Navigating hidradenitis suppurativa triggers is difficult. A diagnosis of hidradenitis suppurativa, a painful, chronic condition in which clumps of hair follicles form under the skin when the hair follicles become clogged, usually results in a feeling of relief and confirmation. I would know – I have the condition myself. But I also know very well that people with hidradenitis suppurativa quickly learn that it can be difficult to find the right treatment. What works for some doesn’t work for others. Lifestyle changes – including avoiding triggers for hidradenitis suppurativa – are a helpful way for people with hidradenitis suppurativa to investigate a treatment.
In the following I spoke to Dr. Benjamin Kaffenberger, a dermatologist at Ohio State University̵
SELF: I wanted to start with some basics. For people with hidradenitis suppurativa, how important is it to: a Skin care routine?
Dr. Kaffenberger: There isn’t any conclusive data to suggest that this has to be done in any way, but many dermatologists will say it is important to follow. Most critical is having a soap that has an antibacterial component, like chlorhexidine (like Hibiclens) or something like a dial antibiotic, especially in the skin folds where hidradenitis suppurativa is more likely and where bacterial colonization is occurring can occur.
However, some people with hidradenitis suppurativa may have eczema, as well as other common skin conditions. And they might say, “Hey, I dry out when I put antibacterial soap on my legs in winter.” It is very sensible to use a much gentler soap all over your body except for the folds of skin – armpits, buttocks, groin, under the breasts.
Should people with hidradenitis suppurativa avoid washcloths and loofahs? Do these things irritate the abscesses or boils?
It could. I think it depends on the stage of hidradenitis suppurativa and how severe it is. I think it could definitely be painful for some. But I don’t think it’s really important for patients to avoid this unless they have had draining wounds. If there’s a lot of fluid leaking out, I don’t want them to use a loofah or washcloth just because they could spread bacteria. But if they are in the early stages I think it would be wise to use them.
What should people with hidradenitis suppurativa avoid in pain management? I know that applying a warm compress to boils or abscesses can help relieve pain and / or bring a boil on the head, but are there things to avoid?
Applying a warm compress is probably one of the best things you can do. Patients should not take other people’s pills or exceed recommended limits with pain medication.
In general, if someone wants to see an acupuncturist who focuses on chronic pain, as long as they see someone who is reputable and does not target areas with hidradenitis suppurativa.
And someone with hidradenitis suppurativa shouldn’t try to pop or lance an abscess on their own, right?
Probably not. I have had patients who do this and then the pain feels better, but there is a risk of infection. And to a certain extent it can happen by itself because you are sitting or putting on a warm compress. In general, I would encourage patients not to do this themselves.
What are the risks of wearing tight clothing or using potentially irritating products like detergents or lotions?
You could get an allergic reaction or inflammation. Irritation of the hair follicles could help block the follicles, which would be the first step in hidradenitis suppurativa. So I would be careful with the products that someone uses.