and keep the area clean and protected. More info here.

Caring for Draining or Open Wounds

  1. Clean with Saline: Wash the wound 1–3 times daily using a saline solution (DIY recipe below).
  2. Bandage Properly:
    • Avoid Band-Aids; they trap moisture and bacteria.
    • Use gauze and secure with minimal tape to prevent irritation. ABD pads can provide extra protection.
  3. Prevent Sticking: Apply a small amount of Vaseline to keep bandages from sticking.
  4. Air Out the Wound: Allow the area to breathe whenever possible, especially at bedtime.

If healing stalls after a couple of weeks, consider Colloidal Silver Gel or consult a dermatologist about steroid injections or debridement.

DIY Saline Solution: Mix 1 cup of warm water with ½ teaspoon of salt (preferably sea or Himalayan salt). Store in an airtight container for up to 15 days.

Supporting Healing with Nutrition

  • Protein: Vital for wound healing. Incorporate lean meats, legumes, or protein shakes (low in sugar). More on protein here.
  • Vitamins: Zinc and Vitamin C may accelerate healing if deficiencies exist. Learn about zinc dosing from Dr. Vivian Shi here.

Soothing Itching, Rashes, and Irritation

  • For Itching: Try Caladryl, Bactine, or zinc oxide creams. Non-drowsy antihistamines can also help.
  • For Rashes: Aloe, Aquaphor, or coconut oil provide relief for irritated skin.
  • Soaps: Use unscented options like Castile soap or Hibiclens, but avoid overuse of antibacterial soaps to protect beneficial bacteria.

Wound Care Supplies

If you’re managing frequent wounds, ask your doctor about prescribing supplies, which may be covered by insurance:

  • ABD pads and gauze
  • Skin barrier wipes for sensitive skin
  • Secure tape options

For a video guide on HS wound care by Katie Scherling, ARNP, watch here.

For products, discussed in the video, click here. 

Additional Treatment Options

  • Steroid Creams or Injections: For stubborn inflammation. Discuss these with your provider.
  • Biologics: Learn about available treatments here.
  • Hormones: If hormones trigger your symptoms, consider hormone therapy here.
  • Botox: May help if excessive sweating triggers symptoms. More here
  • Surgery: Explore options for severe cases here.

Practical Clothing Tips

  • For Lower Body: Cotton bike or yoga shorts reduce friction and hold bandages in place.
  • For Upper Body: Fitted cotton tops minimize irritation.

Avoid shaving; use a trimmer instead. If you must use deodorant, opt for aluminum-free, natural options.

Things to Avoid

  • Picking or Squeezing: This can worsen inflammation and delay healing.
  • Overuse of Heat or Moisture: Can increase bacterial growth.

Final Thoughts

Managing HS abscesses and wounds requires patience, care, and attention to your unique needs. While this guide offers helpful suggestions, always consult with your healthcare provider for personalized advice. With the right approach, you can promote healing and reduce discomfort effectively.

Wound care is a standard part of HS, no matter what stage. Please do not self lance and if you suspect cellulitis with any abscess, please see medical attention ASAP.

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