Q: What is Hidradenitis Suppurtiva?
A: Hidradenitis Suppurtiva (HS) is a chronic and often times debilitating condition which affects the areas of the skin containing apocrine sweat glands (larger sweat glands found in certain areas of the body). HS is often hereditary, presenting after puberty with a higher prevalence among woman and African Americans. Patients may suffer from painful nodules and abscesses that recur and are predominately found in the skin folds including the axilla (armpits), breast fold, groin, and buttocks. HS may first appear as a small, painful, inflamed bump. As the condition progresses patients may have thickened, woody scar tissue with multiple connecting sinus tracts.
Q: What conservative treatment options exist for HS?
A: Conservative treatments include hot compresses, topical cleansing agents and suppressive antibiotics. These can decrease the severity of the condition and increase the time period between flare ups. Medical treatments can include anti-microbial (killing microorganisms or stopping their growth) and anti-inflammatory approaches to try and control the condition. This may require the use of antibiotics as well as biologic medications. Definitive treatment will usually involve surgical excision of the affected portion of skin.
Q: Is surgery an option?
A: Surgery is the definitive treatment in regards to HS as it removes the involved tissues, including areas of active disease as well as regions with significant fibrosis and scarring that are limiting and painful to patients. Surgery is ideally performed during periods of dormancy of the active condition and is typically done on an outpatient basis. At The Plastic Surgery Center, we approach HS in a multimodal treatment fashion. Your treatment plan will be tailored to your specific needs by the involvement of a Plastic Surgeon as well as a Rheumatologist.