Natural and Complementary Therapies for Hidradenitis Suppurativa

Hidradenitis suppurativa is a chronic inflammatory condition of the skin that causes fluid-filled and painful lesions or bumps to appear on areas of the body where the skin rubs against skin, such as the armpits, under the breasts, groin area, and the buttocks. There is no cure for hidradenitis suppurativa, but if you are living with this condition, you will be put on certain treatments to manage your condition. These treatment options for Hidradenitis suppurativa may include anti-inflammatory medications like antibiotics, hormone therapy, or biologics. However, the symptoms of hidradenitis suppurativa can be unpredictable, and you are likely to experience periods of time when you need some extra relief when you are having a flare-up. Here are some natural and complementary therapies for hidradenitis suppurativa.

Overview of Hidradenitis Suppurativa

Hidradenitis suppurativa is a chronic inflammatory skin condition that can occur in different forms, such as small, pimple-like bumps, boils, or even deeper acne-like nodules on parts of the body where the skin touches against the skin.(1,2,3,4) Although hidradenitis suppurativa is not classified as a form of acne, it is sometimes also referred to as acne inversa.(5,6) The exact cause of hidradenitis suppurativa is not known, though researchers believe there is a genetic link to the disease.(7,8)

There is no cure for hidradenitis suppurativa, but there are several treatment options to help you manage the condition. These include anti-inflammatory medications like antibiotics, biologics, or hormone therapy. However, the symptoms of hidradenitis suppurativa differ from person to person and are unpredictable. Most people always end up experiencing periods of time when they need some extra relief when you are having a flare-up of the disease. There are some natural and complementary therapies that are safe to use along with your other prescribed hidradenitis suppurativa treatments that can help you manage the discomfort caused by your symptoms. However, remember to always consult your doctor before you start using any of these therapies to make sure they do not interact with your other medications.(9,10)

Natural and Complementary Therapies for Hidradenitis Suppurativa

1. Using Tea Tree Oil

Tea tree oil is an essential oil derived from the leaves of the shrub called Melaleuca alternifolia. A 2013 study found that doctors can recommend the use of tea tree oil as a temporary method of helping keep the affected part of the body clean.(11)

Several studies have shown that tea tree oil has potent antimicrobial, anti-inflammatory, and antibacterial properties.(12) A 2015 study found that tea tree oil boosted the effects of an antifungal medication known as fluconazole.(13) The researching team tested a combination of tea tree oil and fluconazole against 32 fluconazole-resistant strains of the fungus Candida albicans. Out of these 32 strains, 87.5 percent were vulnerable to the combination treatment of tea tree oil and fluconazole.

However, another 2018 study found that not all commercially available tea tree oil brands are equally effective, which is why you need to make sure that you purchase a reliable brand of tea tree oil. The research team tested batches of ten tea tree oil brands against several microbes, such as Staphylococcus aureus, herpes simplex virus type 1, and Candida glabrata. Just five of the brands displayed significant antimicrobial activity.(14)

When used in the management of hidradenitis suppurativa lesions, it can help bring down the swelling and also dry out the wound, thus reducing the pain. However, you should be careful when using tea tree oil as it can be toxic is swallowed.

To use tea tree oil in hidradenitis suppurativa, mix a couple of drops of this oil with two tablespoons of any carrier oil and then apply it to the area directly. You can use a cotton ball to apply the mixture.

2. Following an Anti-inflammatory Diet

Once you have been diagnosed with hidradenitis suppurativa, it will help you to switch over to an anti-inflammatory diet. This could make a huge difference in the frequency and severity of your lesions and breakouts. It is essential to know that items like sugar, red meat, and nightshade vegetables like tomatoes, potatoes, eggplant, hot peppers, and bell peppers can increase the chances of getting a flare-up. You should try to restrict these foods from your diet and opt for having anti-inflammatory options like nuts, oily fish, and leafy green vegetables instead.(15)

Foods that contain brewer’s yeast, such as cake, beer, and pizza dough and dairy products are also known to aggravate the symptoms of hidradenitis suppurativa. However, more research is still needed to determine whether brewer’s yeast affects all people with this condition or just those who have wheat intolerance or other food allergies.(16) In any case, it is a good idea to consider eliminating brewer’s yeast and certain dairy products from your diet.

