Hidradenitis suppurativa (212)-644-9494 New York, NY

Hidradenitis suppurativa

Hidradenitis suppurativa

 Hidradenitis suppurativa (HS) is a chronic disease of a type of sweat gland. It can occur in one or multiple areas of your body. HS usually develops in your armpits, groin and anal area. It causes long-term skin inflammation and can be painful.

Medical management (212)-644-9494

Medical management includes:

Treatments include antibiotics, anti-inflammatory medicines and sometimes surgery. Losing weight and wearing loose clothing can help, too..

Surgical management (212)-644-9494

  • Incision and drainage of abscesses – at the very painful pointing stage.
  • Persistent hidradenitis lumps may be excised after several months of conservative treatment (i.e. waiting and/or antibiotics).
  • Radical excisional surgery is reserved for very severe cases of hidradenitis suppurativa.
  • Experimentally, laser ablation may be useful in some patients.
Carbon dioxide laser treatment is a relatively new treatment for hidradenitis suppurativa. It is suitable for those with mild to moderate/severe disease and doesn’t require hospitalisation.

What is the treatment of hidradenitis suppurativa? (212)-644-9494 New York, NY

What is the treatment of hidradenitis suppurativa?

Treating hidradenitis suppurativa is difficult. It is best treated in the early stages before extensive scarring develops. However, it must be diagnosed correctly. The following are some of the treatment options:

Antibiotics - Oral antibiotics may help suppress the inflammation especially in mild cases, but they do not cure the disease. The same antibiotics that are used for acne are used for hidradenitis suppurativa, only in higher doses. These antibiotics include erythromycin, tetracycline, minocycline, and doxycycline. Topical antibiotics do not help.

Isotretinoin (Accutane) - Isotretinoin may be helpful in mild cases, but the response is unpredictable. Sometimes isotretinoin is used to reduce the size of the affected areas prior to surgery. Isotretinoin does have significant side effects and must not be used by pregnant women.

Steroid injection - Injecting a steroid into an inflamed lesion is sometimes helpful. The injection helps reduce inflammation and may be used if an area is especially painful. Steroid injections are normally combined with other treatments.

Surgery - In moderate to severe cases, surgery is the most definitive option. Taking out only the immediately affected area only leads to recurrence of the disease. The treatment of choice is called wide local excision. In this procedure, the affected area and surrounding normal tissue are surgically excised. The excision is not stitched back together but left open to heal from the inside out. Skin grafts may be placed in the excised area to speed healing.

    What causes hidradenitis suppurativa and who gets it? (212)-644-9494

    The exact cause of hidradenitis suppurativa remains unclear. What is understood is that the condition is a disorder of follicular occlusion. This begins with follicular plugging that obstructs the apocrine gland ducts and perifolliculitis around the ducts. This is followed by rupture of the follicular epithelium, bacterial infection and formation of sinus tracts between abscesses under the skin, all which lead to the characteristic symptoms and signs of hidradenitis suppurativa.

    (212)-644-9494 New York, NY

    The following are thought to play a role in the development of hidradenitis suppurativa.
    • Genetics – frequently reported cases of hidradenitis suppurativa affecting multiple members of a family
    • Sex hormones – apocrine sweat glands are stimulated by androgen and suppressed by oestrogen (exact role these hormones play remains controversial)
    • Endocrine factors – obesity, hirsutism and acne are common findings among women with hidradenitis suppurativa
    • Cigarette smoking – hidradenitis suppurativa appears to occur more frequently in smokers than non-smokers