Finding soaps that cleanse without irritating the skin can be a challenge for people with hidradenitis suppurativa (HS) — a chronic inflammatory skin condition characterized by painful, recurring lesions that develop where skin-to-skin contact occurs. Experts and myHSteam members have shared their recommendations on the best soaps and body washes for people with HS. In this article, we will explore how to choose the right soaps when living with HS, including what to look for and what to avoid.

What myHSteam Members Say About Soaps for HS

Many myHSteam members have discussed the soaps they like to use — and which they avoid. For some, prescribed or medical washes provide thorough cleansing. As one member wrote, “I can control my flare-ups daily with a pink surgical wash called chlorhexidine wash 5 percent. I use it every day in the shower, but find it best to apply for 10 minutes directly to sores, then wash it off. It dries them up very quickly.”

One member shared that they “shower every day using Hibiscrub on my body. Since using this ‘pre-surgery’ wash, my flare-ups have been very infrequent.” Hibiscrub is also sold as Hibiclens.

Some members, however, find medicated washes to be irritating. One member wrote, “The body wash my doctor has me using makes it worse. Showers are the only relief I get.”

Other members reach for gentle cleansers like Cetaphil. “I’ve been using Cetaphil soaps and body wash,” wrote one member. “I don’t use a rag on those areas — just the soap in my hands. Rags make it worse. It’s really been helping.”

Members have also suggested acne bar soap, African black soap, Crusader Safety Soap, Dial antibacterial soap, and carbolic soap.

Types of Cleansers

Even for people without a skin condition like HS, the soap and bodywash aisle at a drugstore can be daunting. Those with hidradenitis suppurativa face the added difficulty of knowing that picking a soap could have major effects on their physical well-being. Knowing what properties to look for when choosing a soap can be a helpful place to start.

Nonsoap Cleansers

Soap and nonsoap cleansers can both clean the body effectively. They differ mainly in their ingredients. To be considered a soap, a body cleanser must be made of fats and oils or fatty acids. Nonsoap cleansers are either partially or entirely composed of synthetic ingredients. For this reason, they’re sometimes referred to as synthetic detergents or “syndet.”

Although using human-made or “unnatural” cleansers may seem counterintuitive, these synthetic detergents have proven milder and less irritating than traditional soaps. They also lack the chemical that causes soap to foam, which can often be harsh on the skin, stripping it of natural moisture and causing it to dry out.

Antibacterial Cleansers

People with hidradenitis suppurativa are commonly concerned about the odor that may result from the rupture of nodules and lesions. When cysts burst, the pus that oozes out consists of bacteria and fragments of tissue cells. The process by which the body’s white blood cells attack these bacteria often emits a chemical compound with the familiar, sometimes unpleasant, odor of HS abscesses. Thus, dermatologists suggest attacking the odor at the source by targeting this bacteria with antibacterial soap. Using a cleanser with an antibacterial agent can help prevent irritation while targeting the source of the odor.

Antimicrobial and Antiseptic Cleansers

There have not yet been many large-scale studies on the efficacy of antimicrobial or antiseptic cleansers on hidradenitis suppurativa. However, there is evidence suggesting that antimicrobial washes lessen bacterial resistance to certain HS treatments, such as antibiotic therapies.

Examples of antiseptic washes include chlorhexidine and benzoyl peroxide. Health care professionals recommend easing into this sort of cleansing treatment, as those with HS often have sensitive skin. Talk to your dermatologist about starting by using antibacterial cleansers once a week and gradually increasing usage up to once per day. Be sure to pat the skin dry (don’t rub) after rinsing.

Tea Tree Oil Cleansers

Tea tree oil, also known as melaleuca oil, is often found in soaps that are used by individuals with hidradenitis suppurativa. Tea tree oil is an essential oil collected by steaming the Australian tea tree’s leaves. Like turmeric, tea tree oil has anti-inflammatory properties and is particularly gentle so as to not dry out sensitive skin. It is also believed to be antibacterial, which may be helpful in managing HS symptoms.

Some myHSteam members have noted success with washes containing tea tree oil. “I’ve been using a medicated soap and Australian Bodycare Tea Tree Body Wash daily, which helps,” wrote one member. Another shared that they “started using a tea tree body wash that is all natural. It helps with odors.”

Some downsides to tea tree oil include its possible side effects and toxicity. Tea tree oil should only be used topically, as it is potentially harmful when ingested. Additionally, it may cause irritation, allergic reactions, dryness, and more in certain individuals.

What To Avoid in Soap for HS

Certain common soaps and skin care products can irritate the skin of people with hidradenitis suppurativa. Talking to your dermatologist is a helpful way to determine what ingredients disagree with your skin, but there are also some general substances to avoid.

The U.S. Food and Drug Administration (FDA) has identified five types of ingredients in cosmetics that can cause skin irritation and allergic reactions. Of these, fragrances, preservatives, and dyes, in particular, may be found in soaps.

Fragrances and Dyes

Most dermatology guides recommend avoiding products with fragrances or dyes. These products contain extra chemical ingredients that are known to irritate the skin.

Parabens

Parabens are used in some cosmetic products as preservatives. They help prevent the growth of bacteria, fungi, and yeast. These preservatives have been known to cause irritation and allergic rashes in some people.

Cleansing Practices and Procedures

It is best to apply skin care and cleansing products with one’s hands. Common items like washcloths and loofahs not only breed bacteria or their own, but can also irritate the skin. When washing affected areas, gently cleanse without squeezing or aggravating lesions. Keep the skin dry when possible and avoid scrubbing. Try not to shave or use hair removal products on affected areas in order to reduce irritation and discomfort. Aloe vera or a warm compress may also be applied to particularly irritated skin.

You Are Not Alone

Living with hidradenitis suppurativa can be difficult. It can help to find a community that understands. By joining myHSteam, the social network made exclusively for people with hidradenitis suppurativa and their loved ones, you can connect with, answer questions for, support, and share stories with others who understand life with HS.

Have you found a soap that works well with your HS? Share your recommendations with others in the comments below or by posting on myHSteam.