Some good anti-inflammatory foods to include in your diet include:

  • Cinnamon
  • Ginger
  • Green tea
  • Dark chocolate
  • Walnuts
  • Salmon and other oily fish

Eating a well-balanced diet will automatically have a variety of anti-inflammatory foods, but you must ensure that your meal contains the following:

  • Oily fish
  • Healthy fats like olive oil, coconut oil, nuts, and seeds
  • Fresh fruits and vegetables

3. Using Aloe Vera

Aloe vera is a succulent plant that contains a gel-like substance inside its leaves. The plant is known to have a variety of health benefits, especially for the skin and hair.(17) The gel found inside the leaves of the aloe vera plant is rich in a variety of vitamins, minerals, and many amino acids. A 2019 study found that the gel has antimicrobial, anti-inflammatory, and wound-healing properties.(18)

According to research by the National Institutes of Health (NIH), aloe vera gel may also help in the following:(19)

  • Improve acne
  • Promote wound healing
  • Relieve pain caused by burns
  • Help treat skin conditions like psoriasis, lichen planus, and herpes.

Aloe vera gel can soothe the inflammation and discomfort caused by hidradenitis suppurativa flare-ups. You can use pure aloe vera gel and apply it directly to the affected parts of the skin. Allow the gel to soak into your skin. It is best to use pure aloe vera that is free from chemical additives since certain additives may aggravate the irritation further.

Preventive Tips

Apart from the steps mentioned above to get relief from your symptoms during a flare-up, there are some steps you can take to help prevent further outbreaks of your condition. If you can successfully incorporate some of these tips into your daily life, you will find them to be even more useful. Some preventive tips are as follows:

  • Keep the area dry: Keeping the affected area where the lesions are dry can help prevent the condition from worsening and also prevent another flare-up. Moist areas increase the risk of bacteria and fungus to grow and thrive.
  • Wear loose cotton clothing: Wearing loose cotton clothes allows your skin to breathe. These clothes don’t trap moisture, and they also don’t irritate you by rubbing against your skin, worsening the lesions. Loose cotton clothes also help keep your skin dry, clean, and bacteria-free.
  • Remove armpit and pubic hair: Removing the hair on your pubic area and underarms can help prevent more flare-ups. However, instead of using a razor for shaving, it is better to talk to your dermatologist or doctor about what is the best way to remove this hair. Many people find that shaving these areas, especially during a flare-up, can cause further irritate the area and aggravate the symptoms.
  • Practice good hygiene: Take a shower daily as it will help wash away the bacteria and dirt from the skin. Using a non-comedogenic body wash or soap that does not clog your pores is recommended. If required, you can also buy a shampoo and conditioner that does not contain any chemicals that can aggravate your condition.
  • Stop smoking: smoking is unhealthy in general, but it is closely linked with flare-ups of hidradenitis suppurativa.(20,21) You can talk to your doctor to seek help on how to stop smoking by following an effective and proven method of smoking cessation.

Conclusion

Hidradenitis suppurativa is a chronic skin condition for which there is no cure. Still, early treatment can help reduce the severity of your symptoms, prevent infection, and also prevent the formation of new lesions/lumps. However, if you find that such home remedies are not working, or if you feel you have hidradenitis suppurativa but have not been diagnosed properly, make an appointment with a doctor who specializes in such rare types of skin conditions.

Your dermatologist can prescribe certain pain and anti-inflammatory medications, oral or topical retinoids, and immunosuppressants if these natural therapies are not enough to manage your flare-ups.

