As a busy person on the go, you don't have time for the pain of HS to slow you down. By better understanding how pain happens and learning ways to lessen it, you can manage your discomfort and get on with your life.
Why Does HS Hurt?
Even though researchers don't know all the exact cause of HS, they do know that the lumps you get happen because of blockages in your hair follicles. HS is an autoinflammatory disease of the hair follicles, meaning your body mistakes the follicle for a foreign invader and attacks it as a way to protect itself.
The lumps are a buildup of a fibrous protein called keratin. They trap sweat and bacteria inside. This causes inflammation, and sometimes the lumps burst. The inflammation itself is painful, and ruptured lumps can get infected, leading to more pain.
Over time, the lumps may connect and form tunnels under your skin. Most HS lumps also cause scarring on the skin when they heal. All of these things cause different types of pain.
Types of HS Pain
The pain you feel from HS can happen in different ways.
Nociceptive pain
Some HS pain is nociceptive, the most common kind of pain. It's the pain you feel after an injury to tissues in your body. Nociceptors are nerve endings that activate after you have an injury. They send signals to your brain to tell if something is wrong.
This pain can come when HS is more advanced and inflamed, and it can feel like:
- Gnawing
- Aching
- Tenderness
- Throbbing
Neuropathic pain
Some HS pain is neuropathic pain, which happens when your nervous system doesn't work right or gets damaged. These damaged nerves send the wrong signals to the pain centers in your body.
Neuropathic pain can happen as the bumps quickly form and can feel like:
- Burning
- Shooting
- Stinging
- Stabbing
Joint pain
People living with HS have a higher risk of getting diseases that affect the joints, like arthritis. You may have swelling, warmth, redness, and pain in your knees, wrists, elbows, and other joints of your body.
On top of these types of pain, the most common places HS bumps form are in already sensitive areas where skin rubs together, such as your armpits, groin, and anus. This friction is hard to avoid in daily movements, and it increases your pain load.
Even healed HS lumps can cause pain. When tunneling and infections scar over, the resulting thick patches of skin can restrict your movement and cause pain, too.
All of these types of pain can happen at the same time when you have HS, leading to frustration and extreme discomfort. This can affect not only your physical health but also your mental and emotional well-being.
HS Pain Management
Pain is a constant in HS. In one study involving 1,795 people with HS, almost 84% reported they'd had HS-related pain in the previous 24 hours.
There are steps you can take to help reduce the pain you have with HS. Doctors recommend these pain-reducing techniques:
Cold relief. You may find some pain relief with cold baths, or with ice packs or cold wraps on tender spots. Cold therapy can help reduce swelling and numb painful areas. Be sure to put something between your skin and any ice packs you use so you don't burn your skin.
Warm compresses. You can make a simple warm water compress by running a cloth under warm water and then putting it on your skin, or you can make a black tea compress:
Put a tea bag of black tea in a cup and steep it in boiling water for 10 minutes. Let the water cool to warm before you use it. Take a clean container and place a soft cloth or gauze inside. Pour the tea over the cloth or gauze. Wring out the extra tea and place the compress on painful HS areas. Keep it on for 10 minutes and repeat throughout the day as needed when you have pain.
Topical ointments. Ask your doctor about over-the-counter options such as lidocaine cream that numbs skin or topical nonsteroidal anti-inflammatory drugs (NSAIDs).
Over-the-counter (OTC) or prescription pain medications. Ibuprofen reduces inflammation, which is behind much of the pain of HS. If over-the-counter pain relievers don't work, your doctor may prescribe stronger options.
Your doctor can also refer you to a pain management specialist. These are doctors trained in pain relief who can focus on reducing your HS-related pain.
Complementary medicine
These options are steps you can add to your daily life to help reduce the chance of pain.
Diet. While there's no miracle diet that cures or treats HS, some research suggests various types of diets have helped certain people reduce HS flare-ups. These include:
- Mediterranean diet (mostly fresh vegetables and fruits, whole grains, fish, beans, seafood, and extra-virgin olive oil)
- Sugar-free diet
- Dairy-free diet
- Plant-based diet
Some people with HS may have food sensitivities that worsen their symptoms. These may include alcohol, gluten, or yeast. Ask your doctor if food sensitivities may be an issue for you and if limiting certain foods is worth trying to treat your flares.
Researchers are also interested to see if zinc and vitamin D may play a role in HS. Small studies suggest boosting these nutrients may help reduce flares in some people. Always ask your doctor before adding a supplement to your diet.
Mind-body techniques. Studies on pain suggest that because pain involves both your mind and your body, you may be able to reduce your pain by changing the way you go through it. In order to do this, certain exercises can help:
- Deep breathing. Inhaling slowly through your nose, briefly holding it, and then exhaling slowly through your mouth with intention
- Meditation and guided imagery. Imagining a relaxing environment and letting thoughts pass by without judgment
- Mindfulness. Focusing your attention on what's around you and the moment you're in
- Yoga and tai chi. Practicing deliberate movements that ground you and focus on your breath
Show Sources
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SOURCES:
National Health Service (U.K.): "Hidradenitis Suppurativa (HS)."
Cleveland Clinic: "Hidradenitis Suppurativa," "Nociceptive pain," "Neuropathic pain."
MedlinePlus: "Hidradenitis Suppurativa."
Mayo Clinic: "Hidradenitis Suppurativa."
Journal of Clinical Medicine: "Pain as Defining Feature of Health Status and Prominent Therapeutic Target in Patients with Hidradenitis Suppurativa."
American Academy of Dermatology: "Hidradenitis Suppurativa," "Is there a diet for hidradenitis suppurativa?"
HS Connect: "Wound Care for All Stages of Abscesses."
Journal of the American Academy of Dermatology: "Pain management in hidradenitis suppurativa and a proposed treatment algorithm."
Harvard Health Publishing: "6 ways to use your mind to control pain."
