HS (hidradenitis suppurativa) treatments aren’t one-size-fits-all, and that’s a good thing. It means that you can work with your health care provider to find the right HS treatment (or combination of treatments) for you that reduces or removes your HS symptoms.
Your health care provider will recommend treatments based on your HS severity, your reaction to prior treatment(s), and your other health conditions. You aren’t alone and you aren’t the first one to go through this. Here are some of the ways you can manage your HS every day. Others are thriving and you can too!
There are two main types of treatments for HS: medicines and procedures. You may get the most benefit from a combination of both.
Medicines are used to decrease the inflammation caused by the immune system. Medicines can vary from things applied to your skin (lotions, washes, etc.) or taken as a pill, injection, or infusion.
When you talk to your health care provider, you might try washes or medicines that you apply to the surface of your skin. The ingredients in topical medicines can be an antibiotic or anti-inflammatory. Washes are used to decrease the bacteria on the surface of the skin that cause odor and may worsen the inflammation. Topical medications can be rubbed on the places where you get HS to either treat spots you have or prevent new spots from coming up.
Pills are used to treat HS, especially if it is happening in multiple spots on your body all at once (it’s hard to rub a medicine over a bunch of places!). Pills are useful because it can be hard for topical medicines to get down through the skin surface. Pills can get the medicine to the skin from the inside.
Antibiotic pills are used to treat HS because bacteria on the skin or in the HS lesions can flood into the inflammation. Remember, bacteria are not the only reason HS happens – it’s also the immune system. Antibiotics can be used for a week or two, or months at a time. Antibiotics can also be used in combination with other treatments.
Pills that influence the hormones in the body can also help treat HS. Your hormones can influence your immune system and your skin. These pills aren’t antibiotics and can be used for years, if needed.
Steroid pills can also be used to lower inflammation. These pills can have side effects if they are used for a long time, so they are often used for a range of one to several weeks to treat a flare-up, or when you are changing from one treatment to another.
Steroids can also be injected into lesions to take the pain and swelling away. These injections don’t help HS bumps in other places, so they tyipcally aren’t a great way to control the HS over many years.
Other HS medicines are injected or infused (through an IV) and are meant to treat all the areas of HS. Many of these medicines lower the overactivity of the immune system but target just a couple of the chemicals in the immune system. Consequently, they aren't lowering the whole immune system. Antibiotics are sometimes given this way rather than in a pill or rubbed on the skin.
Procedures are used to decrease inflammation in the skin, but do so by changing the structure of the skin. Procedures can vary from laser treatments that don’t break the skin, to lancing the skin, to small surgeries that can often be done in a clinic, or larger surgeries that may require a hospital operating room.
A deroofing is a procedure done in the office (while you are awake, not in an operating room). The top of a tunnel of HS is opened to remove that one area of HS. The rest of the skin that doesn’t have HS is left alone.
Larger procedures are used to remove tunnels completely, sometimes removing a large area of skin affected my multiple tunnels.
Complementary and alternative medicine (CAM)
CAM typically includes a diverse group of medical and health care products and practices, which includes diet and nutrition, acupuncture, supplements, mind/body techniques, and others. These therapies may build onto your current treatment plan. You and your health care provider may talk about these options.
Pain, Stress, and Emotional Strain
HS can be very painful. We want to treat the pain by treating the thing that causes it – the HS inflammation. That is where the treatments described above come in! If you’re having pain that isn’t controlled, tell your doctor. You can add other treatments into your HS treatment plan, including pain medicines, wound care, and/or physical therapy. Your doctor may have you meet a pain specialist to help you manage your pain.
While HS is a physical disease, the pain and other symptoms can take a real emotional toll. Don’t be afraid to ask for help when you need it. Join a patient support group to connect with others who share your story.
We believe in a cure for HS.
We are learning more from research about what causes HS. This is helping us to better treat HS. So if you think you might have HS, the good news is: You are not alone. You are a part of our community.
Learn more, connect now.