8 Wound Care Tips for Hidradenitis Suppurativa

It’s important to care for HS wounds properly to promote healing and prevent infection. These tips can help you stay comfortable, avoid staining your clothes, and protect your skin from irritation and infection.

Your recommended dressings and cleaning instructions may depend on the severity and depth of your wounds, where they are located, and how well they are healing.

“[Care] has to be tailored to what’s going on with your skin in the moment,” Sayed says.

After surgery, you usually should wash your wound once a day with soap and water, says Joslyn Sciacca Kirby, MD, an associate professor and the vice chair of education in the department of dermatology at Penn State College of Medicine in State College, Pennsylvania. The goal is to remove any buildup of liquid draining from the wound and any petroleum jelly used to keep the wound moist.

A mild cleanser is fine, Sayed says. There’s no need to use harsh soaps, scrubs, or rubbing alcohol.

“Occasionally, patients will use harsh chemicals, but most learn pretty quickly that if they’re too rough on that skin, it’s just going to make things worse,” Sayed says.

“If hygiene fixed HS, there’d be no HS,” Sayed says. “The first thing that these patients or anybody else does if they’ve got pus draining from an area is to try to keep the area clean and protect it the best they can. But it’s not as simple as that.”

Sayed suggests applying a thin layer of petroleum jelly to a wound to soothe pain and even aid healing.

“A moist wound base is usually more ideal for healing than if it sort of dries out and crusts over, and a big scab forms,” he says.

After applying petroleum jelly, top the wound with a dressing that will absorb fluid.

“What can be challenging is that a wound after surgery and the wounds from the inflammation of HS can create a lot of liquid (and) a lot of drainage,” Dr. Kirby says. “So we need something to catch that. Because if it just sits against the skin, it’ll cause more irritation to the surrounding skin and sometimes get in the way of healing.”

Your health insurance might cover dressings made of highly absorbent alginate or foam, Kirby says. If not, simple gauze can work well.

Use a gentle medical tape to affix the dressing to your skin, placing the tape a few centimeters away from the actual wound, Sayed says. Many adhesive tapes and bandages are irritating, especially if you must apply them daily.

“A lot of patients like a type of tape called Hypafix,” he says. “It’s a cloth tape that’s a bit more flexible and breathable and gentle than a lot of other medical tapes.”

• Odor If your wound has an unpleasant scent, you could apply a washcloth soaked in diluted vinegar to the area before you apply new dressing.
• Pain An antiseptic wash between dressings could relieve discomfort.

Pus can make HS look like an infection, even though it is not.

“One of the things with these chronic HS wounds is that a lot of people fear that they’re going to get infected, and it’s often misdiagnosed as infection,” Sayed says.

HS complications may lead to an infection, however. It’s important to watch for danger signs so that you can catch and treat infection early if it does occur.

“If it looks like it’s beyond a typical flare, it’s worth talking to your doctor,” Sayed says.

If you are a woman with a flare under your breasts, consider avoiding bras that will rub and create friction.

“Sometimes it’s a matter of using a soft bandage underneath an elastic bra strap that will hold it in place,” Sayed says.

Good wound care is helpful, but it’s not always enough. Sometimes HS inflammation causes wounds that break open and leave behind a hole that does not seem to heal, Kirby says.

“That’s really a sign that the HS inflammation, the power of the immune system, is not being adequately controlled,” she says. “It’s not because of what you’re doing on the surface. It’s because of the immune system that this wound isn’t healing.”

Kirby says that a healing wound fills in from the bottom first, and you will start to see a new film of skin stretching over the top. If the moist, shiny center of the wound is getting smaller, that’s good news. Reach out to your dermatologist if your wound:

• Does not start closing
• Reopens after filling in
• Starts a cycle of pain, redness, and drainage

• Hidradenitis suppurativa wounds may take weeks or months to heal.
• It’s important to clean the wound area at least once daily using only soap and water.
• A thin layer of petroleum jelly atop the wound may help it stay moist and heal faster.
• Although a hidradenitis suppurativa wound may look infected, it may not be. Watch for warning signs of infection beyond the oozing of pus.
• Contact your healthcare provider if your wound does not close, reopens, or becomes consistently painful.