People with hidradenitis suppurativa (HS) who have painful abscesses in the groin and buttock region experience discomfort when using the toilet. As one myHSteam member asked, “Does anyone else suffer from boils, hard lumps, or spots inside their lady parts?”
An inflammatory skin condition, HS affects areas that have hair follicles, such as the underarms, and causes abscesses across the body. Hidradenitis suppurativa symptom commonly appears around the inner thighs and groin area, which can make bathroom trips uncomfortable. “For patients with open wounds on the labia or perineal area, there is potential for discomfort with urination or bowel movements,” said Dr. Chris Sayed, a dermatologist at the University of North Carolina School of Medicine.
Here, we share tips for pain relief and cleanliness when managing HS that affects the genitals (such as vulvar HS, which affects the vulva) and buttocks. If you experience any new symptoms, make sure to update your dermatologist before trying any home remedies.
In some cases, applying specially formulated creams or ointments can help prevent the stinging and irritation that come with toilet use. “Barrier creams with zinc oxide (such as Desitin and A+D Ointment) can act as barriers that protect the skin and minimize stinging,” Dr. Sayed noted.
Topical skin care can be an underestimated tool against the bacteria that cause HS. These creams not only provide moisture to reduce redness and irritation —they’re also medicated, providing an antimicrobial shield to prevent inflammation. These medications can be prescribed by your doctor or purchased over the counter at your local drugstore.
Consider asking your dermatologist whether cool or warm compresses can help. One myHSteam member said, “I have chronic lesions in that area, unfortunately, and I’ve only found cold compresses to help.” Another member said, “I try to press hot compresses between times that I use the bathroom.”
Generally, heat is associated with increased inflammation and swelling because it causes blood to rise to the surface, so it may not be the best therapy for HS flares. However, when a boil is about to burst, a lukewarm wet towel can help soften the skin. Cold compresses reduce swelling, but be sure to cover ice with a towel or washcloth before applying it to skin to reduce discomfort.
Some people with HS have success after swapping toilet paper for hypoallergenic, unscented wet wipes. This can help reduce inflammation by minimizing friction while also ensuring a cleaner bathroom experience. “Sensitive skin sanitary wipes may be more gentle on the skin than standard toilet paper for some patients,” Dr. Sayed said. Make sure these products do not contain perfumes or deodorants, which can include allergens or irritants.
Some people with HS nodules in the groin area use sanitary napkins to pad undergarments and keep a clean environment for affected skin. These products help soak up excess moisture, pus, and discharge, and you can change them each time you use the bathroom.
A variety of natural remedies may provide anti-inflammatory symptom relief:
It’s also important to avoid certain products that might be found in your medicine cabinet. Tea tree oil, although praised for its antifungal properties, is known to clog pores and worsen the pus associated with HS. You shouldn’t use rubbing alcohol on large surfaces or routinely — it can severely dry your skin and cause cysts to burst.
Bleach baths, though often used by people with eczema, can actually worsen HS abscesses. Make sure to consult your doctor before trying any home remedies, especially those you’d use topically on sensitive and symptomatic skin.
Although HS is not caused by poor hygiene, it doesn’t hurt to keep affected areas extra clean. One myHSteam member shared, “I wash that area every time I use the bathroom.”
Antibacterial soap and warm water on external body parts can help disinfect your skin without irritating it. Make sure to avoid commercial body washes and cleansers that contain irritating ingredients, and take care with water temperature — hot water can cause burns and irritation.
However, don’t feel limited to using the toilet only when at home. “Public toilets don’t present particular risks,” explained Dr. Sayed. Just make sure to use toilet seat covers when available and wash affected areas when you return home.
Diet and exercise are known to improve HS symptoms. One myHSteam member said, “I do find that cleaner diets do decrease the flare-ups.”
Because obesity is a major risk factor for HS, losing weight through daily exercise and a healthy diet is often the first step toward reducing triggers for HS and other related comorbidities (conditions that occur with another disease).
Practicing self-care through engaging in daily movement and eating fresh, unprocessed, anti-inflammatory foods can help improve your well-being and overall quality of life. Examples of HS-friendly eating plans include Mediterranean and plant-based diets, as well as low-sugar, low-dairy diets. Cutting use of alcohol and tobacco has also been shown to reduce the severity of HS and improve overall wellness.
HS treatment options include antibiotics (both oral and topical), birth control pills, corticosteroids, retinoids, biologics, and a variety of skin procedures. For genital HS in particular, one member gets corticosteroid injections that quickly clear bad flare-ups: “My dermatologist gives the worst breakouts an injection, and they go down immediately.”
Following your treatment plan exactly as prescribed by your physician can help you prevent HS flares and treat your HS. This should reduce the risk of both genital flares and symptoms in other areas.
Keep in mind that the genital area is sensitive, so excisions and lancing might not be an option for HS boils around this area. One member shared, “My dermatologist will not lance genital boils. I do not recommend asking for them to be lanced unless they are extremely large.”
If you are facing unusual side effects or feel that your treatment isn’t working, speak with your doctor about making changes to your HS skin care regimen.
On myHSteam, the social network for people with HS and their loved ones, more than 27,000 members come together to ask questions, give advice, and share their stories with others who understand life with hidradenitis suppurativa.
What are your struggles with bathroom comfort and cleanliness with HS? Do you have any life hacks to share with other people living with HS? Share your experiences in a comment below or on your Activities page.