Hidradenitis Pain, Itch, and Sleep: What to Log at Night

Updated 29 Oct 2026

With hidradenitis suppurativa, the nights can be the hardest part, and by the morning, the details of what kept you awake are already fading.

This guide explains what to log at night: pain and itch by body area, how you slept, the bedroom and the evening, the day after, and how to bring it to your dermatologist.

Why log nights with hidradenitis

The AAD notes that pain and itch can affect your ability to fall asleep and stay asleep, making the next day feel harder, and that continual sleep loss can lead to feeling fatigued every day (AAD). It adds that some patients say they were unaware of how fatigue was affecting their life until treatment improved their symptoms (AAD).

That last point is the case for a log. Tiredness that builds slowly is easy to accept as normal. A dated record of nights and days makes it visible, both to you and to your dermatologist, and it gives you a starting point to compare against if treatment changes.

Keep the entry short so you can do it on bad mornings: a few fixed fields at the same time each day are more useful than a long note written once a week.

For the visit itself, see what to bring to a short hidradenitis visit.

In Hidradenitis Journey, the Daily check-in holds sleep beside pain, drainage, and mood, so nights and flares line up.

How to score pain and itch at bedtime

The AAD notes that the deep lumps and tunnels beneath the skin can be painful, and that the groin, armpits, and thighs tend to be itchiest (AAD). It also notes that before a lump appears, an area of skin may feel tender or painful, and some people say their skin burns, itches, or sweats excessively (AAD).

At bedtime, rate pain and itch separately from 0 to 10, and name the body area for each, such as left armpit or inner thigh. If one area is much worse, note it on its own line.

Add a word if an area feels tender or burns without a visible lump. Those early signs are worth a date, since a lump may follow in the same place over the next days.

If you use a warm compress for a painful lump, log the time and the area. The AAD describes a warm water compress left on for 10 minutes, repeated several times during the day, to reduce pain (AAD). Note how the pain felt before and after.

In Hidradenitis Journey, the Daily check-in holds the scores, and the Flare Tracker marks a night when a flare is clearly worse than usual.

What to record about the night

The NHS lists signs of insomnia that can each become one field: finding it hard to go to sleep, waking up several times during the night, lying awake at night, and still feeling tired after waking up (NHS).

Each morning, write the time you went to bed, a rough guess of how long it took to fall asleep, how many times you woke, and the time you got up. Then rate how rested you feel from 0 to 10.

For each waking, add what woke you in a word or two: pain, itch, a lump that drained, a damp dressing, or being too hot. A pattern such as "woke from itch, right armpit" across several nights says more than a general bad-sleep score.

If an abscess broke open in the night, note it. The AAD notes that when an abscess breaks open, blood and pus can cause wet spots on your clothes (AAD). The note helps you see how often it happens. For drainage days, see what to note on drainage days.

In Hidradenitis Journey, the Daily Journal holds the short notes, by voice if typing hurts.

What to note about the bedroom and the evening

The AAD notes that sweating and overheating can cause a flare-up, and advises staying in a cool space (AAD). The NHS lists a room that's too hot or cold, noise, and uncomfortable beds among common causes of insomnia, and advises a dark, quiet bedroom (NHS).

Each night, note how warm the room felt, whether you woke sweating, and what you slept in. The AAD notes that clothing rubbing on a painful lump can irritate the skin (AAD, self-care tips), so note whether nightwear was loose or tight over the sore areas.

Add the evening basics the NHS links to poor sleep: any alcohol, tea, or coffee in the last 6 hours before bed, a big late meal, and screens right before bed (NHS, Insomnia). Tick them rather than writing paragraphs.

After two or three weeks, compare cooler nights with warmer ones, and loose nightwear with tighter, for both waking and new lumps in the following days.

In Hidradenitis Journey, the Daily check-in records external factors such as a hot night, and Weekly Goals can hold one change, such as a cooler room.

How to log the day after a bad night

The AAD notes that sleep loss can make the next day feel harder and lead to feeling fatigued every day (AAD). The NHS notes that poor sleep can leave you tired and irritable and make it difficult to concentrate during the day (NHS). The AAD also notes that some people feel less motivated or less able to perform at work or school (AAD).

Each evening, rate tiredness and concentration from 0 to 10, and add one line on what the day allowed: a full day at work, a shortened day, or plans canceled.

Log naps with their start time and length. Then check whether the following night was better or worse, since the link can run both ways.

Mood belongs here too. The AAD notes that studies have found people with hidradenitis suppurativa tend to develop depression more often than people without it, and that anxiety can come with not knowing why lumps keep returning (AAD). A daily mood score next to sleep helps you raise both with your care team.

In Hidradenitis Journey, the weekly view sets tiredness and mood beside pain and flares.

How to bring a night log to your dermatologist

The AAD notes that dermatologists help patients manage pain, and that working one-on-one with a board-certified dermatologist can help you find what works best for you (AAD, AAD). The NHS advises seeing a GP if changing your sleeping habits has not helped, or if you've had trouble sleeping for months (NHS).

Before the visit, prepare a few lines: how many weeks you logged, average pain and itch scores at bedtime, how many nights a week you woke from pain or itch, the areas involved, average rested score, and how tired the days were. Put your main question at the top, such as how to manage night pain or itch.

List anything you use at night, including compresses, dressings, creams, and medicines, with start dates. The NHS advises checking with your doctor before taking anything for your sleep problems (NHS, Insomnia).

If a flare area changed, bring a comparable photo too; see what to note in underarm flare weeks.

In Hidradenitis Journey, My Meds keeps names and start dates, and the Doctor Report builds a dated summary for a saved doctor.

How Hidradenitis Journey can help

A notebook can hold a pain score. The harder part is keeping nights, pain, itch, flares, and days in one dated record.

Hidradenitis Journey is a personal hidradenitis suppurativa tracker from Health Journey Labs on the App Store and Google Play. It records flares, pain, drainage, sleep, medicines, and test dates in one dated history, and its insights show which habits and treatments come before calmer or harder weeks. 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

• American Academy of Dermatology — Hidradenitis suppurativa: Signs and symptoms
• American Academy of Dermatology — Hidradenitis suppurativa: Tips dermatologists give their patients
• NHS — Insomnia

FAQ