It can take a lot of trial and error to manage the hidradenitis suppurativa smell associated with flare-ups. The chronic skin condition causes painful bumps (generally in areas where the skin rubs together, like your groin and underarm regions) that can become inflamed and burst open, releasing pus, according to the Mayo Clinic. Not only is this physically uncomfortable, but the fluid may have an odor that makes some people feel self-conscious. On top of that, you may find that antiperspirants and deodorants irritate your skin, which can make it difficult to manage body odor. So we asked individuals with hidradenitis suppurativa for tips on how they deal with this common challenge. Oftentimes, people try their best to reduce flare-ups, but there are ways to manage odor directly when you do get bumps.
1. Identify your hidradenitis suppurativa triggers.
Unfortunately, there isn’t a universal list of triggers that you can monitor to reduce flare-ups, but stress, heat, perspiration, and hormonal changes during menstruation commonly make symptoms worse, according to the National Organization for Rare Disorders. For some people, certain food groups or ingredients may trigger bumps, according to the Mayo Clinic. For example, Annai I., 37, says she experiences fewer flare-ups when she follows a mostly anti-inflammatory, plant-based diet that includes some fish. And when she does have symptoms, Annai’s bumps are typically less severe and don’t burst open. “I went from being in pain 85% of the time to being in pain 45% of the time,” she tells SELF. That said, no specific diet can cure hidradenitis suppurativa, according to the Mayo Clinic. (If you’re interested in making dietary changes to see if it helps your hidradenitis suppurativa, it’s a good idea to talk to your doctor about the best way to do this.)
Tracking your symptoms and lifestyle habits can help you identify triggers. Here are some things to monitor in your journal:
- How often you experience flare-ups.
- The dates of your menstrual cycle.
- What you eat and drink.
- How often you smoke (if at all).
- Your stress levels.
- The weather, particularly warmer temperatures.
2. Use soap that doesn’t aggravate your skin.
Your skin care routine is highly personal, and the cleanser that works for you might not help others manage the hidradenitis suppurativa smell from flare-ups. Your physician may recommend washing areas where you get flare-ups, particularly around skin folds, using an antibacterial soap such as Hibiclens. (Sweat is actually odorless until it mixes with bacteria on your skin, which is why antibacterial soaps help reduce body odor, according to the Mayo Clinic.) However, some people, like Alicia S., 33, find that antibacterial soaps make their hidradenitis suppurativa worse, which can delay healing and increase the amount of time your bumps release fluid. Instead, Alicia uses castile soap. “I soak a washcloth in water and add just a drop of Dr. Bronner’s Pure Castile Soap in peppermint. I work it around the towel to evenly disperse it and then use the towel like a wipe. It helps keep me clean and leaves a refreshing cooling sensation and fresh smell,” she tells SELF.
3. Look for natural deodorants.
You might try to find the most potent antiperspirant and deodorant in order to reduce sweat and body odor, but that could make flare-ups worse, according to the American Academy of Dermatology. Franchesca T., 33 uses Lume (Amazon, $17), a natural deodorant that she swears by. “My former routine consisted of only Hibiclens and regular deodorant, but I found that I could still smell the odor from my hidradenitis suppurativa drainage. I was pleasantly surprised when I used Lume for a few days and didn’t notice any odor at all,” she tells SELF.
4. Keep your underarms as dry as possible.
Minimizing sweat and wearing loose, comfortable clothing that wicks away moisture can reduce body odor and improve your overall scent, according to Susan Massick, M.D., a dermatologist and associate professor in the Division of Dermatology at the Ohio State University Wexner Medical Center. Alicia keeps her underarms dry by keeping washcloths with her to wipe away sweat whenever she feels uncomfortable. These quick-drying washcloths are one good option, Amazon, $18. (She also places washcloths under her clothes to use as dressings for her abscesses.) “They are absorbent so they can keep your flare areas dry and can cover very large areas. Hands down, a huge stack of wash towels has been my best investment,” she says. In place of washcloths, you can also use a gentle retention tape like Hypafix Gentle (Amazon $13) with antibacterial gauze (like this one from Amazon, $5) to cover your wounds.
5. Try using vinegar to mask odors.
Denise P., 50, cofounder of HS Connect, makes her own fragrance using apple cider vinegar because it doesn’t irritate her flare-ups when she sprays the solution directly on her skin. You can try this by filling a two-ounce spray bottle with one part apple cider vinegar and three parts water.
According to Dr. Messick, using diluted white vinegar to clean your bumps can reduce odors during drainage. She recommends mixing one tablespoon of white vinegar with one cup of water. You can soak some gauze or a towel in the fluid and apply it to the affected areas for about 5-10 minutes several times a day. However, this may not work for everyone, and you may find the acid irritating on your skin. If that’s the case, you should avoid using vinegar and consider asking your doctor for gentler alternatives. You might need to try a few of these suggestions to develop a skin care routine that works for you. If you find that your symptoms are worsening, then you might want to look for a hidradenitis suppurativa expert who can help you develop a care plan that improves your quality of life. (Here’s how you can tell if your doctor is knowledgeable about the condition.) It may take some experimentation, but there are ways to manage your discomfort and hopefully improve your confidence.