Hidradenitis Suppurativa Wound Care

Managing the wounds of hidradenitis suppurativa (HS) can present its challenges. Wounds that occur in HS can be painful and embarrassing. They can also impact your daily life. Trying to find information on the best way to manage these wounds can be overwhelming.

It is important to talk to your doctor to make sure you are using the best products for your current wounds. However, sometimes seeing your doctor does not always give you all the answers you need when it comes to wound care.

Understanding overall wound care can help you manage your HS symptoms and improve your quality of life.

What do HS wounds look like?

Wounds in HS may look different for everyone. However, there are some features to HS wounds that are similar for everyone:^1,2

• The wounds occur in areas that rub together, have sweat glands, or have oil glands
• Many of the wounds drain at some point
• Wounds vary in inflammation, with some being very painful

There are other features to HS wounds that make them challenging to treat. Many times HS wounds involve tunneling, where a wound develops a hollow space under the skin. This hollow space makes it easier for the wound to get infected and cause more complications. It is also harder to treat wounds with tunneling.

Since some of the wounds in HS may allow for bacteria growth, these wounds may have a bad odor. Not only are these challenging to treat, they become embarrassing and emotionally distressful.

Goals of wound care

Not all HS wounds are the same. However, wound management in HS includes goals that are common to everyone. These include:³

• Prevention of infection
• Decrease scarring
• Management of pain

There is not one common wound care regimen for HS. This can make it confusing, since you may hear different recommendations. Remember to speak to your doctor about wound care.

Basics of wound management in HS

Not all wounds are the same. This holds true for the wounds that happen with HS as well. However, there are basic steps to wound management that are true for everyone.

Cleaning and preventing infection:³

• Antibacterial washes, soaps, or creams may be recommended
• Mild soap and water may help to prevent further irritation

Promoting and supporting drainage:³

• Specific dressings may be used for excessive drainage, such as hydrocolloid dressings
• If you require surgery for your wounds, advanced dressings may be used
• You may need to use absorbent dressings between your wound and clothing in order to soak up the wound drainage

Promoting healing:³

• Maintaining a moist (not wet or dry) wound base
• Frequent dressing changes may be needed
• Wearing breathable, loose-fitting clothing
• Advanced wound care may be needed for wounds hard to heal
• Managing underlying medical conditions that decrease healing

Underlying conditions and the impact on wound care in HS

Doctors use the term comorbidity to describe a condition or illness that occurs at the same time of another condition or illness. Morbidity should not be confused with the term mortality. Morbidity means disease or illness, and mortality means death.⁴

There are several comorbid conditions in HS. Make sure and discuss these conditions with your doctor so you can have a game plan on managing these potential conditions.

Because HS causes chronic irritation or inflammation within the body, the comorbid conditions of HS are also ones that are known to be caused by this as well. Certain comorbid conditions make wound healing more difficult and can co-exist with HS. Examples of these include:

• Obesity
• Diabetes
• Impaired hormone function

In short, wound management in HS is not a one-size-fits-all solution. Talking to your doctor, maintaining a healthy weight, and managing underlying conditions will all help to support wound care in HS.

Be mindful that your wound care needs may change depending on flares and remission of HS. There are options available, and having the knowledge about wound care in general will help you be better informed about your wound care needs in HS.