Hidradenitis Suppurativa Underwear Tips: Fabrics, Fit, and Care

Choosing the Best Underwear for Hidradenitis Suppurativa

Finding the right underwear is an important part of managing hidradenitis suppurativa (HS). Underwear that rubs, chafes or doesn't breathe well can exacerbate painful HS lesions in the groin, buttocks, and other areas. The proper underwear fabric, fit, and style can help prevent friction, minimize inflammation, and support healing.

How Underwear Impacts HS

HS causes painful bumps and boils to form in areas where skin rubs together, such as the armpits, groin, and under the breasts. The groin is a common trouble spot prone to recurrent lesions and tunneling wounds. Tight, ill-fitting, or rough underwear that rubs and chafes the inner thighs and genital area can worsen HS symptoms.

Choosing underwear made of soft, breathable fabrics can help reduce irritation. A good fit that avoids tight elastic digging into the skin is also important. Going without underwear may seem like a solution, but can allow more friction that exacerbates HS lesions. The right underwear provides a protective buffer.

Underwear Fabrics to Choose and Avoid

Soft, moisture-wicking fabrics that minimize friction on sensitive HS skin are ideal. Recommended options include:

• Cotton - Breathable and lightweight; look for 100% cotton or cotton blends
• Modal - Soft, smooth fabric made from beech trees
• Microfiber - Lightweight, stretchy, and quick-drying
• Bamboo rayon - Silky yetabsorbent and antimicrobial

Avoid underwear made from rough, stiff, and non-breathable materials like:

• Nylon
• Polyester
• Spandex
• Lace
• Silk
• Vinyl

The materials above tend to cause or worsen chafing. Underwear with scratchy tags, seams in irritation-prone areas, and restrictive elastic bands should also be avoided.

A Well-Fitted Underwear Waistband

The waistband of your underwear should fit snugly but not dig into the skin or fold over. High cut waistbands that extend over areas prone to HS boils and lesions may be preferable. Look for:

• Encased elastic that lays flat
• Soft, unrestrictive stretch fabrics
• Flexible waistbands that move with your body

If regular waistbands irritate HS groin tunnels and wounds, consider modifying underwear or transitioning to styles with adjustable or customizable fits.

Seamless Underwear Construction

Seams on underwear can allow moisture buildup and also rub directly against HS lesion sites. Seamless styles help avoid this friction. Other features to look for include:

• Seam-free inner thigh area and groin
• Flat-lock seams on outer hip area
• Seamless rear and front panel
• Panty styles instead of thongs

Full rear coverage also limits abrasion from seams. Wear underwear inside out if inner leg seams cause issues temporarily.

The Proper Underwear Fit

Underwear that is too small can constrict movement and tighten against HS lesions. Loose, baggy underwear causes excess friction. Use these tips to find well-fitted styles:

• High cut leg openings
• Full rear coverage
• Breathable cotten gussets
• Avoid thongs or skinny cuts
• Try both bikini and hipster styles

Replace underwear once the elastic begins to loosen. Try both male and female styles to find the best fit for your body. Breathable cotton gussets stay cooler.

Wicking Away Moisture

HS lesions and wounds seep serous fluid. The moisture can become trapped against the skin by underwear. Fabrics like cotton and bamboo rayon that wick moisture outward and dry quickly help avoid this.

Anti-chafing powders like corn starch can also reduce humid friction hot spots. Change underwear as soon as it becomes damp or soiled to restore dryness.

Concealing HS Wounds and Odor

Underwear can provide an extra layer of protection over the drainage, odor, and appearance of HS wounds. Choose:

• Darker colors and patterns to hide drainage stains
• Antimicrobial fabrics like bamboo viscose
• Moisture-wicking performance synthetics
• Absorptive fabrics like cotton-flannel

Layering boxer briefs under loose shorts, or using dark leggings over underwear can further disguise HS wounds when out in public.

Caring for Your Underwear Properly

Follow these tips to keep underwear clean and minimize irritation:

• Wash daily in a sensitive skin detergent
• Avoid scented detergents and fabric softeners
• Wash with bleach or disinfectant to kill bacteria
• Rinse thoroughly to remove all detergent residue
• Avoid shared laundry loads that may cross-contaminate

Hand wash or use a delicate cycle if possible. Replace underwear every 6-12 months as fabrics lose their softness and elasticity.

Specialized HS Underwear Options

Specialized underwear for managing hidradenitis suppurativa may be beneficial in some cases. Options include:

• Antimicrobial underwear - Reduces bacterial contamination risk
• Moisture-wicking athletic underwear - Keeps HS lesions drier
• Loose boxer briefs - Provides breathability
• Adjustable waistbands - Accommodate variable swelling
• Custom tailored underwear - Provides optimal individualized fit

For severe HS cases, customized medical underwear may be constructed to work around wound vacuums or drainage tubes.

Alternative HS Underwear Solutions

In some instances, going without underwear or modifying garments may be beneficial:

• Wear loose-fitting skirts, dresses or nightgowns around the house for a "no underwear" option
• Modify underwear by cutting out inner thigh fabric over lesion sites
• Wear two pairs of underwear to reduce friction in the groin and inner thighs
• Use unisex boxer briefs for a roomier fit

Avoid going fully commando when wearing pants or shorts since the seams and zippers could worsen HS symptoms. Discuss any underwear concerns with your doctor.

Caring for HS Wounds Related to Underwear

Follow good wound care practices for any HS lesions caused by underwear friction:

• Clean areas gently with antimicrobial soap and water
• Apply antibiotic ointment and non-stick bandages
• Take warm Epsom salt baths to soothe irritation
• Keep the area dry to help wounds heal faster
• Wear loose, breathable cotton clothing
• See a doctor if wounds exhibit signs of infection

Avoid scratching or picking at lesions

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.