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How to manage a worsening HS flare while you wait for a specialist
HS flare getting worse while you wait for a specialist? Learn how to get seen sooner, start treatment with primary care, and ease painful lumps at home.
Key takeaways
You don't have to wait for a specialist to start managing worsening HS. If your flares are becoming more frequent, painful, or widespread, your primary care clinician may be able to start treatment while you wait for a dermatology appointment.
Simple steps at home can help ease discomfort during a flare. Warm compresses, gentle cleansing, and loose clothing may help. Avoid squeezing, popping, or scrubbing painful lumps, which can make irritation worse.
There may be ways to see an HS specialist sooner. Ask about cancellation lists, updating your referral to reflect worsening symptoms, or scheduling a virtual appointment with a dermatologist experienced in HS.
Know when worsening symptoms need urgent attention. Fever, chills, or rapidly spreading redness and swelling can be signs of infection. Seek prompt medical care rather than waiting for your scheduled appointment.
If your hidradenitis suppurativa (HS) flares are becoming more frequent, more painful, or spreading to new areas, waiting weeks or months for a dermatologist can be frustrating. HS causes painful lumps deep beneath the skin, often in areas where skin rubs together, and symptoms can worsen without appropriate treatment.
The good news is that you don't have to put your care on hold while waiting for a specialist. There are steps you can take at home to manage discomfort, treatments your primary care clinician may be able to start, and ways to access specialized HS care sooner.
Here's what to do if your HS is getting worse while you wait for an appointment.
Why a worsening pattern matters
HS is a chronic inflammatory skin condition that can progress over time, particularly when inflammation isn't adequately controlled.
According to the American Academy of Dermatology (AAD), repeated HS flares can lead to scarring and the formation of tunnels beneath the skin. These tunnels connect affected areas and can cause persistent drainage and discomfort.
If you're experiencing more frequent flares, developing lumps in new areas, or noticing changes in existing lesions, it's worth seeking care sooner rather than waiting for your next scheduled appointment.
Dermatologists use the Hurley staging system to assess the extent of HS, including whether scarring and tunnels have developed. Learn more about Hurley stages 1, 2, and 3 and what they mean for treatment.
How to see an HS specialist sooner
The clearest step is also the most useful one. You may not need to wait months to see a dermatologist experienced in HS.
A few practical moves can help you get seen sooner:
Ask to be added to the cancellation list.
Tell the clinic your flares have worsened, with specifics such as how often they happen and how many areas are involved.
Ask your referring clinician to describe the worsening in the referral itself.
Check whether your insurance plan actually requires a referral.
Ask whether a video visit with a dermatologist experienced in HS is available.
When you call, you can say: "My flares have gotten worse over the past year. I now have new lumps in more places. Is there an earlier appointment or a cancellation list?"
Tono's HS specialists see patients by video, and appointments are available in 2 days or less. No referral is needed, most insurance is accepted, and every visit is led by a specialist.
Because visits happen from home, a specialist can see you during a flare, while lumps are active. When you need an in-person exam, labs, or a procedure, Tono coordinates it. Prescriptions go to your local pharmacy.
Tono's HS specialty program covers diagnosis, biologic management, treatment escalation, long-term follow-up, and coordination of procedural care. Biologics are medicines that calm specific parts of the immune system. Tono has cared for more than 20,000 patients across a 33-state clinical footprint.
A video visit is one way to reach the right specialist. You can learn why virtual-first HS care works, including how in-person care fits in when you need it.
What your primary care clinician can do now
A primary care clinician can often start treatment while you wait. Book a visit and describe how your flares have changed over the past year.
The AAD notes that antibiotics are often prescribed for HS, even though HS is not an infection. Depending on your symptoms, your clinician may consider:
A topical antibiotic such as clindamycin, which you apply to the skin
A course of a tetracycline-class antibiotic such as doxycycline, taken by mouth
A 2019 primary care HS evidence review in American Family Physician found these antibiotics effective for mild to moderate HS. The same review advises dermatology referral for moderate to severe HS. Your clinician decides which medicine fits you, so talk with them before starting anything.
If a single abscess is very painful, a clinician may drain it to relieve pressure. You can ask whether your clinic offers this. The review notes that lumps usually return after drainage, which is why HS needs a longer-term plan.
Before you leave, ask your clinician to note your HS diagnosis or suspected HS in your chart. You can also ask them to update your referral with what has changed. Both steps help the dermatology clinic understand your situation.
Safe care at home during a flare
Home care can ease symptoms and protect your skin until treatment is in place. These steps also help you avoid making a flare worse.
The AAD's dermatologists' HS self-care tips start with a warm, wet washcloth held on a painful lump for 10 minutes. The AAD also suggests a benzoyl peroxide wash or a zinc pyrithione soap. It advises against squeezing or scrubbing lumps, because scrubbing causes inflammation that can worsen HS.
What helps | What to skip |
|---|---|
A warm compress for 10 minutes, repeated through the day | Squeezing lumps |
A benzoyl peroxide wash or zinc pyrithione soap, then patting dry | Popping or draining lumps at home |
Looser clothing and staying cool | Tight clothing that rubs |
A fragrance-free, alcohol-free antiperspirant | Waxing affected areas |
Clean dressings over draining spots | Scrubbing skin with a washcloth or loofah |
Change dressings as often as drainage requires, and keep the skin around them clean and dry. Ask a clinician which dressings suit your skin and the amount of drainage you have.
Easing pain and getting rest
HS pain relief often combines home care with a plan from your clinician. The AAD guide to HS treatment lists pain options dermatologists may add, and notes that opioids are used only occasionally.
