If you are reading this post then you probably either have Hidradenitis Suppurativa (HS) or you are acquainted with someone who does.
And so you know.
You know about the painful, swollen bumps that accumulate in your groin and armpits and buttocks – sometimes so severe it is difficult to move, and just as difficult to sit down.
You know about the secondary infections in these skin lesions, and the occasional spontaneous drainage and the development of unseemly scars and chronic tunnels in the skin.
And, of course, you know about the odor that develops within these complicated wounds, and the self-consciousness, and the self-imposed social isolation, and the bouts of depression.
But what is less well known, even to many HS patients and their caregivers, are the advances in the topical care of HS in just the last several months. No longer are the days when the only available topical therapies were the application of prescription antibiotics (usually clindamycin) or scrubbing with a surgical disinfectant like chlorhexidine – with the next steps being the administration of oral antibiotics or the injection of steroids directly into the lesions.
And though recent years have seen the successful advent of metabolic medications and immune-modulating antibodies in the treatment of HS, one of the more impressive breakthroughs has been a step back toward patient-directed OTC care: the local and intermittent application of cleansing gel formulated with sodium hypochlorite and surfactant.
What Does the Science Say?
At the November, 2024 Symposium on Hidradenitis Suppurativa Advances (SHSA), sponsored by the HS Foundation and the Canadian HS Foundation, dermatology researchers from Michigan State University and Wayne State University published a poster presentation on the treatment of HS with sodium hypochlorite cleansers using two different techniques.
In this study, HS patients used a sodium hypochlorite BodyWash (CLn BodyWash) once a day, lathering it on their bodies for 1-2 minutes and subsequently rinsing it off in the shower. By four weeks, the patients saw an approximate 50% reduction in symptom scores of pan, redness, itching, odor, drainage and swelling.
In another arm of the study, patients used a dab technique, where they applied the sodium hypochlorite wash only on active lesions at bedtime, and washed it off in the morning. These patients saw an even greater improvement in symptom scores, with greater than 50% reductions in redness, pain, odor, drainage and swelling.
And all of this therapeutic benefit was achieved with a commercially prepared non-prescription over the counter (OTC) body cleanser.
What Explains This Response to Sodium Hypochlorite?
The drainage, swelling, odor itching and skin irritation seen in HS occurs as the result of bacterial and fungal overgrowth on the surface of the skin, which occurs after the keratin proteins on the skin’s surface plug up hair follicles and trap microbes within them – where they grow unchecked by the skin surface’s usual immune mechanisms.
But sodium hypochlorite is a powerful antimicrobial (there is a reason bleach is used to clean the floors in hospital rooms), with both antibacterial and antifungal properties. When used to cleanse the skin, studies have demonstrated that sodium hypochlorite can reduce the microbial colony counts that are often implicated in flares of HS.
In this manner, it makes intuitive sense that researchers were able to show HS symptom improvements following cleansing with sodium hypochlorite formulated skin cleanser.
Support HS Skin Health with CLn Skin Care
Managing Hidradenitis Suppurativa (HS) should include sodium hypochlorite cleansing as part of its skin care regimen. The CLn BodyWash and the CLn SportWash are both formulated with sodium hypochlorite and surfactants and can be used as a cleanser for patients who suffer from HS.