If you have hidradenitis suppurativa, you’re probably well acquainted with hidradenitis suppurativa armpit flare-ups. This chronic skin disease results in painful bumps that typically occur in areas where the skin rubs together, including the groin, buttocks, breasts—and underarms. These bumps can burst open at any time, which unsurprisingly feels terrible, and can also produce pus that may have an odor.
While hidradenitis suppurativa is painful and challenging no matter where the flare-ups occur, it can be particularly difficult to manage when it occurs in your underarms. The pus can stain clothes, and hair removal methods like shaving can make hidradenitis suppurativa symptoms worse. So, since this can be so tough to handle, we asked people with hidradenitis suppurativa how they manage underarm flare-ups and what advice they have for others.
1. First try to identify what triggers your flare-ups.
Something people with hidradenitis suppurativa quickly learn is that flare-up triggers vary from person to person. Common triggers include stress, heat, and hormonal changes due to things like menstruation, according to the National Organization for Rare Disorders. Some individuals say that certain food groups or ingredients make symptoms worse, while others notice that they have more flare-ups when they are stressed.
When it comes to underarm flare-ups specifically, there’s one particularly inconvenient trigger: sweat. Stephanie H., 34, has had hidradenitis suppurativa for 18 years, and she’s experienced symptoms in her armpits specifically for 10 years. She says that sweating tends to cause a flare-up in her underarms, so she wears tank tops year-round to stay cool. Her favorite brands are Hanes and Danskin. She also uses ice packs or cold towels on hot summer days to reduce the amount of sweating and minimize the risk of a flare-up.
2. Avoid using harsh deodorant or antiperspirant.
Your first instinct to reduce sweat in general but especially when hidradenitis suppurativa armpit flare-ups might be to reach for antiperspirant and deodorant. Unfortunately, that can just make matters worse. Harsh forms of these products may irritate your skin even more, according to the American Academy of Dermatology (AAD). So you might have to experiment to find a product that works for you in this realm if you have hidradenitis suppurativa. Stephanie C., 30, director and co-founder of HS Heroes, finds that unscented sprays cause fewer flare-ups for her than using a product that’s a bar or gel deodorant. “And I only use it when I don’t have open lesions,” she tells SELF.
Others with hidradenitis suppurativa forgo products like deodorant unless they feel it’s absolutely necessary. “I no longer use deodorants [on a regular basis],” Donna A., 70, tells SELF.
3. Stay away from harsh soaps, too.
Here’s another area where it’s really important to find a routine that works for you. Some people with hidradenitis suppurativa use an antibacterial soap like Hibiclens on a daily basis while others only use it during flare-ups or don’t use it at all because they find it’s too harsh for their skin. Overall, many people with the condition use a range of cleansing products or treatments to help manage or prevent symptoms. Kelly M., 44, uses a benzoyl peroxide acne wash, antibacterial topical solution, and benzoyl peroxide cream on her skin, she explains.
“If you’re going to try a product topically, try a test spot first to see how your HS reacts,” Denise P., 50, who co-founded HS Connect and is a long-time advocate for others with the condition, tells SELF. (This can be good advice for trying new skin products no matter which, if any, conditions a person may have!) And no matter what kind of soap you use on your underarms, be sure to avoid using items like washcloths and loofahs, which can be too rough for your skin (especially if you’re dealing with open wounds).
4. Avoid shaving your underarms during a flare-up (or even at all).
The Mayo Clinic definitively advises people with hidradenitis suppurativa to stop shaving the affected skin, and every individual we spoke with mentioned that shaving only worsened their flare-ups.
“I stopped shaving my underarms almost two years ago. Shaving always makes me get flares. I seem to be okay when I use trimmers though,” Ashley A., 34, tells SELF. And Stephanie C. says if she feels the need to remove hair in her underarms, she uses an electric razor to try to irritate the area as little as possible.
If you’re going to shave and you know you’re prone to hidradenitis suppurativa armpit flare-ups, be sure to follow best shaving practices like using some type of moisturizing product when you shave and shaving in the direction the hair is growing (not against the grain).
5. Use dressings to help with drainage.
As we mentioned, one frustrating thing about hidradenitis suppurativa armpit flare-ups is that, in addition to the pain, you might have to deal with abscesses that burst and leak fluid. Using dressings can help you handle this aspect of hidradenitis suppurativa by protecting both your wounds and your clothes. If you haven’t already, check in with your dermatologist to make sure you understand the best dressing protocol for your specific situation. Stephanie C., for instance, uses gentle dressing-retention tape to make sure her antimicrobial dressing adheres to her skin. After leaving the dressing on for a day or two, she removes it in the shower since the water helps get rid of the adhesive.
6. Continue to experiment, and get support if you need it.
One of the most important things to remember is that what works for one person with hidradenitis suppurativa may not work for another. You may find that certain products others recommend actually irritate your skin or make things worse. It’s all about developing a routine that helps make your life with this condition more manageable.
Many people with hidradenitis suppurativa find that a combination of medication, home remedies, and/or surgery can help reduce their pain and improve their quality of life. But if you find that your symptoms are worsening with your current treatment regimen, it’s important to find a dermatologist who has knowledge of this disease and can help you find a treatment or medication that may help. Here are some signs a doctor you’ve found is a hidradenitis suppurativa expert.
It’s also important to note that having hidradenitis suppurativa can greatly affect your mental health. There is no shame in getting professional help or seeking out a support group if you need one. It can help to know you are not alone, especially as you find ways to manage your pain and symptoms.