References:

  1. Jemec, G.B., 2012. Hidradenitis suppurativa. New England Journal of Medicine, 366(2), pp.158-164.
  2. Revuz, J., 2009. Hidradenitis suppurativa. Journal of the European Academy of Dermatology and Venereology, 23(9), pp.985-998.
  3. Alikhan, A., Lynch, P.J. and Eisen, D.B., 2009. Hidradenitis suppurativa: a comprehensive review. Journal of the American Academy of Dermatology, 60(4), pp.539-561.
  4. Slade, D.E.M., Powell, B.W. and Mortimer, P.S., 2003. Hidradenitis suppurativa: pathogenesis and management. British journal of plastic surgery, 56(5), pp.451-461.
  5. Zouboulis, C.C., Del Marmol, V., Mrowietz, U., Prens, E.P., Tzellos, T. and Jemec, G.B., 2015. Hidradenitis suppurativa/acne inversa: criteria for diagnosis, severity assessment, classification and disease evaluation. Dermatology, 231(2), pp.184-190.
  6. Boer, J. and Weltevreden, E.F., 1996. Hidradenitis suppurativa or acne inversa. A clinicopathological study of early lesions. British Journal of Dermatology, 135(5), pp.721-725.
  7. Von Der Werth, J.M., Williams, H.C. and Raeburn, J.A., 2000. The clinical genetics of hidradenitis suppurativa revisited. British Journal of Dermatology, 142(5), pp.947-953.
  8. Ingram, J.R., 2016. The genetics of hidradenitis suppurativa. Dermatologic clinics, 34(1), pp.23-28.
  9. Shah, N.R., 2005. Hidradenitis suppurativa: a treatment challenge. American family physician, 72(8), pp.1547-1552.
  10. Bettoli, V., Join-Lambert, O. and Nassif, A., 2016. Antibiotic treatment of hidradenitis suppurativa. Dermatologic clinics, 34(1), pp.81-89.
  11. Witmanowski, H., Szychta, P., Stępniewski, S., Mackiewicz-Wysocka, M., Czyżewska-Majchrzak, Ł. and Wasilewska, A., 2013. Acne inversa goes an extra mile than hidradenitis suppurativa. Advances in Dermatology and Allergology/Postȩpy Dermatologii I Alergologii, 30(4), p.255.
  12. Carson, C.F., Hammer, K.A. and Riley, T.V., 2006. Melaleuca alternifolia (tea tree) oil: a review of antimicrobial and other medicinal properties. Clinical microbiology reviews, 19(1), pp.50-62.
  13. Mertas, A., Garbusińska, A., Szliszka, E., Jureczko, A., Kowalska, M. and Król, W., 2015. The influence of tea tree oil (Melaleuca alternifolia) on fluconazole activity against fluconazole-resistant Candida albicans strains. BioMed Research International, 2015.
  14. Brun, P., Bernabè, G., Filippini, R. and Piovan, A., 2019. In vitro antimicrobial activities of commercially available tea tree (Melaleuca alternifolia) essential oils. Current microbiology, 76(1), pp.108-116.
  15. Silfvast‐Kaiser, A., Youssef, R. and Paek, S.Y., 2019. Diet in hidradenitis suppurativa: a review of published and lay literature. International journal of dermatology, 58(11), pp.1225-1230.
  16. Danby, F.W., 2015. Diet in the prevention of hidradenitis suppurativa (acne inversa). Journal of the American Academy of Dermatology, 73(5), pp.S52-S54.
  17. Hamman, J.H., 2008. Composition and applications of Aloe vera leaf gel. Molecules, 13(8), pp.1599-1616.
  18. Hekmatpou, D., Mehrabi, F., Rahzani, K. and Aminiyan, A., 2019. The effect of aloe vera clinical trials on prevention and healing of skin wound: A systematic review. Iranian journal of medical sciences, 44(1), p.1.
  19. Nccih.nih.gov. 2020. [online] Available at: <https://www.nccih.nih.gov/health/aloe-vera> [Accessed 22 December 2020].
  20. König, A., Lehmann, C., Rompel, R. and Happle, R., 1999. Cigarette smoking as a triggering factor of hidradenitis suppurativa. Dermatology, 198(3), pp.261-264.
  21. 21. Simonart, T., 2010. Hidradenitis suppurativa and smoking. Journal of the American Academy of Dermatology, 62(1), pp.149-150.

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