How to Treat Hidradenitis Suppurativa Scars, According to Derms

Hidradenitis suppurativa (HS) is often referred to as acne inversa — aka reverse acne — due to the cysts, lumps, and abscesses that occur in and under the skin. But contrary to the assumptions about the name, it's not treatable with your typical zit-fighting concoction of salicylic acid and hydrocolloid patches. "People can think that it looks like acne, but acne is a disease of the sebaceous gland and (HS) is a disease of the sweat gland — it can be much more extensive than acne," Connecticut-based board-certified dermatologist Mona Gohara explains. The often painful symptoms of hidradenitis suppurativa frequently occur near sweat-prone areas where friction occurs such as armpits, breasts, and groins.

"You can have these open oozing nodules that can get secondarily infected, and they can actually smell quite bad," New York City-based board-certified dermatologist Michelle Henry adds. "I've even had patients who have them on the face. That's very severe, but areas with excess frictions also tend to be areas where we have more sweat glands, as well."

Even without secondary infections, these pus-filled lumps and bumps harden into inflamed lesions as they heal, ultimately lead to deep scarring. "The lesions not only drain malodorous pus, but they are also extremely painful and can take a deep psychological toll as well," adds New York City-based board-certified dermatologist Shereene Idriss.

Because hidradenitis suppurativa is chronic and recurring without a cure so far, treatment and management of scarring often requires continuous support from your dermatologist and a gentle body-care routine to help restore the skin barrier. For some, making certain lifestyle changes—which include weight loss, exercise, and quitting smoking — may also prove beneficial for overall HS management. New York City-based board-certified dermatologist Robert Finney also suggests getting laser hair removal as soon as possible to "get rid of the follicle and thus the problem and prevent scarring." Here, our recommendations for products with dermatologist-approved ingredients that may help reduce, manage, and fade scarring.

Korres Greek Yoghurt Nourishing Probiotic Gel-Cream

Because secondary bacterial infection is common with hidradenitis suppurativa, Finney recommends trying moisturizers formulated with probiotics and prebiotics, which are live beneficial bacteria and nutrients for healthy bacteria, respectively, to support skin health on the microbial level. The Korres Greek Yoghurt Nourishing Probiotic Gel-Cream is a lightweight whipped formulation that contains both prebiotics and probiotics to nourish and soothe skin.

Dr. Brandt Skincare Cool Biotic Prebiotic Redness Relief Cream

Hidradenitis suppurativa can make you feel itchy in irritated areas. Powered by soothing cannabis sativa seed oil, anti-inflammatory colloidal oatmeal, probiotics like lactococcus ferment lysate, and prebiotics in the form of oligosaccharides (such as sucrose, fructose, and glucose), the Dr. Brandt Skincare Cool Biotic Prebiotic Redness Relief Cream is an everyday moisturizer that reduces the appearance of skin distress and instantly feels cool upon contact.

Colorescience Sunforgettable Total Protection Sheer Matte SPF 30 Sunscreen Brush

Don't forget your sunscreen, especially as scar tissue is particularly sensitive to UV rays and can lead to hyperpigmentation with prolonged exposure. Unfortunately, many mineral sunscreen formulas can be too thick for skin affected by hidradenitis suppurativa. The Colorescience Sunforgettable Total Protection Sheer Matte SPF 30 Sunscreen, however, is a brush-on powder made for easy, lightweight application. Bonus: The bristles are antimicrobial.

First Aid Beauty FAB Pharma White Clay Acne Treatment Pads 2% Salicylic Acid

Gohara recommends wipes containing salicylic acid, which is a beta hydroxy acid (BHA), to help absorb and reduce sweating. These First Aid Beauty FAB Pharma White Clay Acne Treatment Pads are made for acne on the face, but they also make convenient treatments for anywhere on your body affected by hidradenitis suppurativa.

Glossier Priming Moisturizer Balance

The gel-cream formulation of the Glossier Priming Moisturizer Balance also contains dimethicone to help smooth and improve the texture of scarring. It's also formulated without fragrance to prevent further irritation. "This is not the time to be fancy," Gohara says, "It's like, less is more."

Proactiv Renewing Cleanser

It's not acne — but your blemish wash may be able to help, as long as it contains benzoyl peroxide, which is an antiseptic that reduces bacteria. "For patients with mild disease [which, along with moderate disease, affects most people with the condition], topical antibacterial washes with benzoyl peroxide or chlorhexidine has been shown to be helpful in reducing bacterial colonization and potential flare-ups," Idriss says. Let the Proactiv Renewing Cleanser do the work, and don't use a washcloth or loofah, as the additional friction can exacerbate the skin.

Eisenberg Paris Lotion Tonique

After cleansing with your antibacterial wash, pat Eisenberg Paris Lotion Tonique, which contains chlorhexidine digluconate, onto skin. Chlorhexidine digluconate is an antiseptic commonly used to disinfect surgical instruments, and combined with soothing liquorice extract and rose water, this makes an ideal prep step in one's morning and evening sensitive skin-care routine.

Cortizone 10 Intensive Healing Anti-Itch Crème

"If you have a little cyst forming, you can put on over-the-counter cortisone creams, which can help to decrease the inflammation," Henry says. The gentle formulation of Cortizone 10 Intensive Healing Anti-Itch Crème also contains seven moisturizing ingredients such as jojoba oil and aloe vera, and lasts for up to 24 hours. But, Henry is quick to note: Hidradenitis suppurativa scarring is unfortunately almost inevitable and requires prescription medication and prompt treatment as it waxes and wanes.

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