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- Best antiseptic cleanser: Dye-Free Antiseptic Cleanser
- Best spot treatment: SOS Daily Rescue Facial Spray
- Best for minimizing infection: Solimo 99% Isopropyl Alcohol
- Best prescription topical: Clindamycin
- Best natural ointment: First Honey Sterile Manuka Honey Ointment
- Best soothing ointment: Bio-First Manuka Skin Saver
- Best for applying medications: Antimicrobial Q-Tips Cotton Swabs
Hidradenitis suppurativa, or HS, is a skin condition that causes painful lumps in the skin, usually in parts of the body where skin touches skin. These lumps can look like pimples or acne-like nodules, which is why many people don’t initially seek a diagnosis. However, without treatment, the skin condition can worsen to the point that it impacts your quality of life.
Research into HS has given us a better understanding of this chronic disease, including treatment options designed to manage symptoms. While HS cannot be cured, it can be treated and controlled with medications and lifestyle changes.
Read on for a look at HS, plus 10 topical products that can help manage symptoms.
HS is sometimes called acne inversa, but it’s not a form of acne. It’s a chronic skin condition that causes painful skin breakouts in any of these areas:
- inner thighs
- beneath the breasts
- between the buttocks
The axilla is the most
During a breakout, people with HS may develop red bumps that resemble pimples, deeper cysts, or boils. These breakouts are often painful, and the lesions can leak or drain. Without treatment, symptoms can get worse and may lead to abscesses that break open and leak blood and pus. When these abscesses heal, they often leave scars.
Abscesses can continue to develop in the same area. Over time, the cycle of developing abscesses and scarring creates tunnels beneath the skin, known as sinus tracts. Left untreated, HS can impair your ability to sit, walk, stretch, or bend.
Topical treatments won’t cure HS, and they aren’t enough to manage HS flares on their own. However, different topical products can be helpful for specific outcomes, such as cleansing affected areas, promoting lesion healing, or easing irritation.
Topical clindamycin, an antibiotic, is typically the first treatment therapy for mild HS.
Other topical products may also help reduce inflammation during an HS flare.
To assemble our list of the best topicals for HS, we looked for feedback from people who have used these products to treat their symptoms successfully. We prioritized brands with positive reputations in the market. We also ensured every product we included meets our internal standards for credibility and good business practices. Learn more about our vetting process.
Best antiseptic cleanser
- Price: $11.49
- Key ingredients: chlorhexidine gluconate
This antiseptic cleaner can be used to clean bacteria around active HS flares. Lesions that burst and are slow to heal need to be kept clean to avoid infection, and this cleanser is a good option for reducing bacteria.
The pump top makes it easy to dispense, and reviewers say it lathers well and isn’t overly drying.
Note that this cleanser should not be used in the genital area.
Best spot treatment
- Price: $28
- Key ingredients: hypochlorous acid, hyaluronic acid, ceramides
This spray is formulated for the face, but it can be safely used over the whole body to soothe active HS flares, including open wounds. According to Tower 28, the hypochlorous acid in this spray has antibacterial and anti-inflammatory properties, which can help promote healing and repair damaged skin barriers.
Best for minimizing infection
- Price: $5.84
- Key ingredients: isopropyl alcohol
HS flare-ups often mean managing open wounds. That means it’s essential to keep the skin clean. Sanitizing with this first-aid antiseptic, which is 99% isopropyl alcohol, can help prevent the risk of infection.
Best prescription topical
- Price: varies (available by prescription)
- Key ingredients: clindamycin phosphate topical suspension
Clindamycin has been extensively
Best natural ointment
- Price: $12.89
- Key ingredients: medical grade Manuka honey from New Zealand
This sterile Manuka honey ointment helps create a moist protective barrier that naturally cleans HS lesions, prevents infection, and minimizes scarring. It also keeps surgical pads from sticking to open wounds, which can slow down the healing process. It can minimize pain on contact too.
Best soothing ointment
- Price: $40
- Key ingredients: medical grade Manuka honey, aloe vera, milk thistle
This steroid-free gel uses medical-grade Manuka honey with a number of other skin-soothing ingredients to soothe multiple skin issues, including eczema, psoriasis, and skin compromised by radiation therapy. For HS lesions, it offers a light, protective film over the skin to soothe and promote healing.
Best for applying medications
- Price: $9.96
- Key ingredients: cotton
To keep HS cysts as clean as possible and avoid the possibility of introducing bacteria, it’s important to apply topical products with something sterile. These cotton buds make it easy to gently apply products to sensitized skin and active HS flares.
Topical treatments used to treat HS can have side effects. These include a burning sensation upon application, redness, general skin irritation, or itching.
Expert Insight: Dr. Amanda Marsh
We want patients with HS to wash gently without friction. The most common recommendations for use of flares are benzoyl peroxide, zinc pyrithione, and chlorhexidine as antiseptic cleansers. During flares, patients may often receive intralesional kenalog (steroid) injections to help minimize the symptoms and decrease the size of the flare. Diluted white vinegar can help decrease odor as well. We want to prevent infection, help minimize inflammation, and decrease pain. Some topicals (wash or medication) may require patients to perform a patch test as we do not want further irritation to these areas.
Managing HS flare-ups often involves multiple therapies and lifestyle changes.
- Personal hygiene: HS isn’t caused by poor hygiene, but the right products to wash the skin can help manage pain and prevent flares. Look for gentle, soap-free body washes that have no fragrances or soaps to help prevent irritation.
- Clothing: Tight clothing can rub affected areas and worsen flare-ups. Loose-fitting clothing made with natural fibers, such as cotton and hemp, can help air circulate. Soft-cupped bras and underwear without elastic on the legs can also reduce irritation on any existing bumps. If you’re worried about bumps breaking open and staining your clothes, a breathable base layer is a good option.
- Diet: Anti-inflammatory foods, such as fresh fruits and veggies, oily fish, and healthy fats, can help minimize flares. Some small studies have found that dairy appears to worsen HS symptoms.
- Healthy habits: If you currently smoke, definitely try to stop. There’s also evidence to suggest that weight loss can help reduce HS symptoms in people who with overweight.
- Community support: Chronic conditions can be isolating. Online support groups for people with HS will put you in contact with people who really understand what you’re going through, which can help you feel supported.
Speak with your doctor about specific things you can do to help manage HS.
What clears up hidradenitis suppurativa bumps quickly?
HS bumps may last a week or 2. It’s important to work with a doctor to create a treatment plan that treats existing bumps and helps prevent new ones. This may be a combination of topical and oral medications and lifestyle modifications.
What triggers hidradenitis suppurativa?
Researchers believe that cigarette smoking is the leading trigger for HS. According to the American Academy of Dermatology Association, between 70% and 90% of people with HS smoke. It’s also more common in people with obesity.
Stress, hot weather, and foods high in sugar or containing dairy may be potential triggers.
For people with menstrual cycles, hormones may also trigger an HS flare-up.
Is hidradenitis suppurativa contagious?
No. While doctors aren’t sure what causes HS, they do know it’s not contagious. It’s also not the result of poor hygiene or infection.
Will hidradenitis suppurativa ever go away?
HS can’t be cured, but there are treatments to manage current flares and help prevent new ones. If you suspect you have HS, it’s important to work with a doctor for a diagnosis and a customized treatment plan. Without treatment, HS can create scars that will ultimately affect your quality of life.
Managing HS properly can’t be done with creams, cleansers, and ointments alone. The best approach is to work with your doctor for a personalized treatment plan to address existing flares and help prevent new ones.
Knowledge is power when you live with HS. Explore our resources for first-person perspectives, nutrition tips, managing physical and mental health, and much more.
Jessica Timmons has been working as a freelance writer since 2007, covering everything from pregnancy and parenting to cannabis, chiropractic, standup paddling, fitness, martial arts, home decor, and much more. Her work has appeared in mindbodygreen, Pregnancy & Newborn, Modern Parents Messy Kids, and Coffee + Crumbs. See what she’s up to now at jessicatimmons.com.