7 Complementary Therapies for Hidradenitis Suppurativa
From aloe vera to zinc, complementary treatments for hidradenitis suppurativa may pick up where conventional medicine leaves off — helping to ease pain, speed healing, and dry up lesions.
Managing hidradenitis suppurativa (HS) poses an array of challenges. This chronic inflammatory skin condition causes multiple symptoms, including painful abscesses in skin folds that ooze pus and give off a foul odor. Each symptom may need to be treated separately.
What’s more, “Some people [with HS] are frustrated with traditional treatments. They may be tired of taking antibiotics or other medications, or they’re concerned about long-term side effects,” says Rita O. Pichardo, MD, a dermatologist at Atrium Health Wake Forest Baptist in Winston-Salem, North Carolina, who runs a clinic for HS patients.
“The response to treatments is also unpredictable,” says Steven Daveluy, MD, professor and dermatology program director at Wayne State University School of Medicine in Dearborn, Michigan. “What works great for one person may not work at all for another. This leads both doctors and patients to be willing to try many different treatments to find the right fit.”
With that in mind, it’s not surprising that 84 percent of people who have HS turn to complementary therapies to help manage the condition.
As is typical of nontraditional medical treatments, most that have been touted to help treat HS have not been proven to work. Several have a good deal of anecdotal evidence to back them up, however, and may be worth trying with a dermatologist’s guidance. “HS is like a puzzle, and we have different pieces to manage it — and every piece counts,” says Dr. Pichardo.
1. Aloe Vera
The thick, fleshy leaves of this succulent contain a gel that is used for an array of medicinal purposes. It can moisturize dry skin, soothe sunburns, and ease irritation and itching. It’s often added to lotions, creams, and other skin-care products.
What it does: Although aloe vera hasn’t been shown to heal HS wounds, it has been found to help ease inflammation related to other skin conditions, and “those anti-inflammatory properties may help in HS,” Dr. Daveluy says.
How to use it: You can buy pure aloe vera gel at your local pharmacy or health food store, or harvest it yourself by slicing a leaf lengthwise and squeezing the gel out. Apply the gel to the affected skin and cover with sterile gauze.
2. Diluted Bleach
At full strength, bleach brightens whites as a laundry additive and kills germs when mixed into household cleaning solutions. As it turns out, it may also help treat some skin conditions.
What it does: Bleach is an antibacterial substance that may help prevent open abscess from becoming infected. It can relieve the pain and itching of lesions and is also thought to decrease levels of inflammatory cytokines, which are proteins that help cells communicate with one another — particularly in the immune system.
How to use it: It may seem potentially dangerous to purposely put bleach on your skin, but it only takes a little bit to be effective. Pichardo advises diluting one-quarter cup of household bleach in a full tub of bathwater. “Soak for 10 to 15 minutes, three times a week,” she says.
3. Epsom Salts
Epsom salts are a naturally occurring mineral salt composed of magnesium sulfate. It’s inexpensive and easy to find at pharmacies, supermarkets, and other stores, as well as online.
What it does: Proponents claim that the magnesium in Epsom salts is absorbed into the skin, although there’s little evidence to support this claim. But, Pichardo says, “An Epsom salts bath can help dry the pus coming from HS lesions, and it will help overall with inflammation.”
How to use it: Create a bath soak by adding about 1 ¼ cups of Epsom salts to a full tub of water. Pichardo also says that you can dampen a clean cloth with a solution of Epsom salts and warm water to use as a compress, applied directly to lesions.
4. Honey
The honey you drizzle on toast or into tea may have benefits that extend beyond sweetening. However, “it’s important to know that we’re not talking about [using] food honey” to treat HS, says Daveluy. “We’re talking about medical grade products made from honey, since they are free from contaminants and safe to use on skin wounds.”
What it does: Honey, particularly a variety called manuka, is antimicrobial and anti-inflammatory and has healing properties, Pichardo says. Laboratory studies have found evidence that honey boosts the immune system via anti-inflammatory and antioxidant activity. It can even be used to treat infected wounds.
