Hidradenitis suppurativa (HS) is a skin condition that frequently causes infection and tunneling under the skin. It most commonly affects areas where there is skin-on-skin contact, like the groin and underarms. Although this condition is painful and difficult to manage, there are treatments that may reduce the severity.

Skin Removal

In some instances, people with HS may find the problem is exacerbated in specific regions where there is excess skin contact, such as under the breasts or beneath the lower stomach. Depending on skin elasticity, weight loss might help, but even with weight loss, many people are left with excess skin that creates significant sagging. When this occurs, a breast reduction or tummy tuck might reduce the problem in these areas. Since most plastic surgery is considered cosmetic, routine documentation of problems in these areas might be considered medically necessary and covered by insurance. People who have these procedures need to be especially careful about their diet and weight after the procedure. Otherwise, the problem will likely resurface.

Medications

Depending on the severity of HS and the current state of the skin, antibiotics might be necessary to reduce current skin and tunnel infections. Antibiotics might be given systemically or topically, depending on the extent of the infection. Unfortunately, any benefit is only temporary, because similar infections often return. More recently, medications used to control HS have appeared on the market. These medications are typically injectable biologics and target HS at the source, which is an autoimmune disease. Suppressing different components of the immune system responsible for inflammation and attacking healthy tissue may reduce flare-ups of HS or the severity of the condition.

Surgical Procedures

Surgical procedures may be done to temporarily alleviate active HS infection. For example, an incision and drainage may be done to reduce pain associated with pockets of infection and make it easier for medications to help clear the infection. This is typically done in-office by either a primary care provider or a dermatologist. More extensive surgery might be done by a general surgeon. A surgeon might remove nodules that are especially painful and prone to infection. More extensive surgeries might be used to remove most or all of the tunnels in a specific location and help reduce the amount of scar tissue that occurs because of tunnels and frequent infections. Speak with a general surgeon to see if this would be the right solution for you.

HS is a painful, chronic condition that can affect multiple areas of the body. As medical professionals better understand the condition, there are more treatment options available to better control the condition.