Options to discuss with your clinician include:
Warm or cool compresses
Lidocaine, a numbing medicine applied to the skin
Acetaminophen
An NSAID, an anti-inflammatory pain reliever such as ibuprofen or naproxen
Ask a pharmacist or clinician which over-the-counter option is safe for you. This matters most if you have kidney, stomach, liver, or bleeding concerns, or take other medicines. Follow the label.
If pain keeps you from sleeping or working, tell your clinician. Longer-term pain options exist. The most lasting relief comes from treating the inflammation behind the lumps.
For rest, wear loose sleepwear that doesn't press on sore areas. Arrange pillows to keep pressure off painful spots, such as between your arms and sides. The AAD notes that HS can affect mood, and you can raise this with your clinician at any visit.
Notes for specific situations
Some situations change what helps while you wait. These notes cover three common ones, and each adds to the steps above rather than replacing them.
If you have a lot of scarring
If you have a lot of scarring, calming new flares is the priority while you wait. The AAD notes that a scar usually forms as an abscess heals. That is one reason calming new flares matters in areas that already have scars.
Treat open areas gently and keep dressings clean. Tell a clinician about any wound that won't heal or that keeps reopening.
The AAD's announcement of its joint HS guidelines notes that untreated HS can cause scarring and wounds that limit mobility. Note what has become hard to do, such as raising your arm or walking comfortably, so your dermatologist can assess it.
Tunnels that persist or keep coming back are treated in person. In-office options include deroofing, which opens and flattens a tunnel under the skin, and surgical removal of affected skin. A steroid injection can treat a painful, flaring bump.
Before your visit, photograph scarred areas in good light. For more detail on scar care, you can read about treating HS scars and marks.
If flares are under your breasts
Flares under the breasts respond to the same home care, with extra attention to moisture and friction. The fold under the breasts is a common HS site because skin touches and rubs there.
The AAD advises looser clothing and avoiding clothing that rubs, which matters in this fold. A few steps can help:
Keep the fold clean and dry.
Pat the skin dry instead of rubbing.
Choose a bra that doesn't dig into or rub the fold.
Use the same compress and wash routine described above.
Changes in the breast itself, rather than the skin of the fold, need a prompt check with a doctor. Tono's guide to HS under the breasts lists the signs to watch for, along with tips on fabrics and fit.
If you've had weight loss surgery
HS can change after weight loss surgery, also called bariatric surgery, in either direction. The evidence is limited, so it helps to involve both your surgical team and a dermatologist.
In a 2021 small bariatric surgery study from France, HS activity improved on average among the 12 of 19 patients who had surgery. The authors also describe a separate case series in which HS started after malabsorptive surgery, often with low zinc. Malabsorptive surgery changes the gut so the body absorbs fewer calories and nutrients.
The same authors note that extra skin after major weight loss can add friction. The first joint HS guidelines, published in October 2026, include 37 evidence-based recommendations for chronic HS and acute flares. They found insufficient evidence to support weight reduction or GLP-1 medicines as HS treatment.
The plan to control HS still comes from a dermatologist. The joint guidelines conditionally recommend zinc supplements, and vitamin D supplements for people with low levels, taken under a doctor's supervision. While you wait, you can:
Tell your surgical or bariatric team about the flare.
Ask whether your nutrient levels, including zinc, should be checked.
Hold off on starting supplements on your own.
Mention any loose skin folds where flares happen.
Signs you need urgent care
Pain and drainage are common in HS. Rapid change and fever are the signals that matter.
Get emergency care right away if you notice any of these:
Fever or chills
A red, swollen area that spreads or changes quickly
Mayo Clinic's skin infection guidance advises emergency care for a swollen rash that is changing rapidly or for any fever. For a swollen or growing rash without fever, it advises seeing a clinician within 24 hours. If any change worries you, call your clinician.
When you get care, say that you have HS or may have HS. Show your flare notes and photos so the team can see your usual pattern. Afterward, share the visit notes with your dermatologist.
It also helps to understand how HS differs from infection. That context makes the warning signs easier to judge.
What to bring to your specialist visit
Lumps may be quieter on the day of your visit. Your records show the specialist what your flares look like at their worst.
Bring these to your appointment:
A flare log with dates, body areas, number of lumps, pain level, and drainage
Dated photos taken during flares
Every treatment you've tried and how it worked, including drainage and antibiotics
Your current medicines and allergies
Relevant history, such as bariatric surgery, and any family history of HS
Your top questions
You can ask questions in your own words. For example:
"How severe is my HS?"
"What can we start today to calm the flares?"
"Which parts of my care can happen by video?"
It also helps to see someone with deep HS experience. This guide to choosing an HS specialist explains what to look for.
The waiting period is a time to act. Calm the flare at home, start treatment where you can, and get to a dermatologist experienced in HS for ongoing care.
Frequently asked questions
Should I drain an HS lump myself?
No. The AAD advises against squeezing or popping lumps, which can injure or irritate the skin. A clinician can drain a very painful abscess when needed.
Does quitting smoking help HS flares?
Quitting may help. The AAD advises people with HS to stop using tobacco, and quitting can reduce flare-ups. You can ask your clinician for help with a plan to quit.
Can an HS specialist see me during a flare by video?
Often, yes. A dermatologist can assess active lumps on video and through your photos. When an in-person exam or procedure is needed, your dermatologist arranges it.
Should I change my diet or take supplements while I wait?
Talk with your dermatologist first, since the joint guidelines found insufficient evidence that specific diet plans help manage HS. They give zinc, and vitamin D for people with low levels, a conditional recommendation under a doctor's supervision. A heart-healthy diet still matters for your overall health.
Schedule an in-person or virtual appointment with a Tono Health specialist.
