Best Treatment for Hidradenitis Supperativa

Since we are overseas my medical treatment all goes through a small family practice clinic on base. I have been dealing with HS off and on for three years. Right now I have a open sore, unlike any I have ever had before with HS.

I have been given Hibiclens, antibiotics, and I have started packing with Iodeform. Today I was told there wasn't anything else they could do for me here. We are moving to Beale AFB outside of Sacramento in a few weeks. What should my first move be to get real treatment?

Doctor Answers 3

Nd:Yag laser, photodynamic therapy and Botox can all be helpful for HS.

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HS is a very troubling condition. Newer studies do show that Nd:Yag laser can be very effective (Journal of the American Academy of Dermatology, from a study at Henry Ford Hospital in Detroit).  Photodynamic therapy as well as botulinum toxin (Botox or Dysport) can also be very effective. In reality, a combination of treatments need to be used including oral antibiotics, topical benzoyl peroxide, topical antibiotics, topical retinoids, topical dapsone, as well as chlorhexidine (hibiclens) scrubs. Surgical excision, however, is sometimes employed for very severe cases (underarm or groin)  but this can lead to significant scarring as well as risk infection, and patients can still have recurrences. This new study on Nd:Yag laser is by far the best news for HS in many many years...showing nice resolution and persistent improvement for some of these patients.

Greenwood Village Dermatologic Surgeon


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HS is an incredibly difficult condition.  It sounds like all the correct steps were taken, but did they do a culture of the wound to find out exactly what bacteria are there?  The culture results may help explain why it is not healing.  Meanwhile keeping it clean with Hibiclens and the iodoform is the right thing to do.

Good luck.  A good medical dermatologist and possibly a surgeon to assess whether an excison of extensive fistula and scar tissue willl be of great value to you in the future.

Madeline Krauss, M.D.

Madeline Krauss, MD
Boston Dermatologic Surgeon

Hidradenitis RX

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Em, There is still a lot that you can do so do not panic yet. HS is a difficult disorder but many are well controlled on different types of therapy. First thing to do is to find a good dermatologist. Accutane often works for this as might hormonal therapy with spironolactone. There is still lots of hope.

Jo Herzog, MD
Birmingham Dermatologist
4.8 out of 5 stars 20 reviews

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