Bathing, Showers, and Hygiene for Hidradenitis Suppurativa
A practical, evidence-informed guide to daily hygiene routines that can help reduce irritation and support skin health for people living with HS.
Medical Disclaimer: This page provides general educational information only. Hidradenitis Suppurativa is a chronic inflammatory disease that requires medical diagnosis and treatment. Hygiene routines support symptom management but do not cure HS. Always consult a board-certified dermatologist for personalized guidance.
Why Hygiene Routines Matter in HS
Hidradenitis Suppurativa (HS) is a chronic inflammatory skin disease that causes painful nodules, abscesses, and tunneling lesions in areas where skin rubs together. While hygiene routines cannot cure HS or stop the underlying inflammatory process, thoughtful daily habits can play an important role in reducing irritation, managing bacterial colonization, and supporting overall skin comfort.
The right bathing routine helps protect the skin barrier, minimize friction, and keep affected areas clean without triggering additional inflammation. This guide covers the key elements of an HS-friendly hygiene routine, from water temperature and cleanser selection to drying techniques and clothing choices.
Section 1: Ideal Water Temperature
Recommended Range
92 - 100 degF
33 - 38 degC
Why warm water helps
- Reduces skin irritation during washing
- Supports circulation without worsening inflammation
- Allows cleansers to work effectively
Why hot water should be avoided
- Increases inflammation in affected areas
- Dries out and damages the skin barrier
- Can worsen tenderness and swelling around lesions
Illustration: Recommended water temperature range for HS hygiene routines
Section 2: How Long to Bathe or Shower
Recommended Duration
10 - 20 minutes
Keeping showers or baths within this range helps balance effective cleansing with skin protection. Extended soaking sessions beyond 20 minutes can sometimes cause problems for HS patients:
- - Prolonged water exposure can soften and macerate lesions, making them more vulnerable to irritation
- - Extended soaking may disrupt the skin barrier, reducing its ability to protect against bacteria and friction
- - Long hot baths in particular can increase inflammation in affected areas
Section 3: Gentle Cleansing Methods
Friction is a well-recognized trigger for HS lesions. The way you wash is just as important as what you wash with. Gentle technique helps cleanse effectively while minimizing mechanical irritation to affected skin.
Recommended
- Wash with clean hands or a soft washcloth
- Use gentle circular motions without pressure
- Let the cleanser do the work
Avoid
- Loofahs and mesh bath sponges
- Abrasive scrubbers or exfoliating pads
- Aggressive scrubbing over lesions or tender areas
Illustration: Gentle cleansing technique using warm water and soft cloth
Section 4: Cleansers Commonly Used by HS Patients
Some dermatologists recommend antimicrobial or anti-inflammatory cleansers as part of an HS management routine. These are not cures, but they may help reduce bacterial colonization and support skin health. Always consult your dermatologist before starting any medicated cleanser.
Benzoyl Peroxide Washes
Antimicrobial properties may help reduce bacterial load on the skin surface. Available in 4-10% concentrations. Can be drying with frequent use.
Chlorhexidine Washes
A broad-spectrum antiseptic sometimes recommended by dermatologists for HS. Often used as a body wash in affected areas. Can cause skin dryness.
Zinc-Based Soaps
Zinc has anti-inflammatory and antimicrobial properties. Some HS patients find zinc-based soaps gentler than stronger antimicrobials.
Sulfur Cleansers
Sulfur has a long history of use in dermatology for its antimicrobial and keratolytic properties. Some patients use sulfur soap as part of their routine.
Safety reminder: Avoid contact with eyes, mouth, and sensitive mucosal areas when using medicated cleansers. Rinse thoroughly. If irritation worsens, discontinue use and consult your dermatologist.
Section 5: Optional Soaks Some Patients Use
Some people with HS experiment with soothing bath additives as a complementary comfort measure. Evidence for these approaches in HS specifically is limited, and medical guidance is important before trying them.
Epsom Salt Baths
Some patients report temporary comfort. Limited clinical evidence in HS specifically. Use warm (not hot) water.
Colloidal Oatmeal Baths
May help soothe irritated skin. Commonly used for inflammatory skin conditions. Generally well-tolerated.
Diluted Bleach Baths
Only if specifically recommended by your doctor. Requires precise dilution. Not appropriate for everyone with HS.
Doctor guidance required
Important: Evidence for bath additives in HS management varies considerably. What helps one person may not help another. Always discuss new additions to your hygiene routine with your dermatologist, particularly if you have open lesions or active inflammation.