How to use it: Honey can be used for HS in a few different ways, says Pichardo: “You can apply it directly to lesions on its own or use a mixture of honey and turmeric. You can also take it by mouth, either alone or mixed in tea or another beverage.”
5. Turmeric
Turmeric is a bright yellow spice that makes a colorful addition to curry powder, stews, marinades, sauces, and more.
What it does: In studies, turmeric has been found to have several potential health benefits, including anti-inflammatory and antibacterial properties, and it is often used to help treat inflammation in dermatologic and rheumatologic conditions, says Pichardo.
How to use it: Turmeric capsules are available at pharmacies, health food stores, and online. Look for a supplement that combines turmeric with piperine, the active compound in black pepper, as research has shown that this common pantry staple enhances the absorption of curcumin.
Piperine also has its own antioxidant and anti-inflammatory effects. “Powdered turmeric can be mixed with water to make a paste, which you can apply directly to HS lesions,” says Pichardo.
6. Topical Menthol Analgesic
An over-the-counter ointment such as Vicks VapoRub includes the active ingredients camphor, eucalyptus, and menthol. It’s typically used as a cough suppressant when inhaled, or as a pain reliever when rubbed on sore muscles.
What it does: Some people who have HS say it helps relieve pain when applied directly to lesions, though there is no published research to support these claims. Some of the topical’s inactive ingredients may offer relief too: Nutmeg oil may help reduce swelling and kill germs, and thyme oil (which is an antifungal) may relieve itching around lesions. Many people also like the strong menthol and eucalyptus scent, which can help mask odors related to HS, Pichardo says.
How to use it: Most people apply a thin layer of ointment to a closed lesion and cover it with a bandage. The important thing to remember is that it should never be applied to open or draining abscesses, says Pichardo.
7. Zinc
Zinc is an essential mineral that helps the immune system fight infection, aids in wound healing, and may even help speed up recovery time from colds. Most people need only a small amount each day: Healthy adult men need 11 milligrams (mg) of zinc per day, and women need 8 mg. It’s found in foods that are high in protein, such as oysters, lobster, crab, beef, poultry, and beans, as well as nuts.
What it does: Zinc helps ensure proper immune system development and function. It’s also known for relieving inflammation.
How to use it: Although the evidence on whether zinc can help with HS symptoms is a bit thin, treatment guidelines state that practitioners may recommend zinc supplements for HS. “I recommend 90 to 100 mg of zinc gluconate daily,” says Pichardo. “The over-the-counter tablets are typically 50 mg each, so take two of those.”
Should You Try a Complementary Therapy for HS?
If you aren’t happy with your current HS treatment, you may want to talk to your doctor about adding a complementary therapy to your current regimen. According to a study that compared those who used alternative therapies to those who didn’t, “Alternative medicine use among patients with hidradenitis is common regardless of disease severity; even mild disease may drive patients to seek alternative treatment.” (Pichardo coauthored the research.)
There are a couple of things to keep in mind though. One is cost: Insurance doesn’t cover nontraditional, over-the-counter therapies such as these. Nearly half of people with HS who use unconventional treatments report spending anywhere from $11 to $50 per month on them, and 1 in 4 spend $51 to $100.
The other is safety and efficacy. “More studies on alternative therapies and HS are needed,” says Pichardo. In her own practice, she uses the experiences of her patients, existing research, and the properties of these therapies to guide recommendations.
Check with your own dermatologist before you try something new to treat HS. They can help you figure out which home remedies may show the most potential for you and are safe to use alongside your existing treatment.
The Takeaway
Hidradenitis suppurativa is a chronic inflammatory illness that can be challenging to treat due to the range of its symptoms, and many HS patients opt to use complementary at-home remedies to supplement traditional medical care.
Several nontraditional options, such as aloe vera, Epsom salts, and topical mentholated ointment, lack definitive scientific evidence as HS treatments — but experts say they’re safe and have enough anecdotal evidence to support trying them.
If you’re unhappy with your current HS treatment regimen, talk to your doctor before adding nontraditional therapies to ensure that they’re not dangerous and will address your specific concerns.
