Hidradenitis Antibiotic Courses: What to Log, Short and Long

Updated 29 Oct 2026

Antibiotics for hidradenitis can mean two very different things: a short course for an infected flare, or months of low doses to calm inflammation. The log for each one looks different, and both are easy to lose track of.

This guide covers what to log for each course: which one you are on, doses, lump counts, side effects, other medicines, and what to bring to the review. Your clinician chooses the medicine and the length.

What to log about which course you are on

The NHS says that if you have lumps that are particularly painful, inflamed, and oozing pus, you may be prescribed a 1- or 2-week course of antibiotics, if tests show that you have a bacterial infection (NHS hidradenitis suppurativa guidance). It says a GP may take a swab of an infected area (NHS hidradenitis suppurativa guidance).

It says that if bacterial infection is not present, low doses of antibiotics may be used to prevent inflammation, and this longer course will last at least 3 months, to reduce the number of lumps that develop (NHS hidradenitis suppurativa guidance). Antibiotics may be given as a cream (topical) or as a tablet, capsule, or liquid (NHS hidradenitis suppurativa guidance).

At the start, write the medicine name, the form, the dose, the start date, and which course it is: short for an infection, or long for inflammation. Add the swab date and result if you were told it. That one line tells any later clinician what the course was meant to do.

In Hidradenitis Journey, My Meds keeps the course with its start date.

What to log about doses

For doxycycline, one of the antibiotics the NHS lists for hidradenitis, the NHS advises taking it at the same time each day, swallowing it with a glass of water while sitting or standing up, and avoiding lying down for at least 30 minutes after (NHS doxycycline guidance). It says to keep taking it until you have finished it all, even if you start to feel better (NHS doxycycline guidance).

If you forget a dose, the NHS says take it as soon as you remember, unless it is nearly time for your next dose, and do not take 2 doses to make up for a missed dose (NHS doxycycline guidance). For other antibiotics, check the leaflet that comes with the medicine.

Tick each dose with the time. On a 3-month course, missed doses add up quietly, so note each one and what you did. A weekly count of missed doses is easier to share than memory.

In Hidradenitis Journey, the Daily check-in keeps each day's doses.

How to count lumps during the course

The NHS describes hidradenitis as causing a mixture of boil-like lumps, blackheads, cysts, scarring, and channels in the skin that leak pus (NHS hidradenitis suppurativa guidance). It says the lumps will either disappear or rupture and leak pus after a few hours or days, and new lumps will then often develop in an area nearby (NHS hidradenitis suppurativa guidance).

The aim of the long course, the NHS says, is to reduce the number of lumps that develop (NHS hidradenitis suppurativa guidance). A count is the simplest way to see whether that is happening.

Once a week, count new lumps, draining lumps, and lumps that settled, by area. Score pain on a 0 to 10 scale. Start the count before the first dose if you can, so the review has a baseline. A dated photo of one area each week can help too.

For drainage weeks, see what to note on drainage days.

In Hidradenitis Journey, the Flare Tracker marks new flare days.

What to log about side effects

For doxycycline, the NHS lists common side effects as headaches, feeling sick (nausea) and being sick (vomiting), and a rash (NHS doxycycline guidance). It advises speaking to a pharmacist or doctor about side effects that bother you or do not go away, and to keep taking the medicine unless you are advised to stop (NHS doxycycline guidance).

It lists possible serious side effects, including an allergic reaction (anaphylaxis), your skin being more sensitive to the sun, with a rash, itching, and redness, inflammation in the bowel, with a stomach ache and bloody diarrhea, and changes in your blood cells, with tiredness, bruising easily, or getting ill a lot (NHS doxycycline guidance). It says to call NHS 111 if you think you might be having serious side effects (NHS doxycycline guidance).

Log each side effect with the date, the time after a dose, and how long it lasted. On a long course, note sun exposure on days with a skin reaction.

In Hidradenitis Journey, the Daily Journal keeps side effects in your own words.

