Hidradenitis suppurativa is a chronic skin condition characterized by the formation of painful cysts on and under the skin. Broken cysts can cause permanent damage to your skin’s appearance if not treated. Scars can be unpleasant to look at and cause many people discomfort and low self-esteem.
Dermatologist Asfa Akhtar, DO, discusses the importance of prompt treatment of hidradenitis and offers several strategies for minimizing scarring.
Hidradenitis suppurativa is a chronic condition, so there isn’t a known permanent cure. Like psoriasis, flare-ups can happen on occasion. When they do, it’s important to address them as early as possible before your condition worsens.
“When cysts form, they connect with each other under the skin through deep tunnels that pull your skin down,” explains Dr. Akhtar. “It almost causes a tent-like phenomenon where your skin will create ridges and then you’re left with these deep scars on your skin.”
Fortunately, there are a few things you can do to reduce scarring.
Get an early diagnosis
At the first sign of pimples or cysts on parts of your body where you grow hair (like your armpits, groin and buttocks), you should see your doctor. Although these may appear like normal acne, if they’re consistently popping up and normal acne treatments aren’t working, you should have them looked at. Left untreated, your cysts connect with each other and, if they continue to be inflamed, they can grow, develop pus and eventually break open. This is what causes scar tissue to form.
Keep your wounds clean and moisturized
If you have a broken cyst that produces discharge, blood or pus, make sure you keep the area clean and disinfected. You can use rubbing alcohol to clean the surface, but try not to do this often because it can dry out your skin and cause further scarring. Aloe vera and other moisturizing creams and topical ointments are available to keep your skin from drying out. But the most important thing is to keep the surface of your skin clean. This will limit further infection until you can see your doctor for further treatment. And you should never pop them.
“Anything that’s oozing or having a discharge should be bandaged,” advises Dr. Akhtar. “You don’t want that discharge to touch other parts of the body because it can spread.”
More advanced treatment options
At a minimum, you should pay close attention to signs and symptoms and seek medical care at the earliest stages to avoid an increase in cysts and scar tissue. But there are other solutions you can use, too, with the help of a board-certified dermatologist.
Laser hair removal
Laser hair removal reduces the number of hairs in one area across several treatments. By removing hair, you prevent infection and the initial clogging of pores that leads to inflammation and hidradenitis suppurativa flare-ups.
“If we get rid of the hair, 30% of the problem is solved because that hair is not coming out and causing inflammation,” says Dr. Akhtar. “I recommend all patients who have hidradenitis suppurativa get laser hair removal.”
Steroid injections
Steroid injections can be used to reduce inflammation in an inflamed cyst. This is especially helpful if you’ve had a cyst break open because the inflammation doesn’t go away even when a cyst has been drained. By reducing inflammation, you reduce the potential for further cyst formation. You also decrease the pressure build-up that causes deep scars to form.
Laser surgery and excision
For severe hidradenitis suppurativa, there are surgical options. Removing the cysts, as well as the deep tunnels that connect them, allows your skin to fall flatter, reducing the severity of the scar tissue. This is helpful because those deep scars can sometimes cause problems with movement, including a feeling of tightness or pressure. You can also benefit from laser surgery to remove large areas of scar tissue that includes surface scars and deep, inflamed follicles.
Can you prevent hidradenitis suppurativa scars?
If you have hidradenitis suppurativa, scarring is inevitable. But you can reduce the severity of the scars that form by treating flare-ups as they happen early on.
“If you have a hole in a bucket that’s full of water, and you don’t patch that hole, the water will keep dripping and you will never have a bucket full of water,” says Dr. Akhtar. “We need to start treating the hidradenitis, and once the hidradenitis improves, some of the scarring or future scarring will improve to a certain degree.”
How Do You Get Rid of Dark Scars from HS?
Dark scars, or hyperpigmentation, are a concern for many individuals with Hidradenitis Suppurativa. Here are some effective methods to reduce dark scars:
- Topical Creams: Over-the-counter or prescription creams containing ingredients like hydroquinone or retinoids can help lighten dark scars over time.
- Chemical Peels: Dermatologists may recommend chemical peels to exfoliate the skin and improve the appearance of hyperpigmentation.
- Laser Therapy: As mentioned earlier, laser treatments can effectively target dark scars and stimulate collagen production.
- Sunscreen: Regularly applying sunscreen with a high SPF can prevent darkening of scars due to sun exposure.
Remember, consistency and patience are key when dealing with hyperpigmentation. It may take several weeks or months to see noticeable improvements.
What Is the Best Laser for Hidradenitis Suppurativa?
The choice of laser treatment for Hidradenitis Suppurativa largely depends on the severity of the condition and the type of scars present. Some of the most effective laser treatments for HS scars include:
- Fractional Laser Resurfacing: This treatment uses tiny beams of light to target small areas of the skin, stimulating collagen production and improving texture.
- Pulsed Dye Laser: Particularly effective in reducing redness and inflammation associated with HS scars.
