How Can You Control the Odor From Hidradenitis?

Christopher Sayed, M.D., associate professor of dermatology at the University of North Carolina at Chapel Hill, discusses the causes of HS odor and a few ways to manage it.

The odor in HS definitely is something that often bothers patients. It can vary a lot, and it's not always an issue.

There is some role for bacteria in the disease, or bacteria probably do flourish in those tunnels that exist. Sometimes there is probably a contribution from some bacteria being present. Things like antibiotics or other medicines that control the disease and reduce the drainage can help there be less odor.

Other times, the odor is caused by the drainage itself. That’s the body's white blood cells and immune system fighting off being triggered by that inflammation. As that drains out and sits on the skin for a while or sits on a bandage those cells start to break down.

Just the breakdown of those immune cells can also lead to some of the odor. I think the more we control drainage, the better we deal with the odor control, a lot of times. We also try to use things like topical antibiotics, sometimes. There are certain antibiotics that maybe help reduce that bacterial burden more than others. There are certain ones that we may use, like Metronidazole, but there is nothing that always helps perfectly, though.