What to log about other treatments and medicines

The NHS says antiseptic washes, such as 4% chlorhexidine, applied daily to affected areas are often prescribed alongside other treatments (NHS hidradenitis suppurativa guidance). In severe cases, it says a combination of clindamycin and rifampicin can be effective, and immunosuppressive treatments such as adalimumab or infliximab can be useful, usually prescribed by a dermatologist if other treatments do not work (NHS hidradenitis suppurativa guidance).

For doxycycline, it says some medicines and supplements may not mix well, including some types of anticoagulants (such as warfarin), antacids and other indigestion treatments, acne medicines, and medicines or supplements that contain iron or zinc (NHS doxycycline guidance). It advises telling your doctor about any other medicines, herbal remedies, vitamins, or supplements (NHS doxycycline guidance).

Keep one list of everything you use, including washes and creams, with the time of day. Bring it to the pharmacist.

In Hidradenitis Journey, My Meds keeps washes and medicines in one list.

What to bring to the review

The NHS says hidradenitis is a lifelong, recurring condition that is often difficult to manage, although the symptoms may improve or eventually stop with treatment (NHS hidradenitis suppurativa guidance). It says surgery may be considered in cases that cannot be controlled with medicine (NHS hidradenitis suppurativa guidance).

It notes that having to regularly change dressings and constantly live with the pain and discomfort of the symptoms can affect your quality of life and lead to depression, and advises speaking to a GP if you are finding it difficult to cope (NHS hidradenitis suppurativa guidance).

Bring the course dates, missed doses, the weekly lump counts from before and during the course, side effects, and how you are coping. Ask what the next step is if the count did not fall, and write the answer down. A short visit goes further with the summary ready.

For that visit, see what to bring to a 15-minute visit. After a first diagnosis, see the first weeks with hidradenitis.

In Hidradenitis Journey, the Doctor Report turns the course into a summary.

How Hidradenitis Journey can help

A notebook can hold one bad day. The harder part is keeping doses, lump counts, side effects, and other treatments in one dated record.

Hidradenitis Journey is a personal hidradenitis tracker from Health Journey Labs on the App Store and Google Play. It records symptoms, medicines, test dates, and visits in one dated history. Below is what you can use and how each part helps:

• Daily check-in — A short guided pass across symptoms, mood, nutrition, sleep, exercise, meds, and external factors, including nodule pain, drainage, and skin-fold flares, so links you would not remember on your own show up side by side.
• Daily Journal — Freer notes, including voice when typing hurts, such as dressing counts, photo notes, and visit debriefs, that add detail a score alone cannot show.
• Flare Tracker — Mark a day clearly worse than your usual, with onset, sites, and intensity, so you can tell a one-off spike from a repeating pattern.
• My Meds — Medicine names and timing, so you can line up a start date or dose change with lump counts, pain, and sleep.
• My Labs — Result dates for swabs, blood work, imaging, and other tests, compared with how you felt in the weeks before and after.
• Weekly Goals — Set one small aim, such as a daily wash routine or looser clothing on long days, and see whether it held and whether flares changed.
• Learn — Short education topics on HS themes such as flares, sleep, pacing, and visit preparation.
• AI companions — Clara and specialist companions already see your logged history, which helps with visit wording or questions after a new diagnosis.
• My Care Team — A profile for each clinician, plus upcoming appointments and notes for each visit, used before, during, and after appointments.
• Doctor Report — Two views: the Appointment Planning Report helps you prepare what to ask, and Generate Report, opened from a saved doctor, builds a dated summary of your recent progress for that doctor.
• My Assessments — Structured check-ins that add context about you across weeks.
• Food Tracker — Meal and drink lines when food is something you and your clinician are watching alongside flares.
• Period Tracker — Cycle dates, so you can see whether new lumps cluster at a certain point in the cycle.
• Weight Tracker — Weight entries when weight is part of what you and your clinician are watching.

Everything you log builds one history. Guided forms include the key questions, and you can add custom symptoms when you need your own labels. Hidradenitis Journey is free to download.

Sources

• NHS — Hidradenitis suppurativa (HS)
• NHS — Doxycycline

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