“I’ve had an abscess break in the crease of my armpit, and it will not heal. Just keeps ripping open with almost every movement,” one member of myHSteam said. Another replied, “I’m still trying to heal my sores — they open and then close, and open, and drain, and bleed a little.”
There’s nothing quite like the satisfaction of seeing a hidradenitis suppurativa (HS) wound finally close. For many people, though, reaching that healing stage takes patience and persistence. HS is a long-term skin condition, and flare-ups can make recovery slow. Learning what affects healing can help you feel more prepared.
If you have open HS wounds, here are some tips that may help them heal. Keep in mind that if you received a wound care plan from your dermatologist, you should follow the instructions carefully. Use home remedies only if your dermatology team says they’re safe.
Make sure your HS wounds stay clean, since this can help prevent infection. When you wash a wound, be very gentle, because scrubbing or rubbing may slow the healing process. You can also create new inflammation by rubbing your skin too hard, which can make HS symptoms worse.
Most dermatologists recommend using warm water and mild soap during cleansing. There’s no single cleanser that works best for HS. Finding the best soap for you may take trial and error. You can talk with your dermatologist, who may recommend a prescription soap.
Once your wound is clean, pat it dry with a soft towel. Be very gentle as you dry it so you don’t damage any healed skin. If you see any scabs forming around the wound, leave them alone. Picking at scabs can make healing take longer.
After cleaning an HS lesion, make sure it dries completely. Then cover it with a bandage or dressing so it can heal without being exposed to irritants. Most healthcare providers recommend using a sterile dressing that won’t stick to the abscess (a pus-filled bump under the skin). Using foam or gauze dressings may be ideal.
The best HS wound dressings are very absorbent. That way, any wound leakage won’t sit on your abscess. If the dressing gets wet or dirty, replace it with a new, clean dressing. Keeping your wound dry can improve healing. Frequent dressing changes may make this easier. The cost of dressings can add up. In some cases, your insurance company may cover the cost of bandages. Ask your doctor about insurance coverage for wound dressings.
Your healthcare provider may suggest applying a topical antibiotic or other cream to the wound before applying your dressing. Only apply topicals that your dermatologist recommends.
“I cover my HS wounds with a hydrocolloid dressing, which acts as a second skin,” one myHSteam member said. “I change it twice a day. I find that if I use a Band-Aid, the wound closes and then just fills up again.”
To help wound healing, consider wearing loose, flowing clothes. Tight clothes can cause irritation and prevent your wounds from healing properly. Make sure the fabrics you’re wearing are breathable and let the air flow through them. Light fabric helps prevent moisture from collecting against your skin. For example, consider underwear made of bamboo, silk, or 100 percent cotton.
“Wearing loose clothing definitely helps,” one myHSteam member wrote. “And cleaning the area regularly and reapplying antibiotic creams or whatever is advised by your doctor helps a lot, too.” Another member said, “I had four large boils on my breast, and I couldn’t wear a bra. I found loose cotton tops were helpful.”
Depending on where your HS wounds are, you may need to adjust your activities temporarily. For instance, if you have open lesions on your armpits, try not to reach over your head because it may cause a healing wound to break open. Consider similar adjustments based on the affected areas of your skin.
“Currently dealing with yet another flare-up, this time on the side of my breast,” one member said. “It’s super sore, especially when I bend over to pick anything up, so I have to avoid that.”
It’s very important to keep your HS wounds clean, dry, and covered. But you might also consider making some lifestyle adjustments that can help reduce chronic inflammation. That way, your wounds may heal faster.
It’s hard not to be stressed out when you’re managing open wounds. But stress can make HS symptoms worse. “I just can’t seem to completely heal,” one myHSteam member said. “I get so close, then my anxieties kick in, and I’m back to the same lesions recurring!”
To curb stress with HS, consider practicing mindfulness. Mindfulness includes deep breathing exercises, meditation, or other activities to help you relax. Connecting with other people who are living with HS may also help cut stress in your life. Hearing that you’re not alone and getting tips from others with the same diagnosis can provide comfort.
If you aren’t able to cut stress using these strategies, ask your provider for a referral to a mental health professional. They can provide techniques that may help you reduce your stress and hopefully ease your inflammation.
People living with HS may have trouble sleeping well. This can be due to itching, having pain, or needing to change positions to avoid disturbing wounds.
To improve your sleep, make sure your bedroom is dark, cool, and quiet. If you live in a noisy area, consider trying earplugs at night. Avoid alcohol and caffeine before bedtime, and try to limit your use of screens such as your phone or computer before you go to sleep. Sleeping better could help make it easier to manage your HS and improve your quality of life.
In many cases, you may be able to heal your HS lesions at home with over-the-counter solutions and a regular skin care routine. But sometimes, you’ll need medical advice before you can heal.
It’s important to get medical attention for chronic wounds that won’t heal or for those that become swollen, warm, or discolored, which may indicate infection. Your doctor may need to prescribe antibiotics or specialized wound care supplies. They can also decide whether your HS treatment plan may need to be adjusted to prevent future flares.
If you have a fever that spikes or you see an infection that’s spreading away from the wound, you may need to go to the hospital. Check with your doctor at the first signs of infection, and if you can’t reach them, go to urgent care or the emergency room.
On myHSteam, people with hidradenitis suppurativa come together to ask questions, share advice, and find support from others who understand life with HS.
How do you heal your HS wounds at home? Let others know in the comments below.
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