HS surgeries associated with high satisfaction, brief recovery and tolerable pain

June 2, 2022

Considering surgery for treating hidradenitis suppurativa (HS) can feel intimidating, especially because it can be hard to know what to expect.  How long will it take to recover?  What will the pain be like?  How likely are patients to be happy with the outcome?  

Patients report being satisfied with HS procedures.

This study of 78 patients that had 194 surgical procedures helps to answer some of these common questions by using surveys to ask patients about their impressions in the months after their procedures.  All procedures in this study were performed by a dermatologist in an office with local anesthesia (shots to numb the procedure area without "going to sleep").  Overall, 76% of patients were "very" or "extremely" satisfied with the results, and another 10% were somewhat satisfied.  85% reported being glad that they had surgery.  

HS procedure-related pain is tolerable.

While the idea of pain during and after the procedure can be intimidating, 65% of patients rated the pain during the first week of their recovery as being less severe than the pain of a typical HS flare.  Pain during the procedure, including from injections or numbing medicine, was rated at 5 or less on a 10-point scale (0 = no pain, 10 = severe pain) for 80% of patients.  

HS procedure-related recovery was short.

The average time to return to work or school was 2 days, and the average time to return to typical activities such as exercise was 10 days.  Of course, some patients with smaller wounds returned to work immediately, while others had longer recoveries.  The time to complete healing was typically 4-5 weeks after surgery.

Recurrences do happen but overall HS is improved after office procedures.

While similar studies have shown rates of recurrence (HS returning along the scar) of 15-25%, this study had a higher rate of recurrence of approximately 40%.  There are a number of factors that may have caused this rate to be higher than typical, but it is important to remember that many recurrences are likely small and temporary.  Generally, satisfaction was still very high despite most recurrences since patients felt improved overall.

Saranya Ravi, PhD1; Jonathan A. Miles, MD, MPH2; Chelsea Steele, MD, MPH3; Mary Kate Christiansen, BS1; Christopher J. Sayed, MD2. Patient Impressions and Outcomes After Clinic-Based Hidradenitis Suppurativa Surgery

JAMA Dermatol. 2022;158(2):132-141. doi:10.1001/jamadermatol.2021.4741