Section 6: Drying the Skin Properly
How you dry your skin after bathing is as important as the bath itself. Moisture trapped in skin folds is a significant contributor to irritation and bacterial overgrowth in HS-affected areas.
Pat skin dry gently with a soft, clean towel - do not rub
Allow skin folds to fully air dry before dressing
Use a clean, dry towel each time to minimize bacterial transfer
Avoid rubbing or dragging the towel across lesions or tender areas
Common HS-Affected Areas to Pay Extra Attention To:
Illustration: Common HS-affected areas and proper pat-dry technique
Section 7: Clothing After Bathing
What you wear after bathing matters for HS management. Friction and sweat trapping are well-recognized contributors to HS flares, and clothing choices directly affect both.
Choose Loose Clothing
Loose-fitting garments reduce friction against affected skin areas and allow air circulation.
Choose Breathable Fabrics
Natural fabrics like cotton allow moisture to evaporate, reducing sweat accumulation in skin folds.
Avoid Tight Clothing
Tight waistbands, underwear, and garments that press against HS-prone areas can trigger or worsen flares.
Tip: Avoid putting on tight clothing while skin is still damp. Damp skin is more vulnerable to friction and maceration. Allow skin folds to fully dry before dressing.
Section 8: Common Bathing Mistakes HS Patients Make
Even well-intentioned hygiene habits can inadvertently worsen HS symptoms. Here are the most common mistakes to avoid:
Using very hot water, which increases inflammation and dries the skin barrier
Scrubbing lesions or tender areas, which can rupture lesions and spread bacteria
Using harsh antiseptics daily without dermatologist guidance, which can disrupt the skin microbiome
Not drying skin folds thoroughly, allowing moisture to accumulate and worsen irritation
Putting on tight clothing while skin is still damp, increasing friction and maceration risk
Using loofahs or abrasive scrubbers that create friction and can trigger new lesions
Soaking for extended periods, which can soften and macerate lesion tissue
Section 9: Sample Daily Hygiene Routine
A consistent daily routine helps maintain skin health and reduces the risk of flares. This sample routine can be adapted to your individual needs and dermatologist's recommendations.
Morning
- 1.Warm shower (92-100 degF)
- 2.Gentle cleanser with hands or soft cloth
- 3.Pat dry thoroughly, especially skin folds
- 4.Allow folds to air dry fully
- 5.Loose, breathable cotton clothing
Midday
- 1.Rinse affected areas if sweating
- 2.Change clothing if damp or sweaty
- 3.Pat dry any rinsed areas
- 4.Reapply any prescribed topicals if directed
Evening
- 1.Gentle wash of affected areas
- 2.Pat dry and allow skin folds to dry
- 3.Skin check for new or worsening lesions
- 4.Note any changes to report to your dermatologist
Infographic: Daily hygiene checklist for HS patients
Section 10: Important Medical Note
Bathing routines and hygiene habits are only one part of HS management. HS is a complex chronic inflammatory disease driven by immune dysregulation, follicular occlusion, and secondary bacterial involvement. No hygiene routine can replace appropriate medical treatment.
Effective HS management typically requires a combination of medical treatments, which may include topical and oral antibiotics, biologic medications, hormonal therapies, and in some cases surgical procedures. A board-certified dermatologist with experience in HS can evaluate your individual situation and recommend an appropriate treatment plan.
Frequently Asked Questions
What is the best water temperature for showering with HS?+
How long should someone with HS shower or bathe?+
What cleansers do dermatologists recommend for HS?+
Should people with HS use loofahs or scrubbers?+
How should someone with HS dry their skin after bathing?+
"Living with HS can be challenging, but small daily habits can help reduce irritation and support skin health."
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Related Resources
Medical References
- [1]Kokolakis G, et al. Optimal wound care management in hidradenitis suppurativa. J Eur Acad Dermatol Venereol. 2017;31(12):1986-1991. PubMed
- [2]Leiphart P, et al. The effect of antimicrobial washes on antibacterial resistance in hidradenitis suppurativa. J Am Acad Dermatol. 2019;80(6):1756-1757. PubMed
- [3]Alikhan A, et al. North American clinical management guidelines for hidradenitis suppurativa. J Am Acad Dermatol. 2019;81(1):76-90. PubMed
- [4]Zouboulis CC, et al. European S1 guideline for the treatment of hidradenitis suppurativa/acne inversa. J Eur Acad Dermatol Venereol. 2015;29(4):619-644. PubMed