Your Guide to Understanding Hidradenitis Suppurativa Treatment

There can be a lot of stigma with hidradenitis suppurativa. Some people mistakenly believe the sores are contagious or that the disease is caused by poor hygiene.⁶ These misconceptions are all untrue and only further contribute to harmful misconceptions about the disease.

How do you get a hidradenitis suppurativa diagnosis?

Hidradenitis suppurativa can be mistaken for other skin conditions, such as an infected hair follicle, so people may not get diagnosed for up to 12 years after they first develop symptoms, according to a 2015 paper published in Mayo Clinic Proceedings.⁷ Seeing a hidradenitis suppurativa expert, if you’re able to, can help you get an accurate diagnosis if you think you have the condition. There is no lab or blood test for hidradenitis suppurativa, but a board-certified dermatologist familiar with the condition will know how to screen you, Dr. Xu says.

Your dermatologist will ask where your lesions typically occur and examine any bumps if you have them at the time of your appointment, according to the ADA.⁸

What are the hidradenitis suppurativa stages?

Hidradenitis suppurativa is classified into three stages, depending on the disease’s symptoms and severity.⁹ They include:

• Hurley stage 1: This is the mildest stage of the disease and you may get abscesses, but you don’t have more severe symptoms like scarring or sinus tracts.
• Hurley stage 2: In this stage you’ll experience reoccurring abscesses, sinus tracts, or scars.
• Hurley stage 3: This is the most severe stage, which may include multiple areas of sinus tracts, and many reoccurring abscesses.

What are my hidradenitis suppurativa treatment options?

Based on your particular situation, your doctor can create a treatment plan to help with your pain, reduce your flares, and help your wounds heal. Your plan can include a combination of at-home remedies, medications, and office procedures.¹⁰ Keep in mind that your treatment options may change over time based on new research and newly available therapies. Make sure you have ongoing conversations with your doctor about which treatment options may be best for you. Since hidradenitis suppurativa can severely affect how you feel about yourself and your self-esteem, you may want to consider mental health care as part of your treatment plant too.

Some people with mild cases of hidradenitis suppurativa may try laser hair removal and see whether they have any improvement, according to the AAD. However, people with dark skin may have an increased risk of skin damage from certain types of laser with laser hair removal, so it’s important that this is done with a dermatologist who can assess what’s right for you. Also, laser hair therapy may not be as effective in individuals with gray, red, blond, or white hair, so it’s always a good idea to talk to a doctor before going to get this done, according to the Mayo Clinic.¹¹

What are some home treatments for hidradenitis suppurativa?

You may feel more comfortable by doing a few simple things at home:

• You can use a warm compress for 10 minutes a day to help reduce inflammation and encourage lesions to drain, according to Dr. Xu.
• You can prevent infections by using an antiseptic cleanser like chlorhexidine 4% or benzoyl peroxide in the shower.
• You can reduce any odor by applying a solution of white vinegar and water to your lesions, Dr. Xu says. To do this, dip a washcloth into a mixture of equal parts water and vinegar.
• Wearing loose, comfortable clothing that doesn’t cause friction can help you avoid irritating flares.
• Try to stay as cool as possible and look for ways to reduce your sweating, like by seeking shade whenever possible, since perspiration can cause hidradenitis suppurativa flares, according to the AAD.

What are some hidradenitis suppurativa medications?

Depending on your particular case, your doctor may prescribe a variety of medications to reduce flares or help with inflammation. Here are some common options: