Hidradenitis suppurativa lesions and abscesses may release pus or an odorous discharge. A warm compress can help people to drain painful lesions at home, but surgical drainage may be necessary in severe cases.

Hidradenitis suppurativa (HS) is a chronic skin condition that leads to the formation of painful, inflamed, and recurrent abscesses or lumps in areas of the body where skin rubs together.

Chronic drainage is a characteristic feature of HS. The affected areas may frequently release pus or an odorous discharge.

Although drainage can relieve pain, it may also cause significant discomfort and embarrassment for those with the condition.

This article examines whether HS drainage is necessary at home or in the hospital, how to prevent discharge, and when to seek help.

Black tea in a bowl that a person can use to make a compress to help with hidradenitis suppurativa drainage -1.Share on Pinterest
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Chronic discharge is a symptom of HS. However, some people with this condition may wish to forcibly drain pus-filled lesions if they are experiencing pain or discomfort.

While drainage may provide temporary relief, it is not a cure for HS. Treatment typically aims to prevent disease progression and reduce symptoms such as discharge and pain.

In the early stages, management of the condition can involve antibiotics, anti-inflammatory medications, and lifestyle changes.

However, in the later stages of the disease, doctors may recommend surgical intervention by a medical professional to remove lesions, scars, and tracts underneath the skin.

People can take steps at home to ease discomfort due to HS lesions. However, healthcare professionals will not typically recommend squeezing lesions to drain them.

Bursting, popping, or squeezing the sores, cysts, and nodules can injure or irritate them, which may worsen symptoms. Instead, the following options may help people to ease discomfort due to chronic discharge:

  • Warm compresses: Applying warm compresses to the lesions can promote drainage and reduce swelling. This may provide temporary relief from excessive discharge.
  • Black tea compress: Black tea contains tannins, which have anti-inflammatory and astringent properties. Applying a black tea compress may help reduce pain and soothe the skin.
  • Topical treatments: Topical agents to manage HS include cleansers, antibiotics, and keratolytic agents.

Learn more ways to manage HS at home.

Before recommending surgical treatments, doctors will consider the following:

  • the extent of a person’s symptoms
  • the location of the lesions
  • how the person has responded to previous treatment options

A surgeon typically performs surgical drainage in a hospital or surgical setting. During the procedure, the surgeon makes an incision in the affected area to drain the abscess or infected material.

They may also remove any damaged or scarred tissue surrounding the lesion. The goal of the surgery is to alleviate pain, promote proper healing, and prevent recurrent abscess formation.

Other surgical options

As well as drainage, doctors may recommend the following surgical options for people with severe HS:

  • Deroofing: This procedure creates an open wound over a sinus tract or abscess to encourage the skin to heal on its own and reduce the risk of recurrence.
  • Wide local excision: This procedure involves the removal of all tissue in the affected area.
  • Laser surgery: In this surgery, surgeons will pass a laser over the affected area to remove all necessary tissue.

Regular follow-up care and a personalized treatment plan are key to effectively managing the condition and minimizing its impact on a person’s life.

How effective is surgical drainage?

The success of surgical drainage as a treatment for HS can vary depending on the person’s specific case and the extent of their condition.

A 2022 narrative review suggests that incision and drainage surgery is very successful at relieving pain and discomfort. However, it also suggests almost all cases of HS recur after this type of surgery.

A 2020 study found that symptoms recurred in 35% of people who had wide excision or limited local excision surgical treatment. Two-thirds of participants reported satisfaction with their surgery and would recommend it.

Since chronic discharge is a symptom of HS, people may be unable to stop it entirely. However, the American Academy of Dermatology (AAD) recommends the following steps to minimize symptoms and prevent infection:

  • Maintain good hygiene: Keeping the affected areas clean is crucial for preventing infection and reducing discharge. A person should regularly wash the affected areas with mild, antibacterial soap and pat them dry gently.
  • Avoid tight clothing: People should wear loose-fitting, breathable clothing to minimize friction and irritation on the affected areas.
  • Weight management: For individuals with excess weight or obesity, losing weight may help to reduce HS symptoms, including discharge.
  • Avoid smoking: Smoking may worsen HS symptoms, so quitting smoking can be beneficial.
  • Be careful when shaving: Cuts or damage to the skin when shaving can lead to flare-ups and infections.
  • Reduce sweating: Where possible, people with HS should avoid sweating and overheating.

While these measures can help a person manage their condition and reduce discharge, complete resolution of HS discharge may not be possible in all cases.

People should contact a healthcare professional if their HS becomes increasingly painful, tender, or swollen.

The AAD recommends that people with this condition speak with a dermatologist who can provide an accurate diagnosis and create a personalized treatment plan. Dermatologists may be able to:

  • treat infections
  • improve wound healing
  • prevent worsening symptoms
  • relieve pain

HS lesions may be painful and release an odorous discharge. Applying a warm compress at home can help affected people relieve pain and manage discharge.

In severe cases, doctors and dermatologists may recommend surgical drainage or other types of surgical management. Lesions typically return after surgical drainage, though it is an effective method to relieve pain from large lesions.