Is it safe to use lidocaine patches for hidradenitis suppurativa abscesses that have not drained yet? (Photo)

Dear question540,Thank you for your question. Hidradenitis is a difficult and vexing condition. I have cured many patients surgically, but not longer treat extensive cases. Surgery used to be the first line option for refractory cases. Now, drugs like Humira can produce complete remission and it is worth talking to a dermatologist. If you are a candidate, you may want to try it. It has cured several patients of mine without the need for further surgery.Good luck,Nirmal R. Nathan, M.D.Certified, American Board of Plastic SurgeryMember, American Society of Plastic Surgeons

There are 2 issues the 1st being the painful abscesses and the 2nd being the actual disease leading to recurrence. If possible it is better to resolve the abscesses before having a definitive surgical excision to prevent recurrence. That will require an incision and drainage. I have had some patients respond to just needle and syringe decompression in preparation for definitive surgery. It is less messy/painful and requires less care afterward than actual incision and drainage. The pain and limited range of motion are due to the pressure of the expanding abscess, which really is the easiest part to treat.

Thank you for sharing your question. I would advise that you seek a consult with a board certified dermatologist. HS can occur in one or multiple areas of your body. HS usually develops in your armpits, groin, and anal area. It causes long-term skin inflammation and can be painful. HS can be treated with bio injectables (Humira) and oral medications. Seek medical treatment to assure that you are getting the best results. In some cases you may need a round of oral antibiotics to help with the inflammation before anything can be done.

Your condition is severe. It is not something that an urgent care doctor can handle. If an in person exam, confirms what my impression is from the picture, you need a complete excision of the hair and apocrine gland bearing skin of your arm pits and possibly a skin graft. The surgery should be done in a hospital under general anesthesia. 

this is a challenging condition it to treat. It should be done either by a plastic surgeon or dermatologist.
 If you feel this infection is significantly worse than what you've had in the past and you should be treated for it sooner rather than later by being on anabiotic's and or having the area incised and drained. Lidocaine patches should be safe but clearing the infection will be more effective at controlling your pain long-term.
 Talk to your primary care doctor. 
Best 
Mats Hagstrom M.D.