How to Build an HS Toolkit for Unpredictable Flares

Chantel Hillstead, a board-certified dermatology nurse practitioner, said patients with hidradenitis suppurativa (HS) often cannot predict when a flare will occur, whether at work, while traveling, or during a social event. This unpredictability can add to the anxiety surrounding the chronic inflammatory condition and leave patients without the supplies they need when symptoms arise.

In a recent Dermatology Times interview, Hillstead encouraged clinicians to help patients assemble a portable HS toolkit stocked with medications, dressing supplies, and other essentials that can help them manage an unexpected flare away from home.

Keeping Flare Supplies Within Reach

Hillstead advised patients to keep an HS toolkit at the office, in a vehicle, or in a backpack or purse so supplies remain accessible regardless of where a flare begins. The toolkit itself does not need to be elaborate; she suggested organizing supplies in a small container with multiple sealed compartments, such as a pillbox, or something as simple as a contact lens case.

“I advise all my patients to carry an HS toolkit with them. They can keep it at the office, in their vehicle, in a backpack or purse,” Hillstead said.

Medications and Cleansing Essentials

For managing symptoms during a flare, Hillstead recommended including oral analgesics, topical medications, and cleansing products appropriate for the individual patient.

“I advise they pick up a little pillbox with several sealed compartments, or even as simple as a contact case, and they can put in oral analgesics, such as acetaminophen, NSAIDs. They can put in some topical clindamycin. They can put in some benzoyl peroxide for cleansing,” Hillstead said.

Having these items readily available can give patients options for addressing pain and caring for affected areas until they can return home or access additional care.

Preparing for Drainage During a Flare

Because HS lesions may drain unexpectedly, Hillstead also recommended including dressing supplies and a change of clothing in the toolkit.

“I advise they also include some dressing supplies. They may want to keep an extra set of clothing, an undergarment, a dark T-shirt, anything just to help them get through the flare,” Hillstead said.

Keeping spare clothing on hand may be particularly useful for patients navigating flares during the workday, travel, or social activities.

A Lower-Cost Dressing Alternative

Hillstead also suggested feminine hygiene pads as a practical alternative to traditional dressing materials, particularly when patients need an option that can be secured to clothing rather than directly to irritated skin.

“This is often less expensive than traditional dressing supplies, and the nice thing is they can just stick on to the clothing, and you do not have to use some tape that can cause further damage to the skin,” Hillstead said.

Helping Patients Feel Prepared

Although a toolkit cannot eliminate the unpredictability of HS, Hillstead said being prepared may help reduce some of the anxiety patients experience when anticipating a flare.

“I want to encourage all of you to support your HS patients with a toolbox, as I think this can decrease anxiety when a flare occurs,” she said.

For clinicians, the strategy offers a simple way to address an aspect of HS management that extends beyond long-term disease control. Helping patients prepare for the practical realities of a flare may allow them to feel better equipped to navigate symptoms when they occur outside the home.

References

1. Alikhan A, Sayed C, Alavi A, et al. North American clinical management guidelines for hidradenitis suppurativa: A publication from the United States and Canadian Hidradenitis Suppurativa Foundations. J Am Acad Dermatol. 2019;81(1):76-90. doi:10.1016/j.jaad.2019.02.067. PubMed
2. Orenstein LAV, Nguyen TV, Damiani G, Sayed C, Jemec GBE, Hamzavi I. Medical and surgical management of hidradenitis suppurativa: A review of international treatment guidelines and implementation in general dermatology practice. Dermatology. 2020;236(5):393-412. doi:10.1159/000507323. PubMed