- CO2 Laser: This ablative laser can be used for more severe scarring, promoting new skin growth and reducing scar depth.
- Nd:YAG Laser: Suitable for darker skin tones, this laser targets pigmented scars and helps achieve more even skin tone.
Consulting a dermatologist is essential to determine the most suitable laser treatment based on individual skin type and scar characteristics.
Can Laser Surgery Remove Hidradenitis Suppurativa Boils?
Laser surgery can provide relief for individuals suffering from painful Hidradenitis Suppurativa boils. Laser treatment, especially Nd:YAG laser, can be used to target and destroy the infected tissue in the boils, promoting healing and preventing recurrence. Additionally, laser therapy can help reduce the inflammation and pain associated with the condition.
It is important to note that laser surgery is not a permanent cure for Hidradenitis Suppurativa. While it can effectively manage existing boils, the condition itself requires comprehensive and ongoing management to minimize flare-ups and prevent further scarring.
Can Hidradenitis Come Back After Surgery?
Unfortunately, Hidradenitis Suppurativa can come back after surgery. While surgical procedures can provide temporary relief by removing infected tissue and draining abscesses, they do not guarantee a permanent cure. HS is a chronic condition with no known definitive cure, and recurrence of symptoms is possible.
To reduce the chances of recurrence, individuals are advised to follow a comprehensive treatment plan that may include lifestyle changes, medications, laser therapy, and post-operative wound care.
What Is the Latest Treatment for Hidradenitis Suppurativa?
Medical research and advancements are continually evolving, and the field of Hidradenitis Suppurativa treatment is no exception. One of the latest treatment approaches is the use of biologics, which are targeted therapies that work on the immune system to reduce inflammation. Biologics have shown promising results in managing HS and preventing further complications.
Other novel treatments being explored include stem cell therapy, immunosuppressants, and innovative surgical techniques. However, it is crucial to remember that not all treatments are suitable for every individual, and consulting a dermatologist or HS specialist is essential to determine the most appropriate treatment plan.
Why Don’t HS Wounds Heal?
HS wounds can be slow to heal due to several factors:
- Chronic Inflammation: The ongoing inflammation in HS-affected areas can impede the natural healing process.
- Infection: HS lesions are prone to infection, which can further delay healing.
- Impaired Immune Response: HS is believed to be an autoimmune condition, and the immune system’s abnormal response can hinder wound healing.
- Friction and Irritation: Constant friction and irritation in affected areas can prevent wounds from closing properly.
To support wound healing, individuals should maintain good wound care practices, avoid picking or squeezing lesions, and follow their healthcare provider’s instructions diligently.
Is HS Surgery Painful?
The level of pain experienced during HS surgery can vary depending on the procedure’s extent and individual pain tolerance. Local anesthesia is typically used to numb the surgical area, minimizing discomfort during the procedure.
Post-surgery, patients may experience some pain and discomfort, but this can be managed with pain medications prescribed by the healthcare provider. Most individuals find that the pain is manageable and improves gradually as the surgical site heals.
Does Hidradenitis Suppurativa Leave a Hole?
Hidradenitis Suppurativa can cause the formation of deep abscesses, resulting in sinus tracts, or “holes,” beneath the skin’s surface. These tunnels can lead to the formation of interconnected nodules and pockets of infection.
Surgical interventions can be used to drain these abscesses and close the sinus tracts to promote healing. However, severe scarring may sometimes result in residual depressions or pitted areas on the skin.
What Are the Complications of HS Surgery?
While HS surgery can provide relief and improve the condition, there are potential complications associated with any surgical procedure. Some possible complications of HS surgery include:
- Infection: Surgical wounds can become infected, requiring additional treatment.
- Wound Healing Issues: Due to the chronic nature of HS, some surgical wounds may take longer to heal or may have difficulty closing completely.
- Scarring: Surgical interventions can lead to new scars, although they may be an improvement over pre-existing HS scars.
- Recurrence: As mentioned earlier, HS can come back after surgery, necessitating ongoing management.
How Long Does It Take to Heal from HS Surgery?
The healing time after HS surgery varies depending on the extent of the procedure and individual healing factors. In general, the initial healing period takes approximately 2 to 4 weeks, during which patients are advised to avoid strenuous activities and keep the surgical site clean and dry.
However, complete wound healing and resolution of post-operative symptoms may take several months. Following the healthcare provider’s post-operative instructions and attending follow-up appointments is essential to ensure proper healing.
How Long Do HS Wounds Take to Heal?
The healing time for HS wounds depends on the severity of the wounds and the individual’s overall health. Superficial wounds may heal within a few weeks, while deeper or more extensive wounds may take several months to close completely.
Regular wound care, maintaining good hygiene, and adhering to the prescribed treatment plan can help expedite the healing process.
Is There a Permanent Cure for Hidradenitis Suppurativa?
As of now, there is no known permanent cure for Hidradenitis Suppurativa. HS is a chronic condition characterized by recurrent flare-ups and remissions. However, there are various treatment options available to manage symptoms, reduce inflammation, and prevent complications.
Individuals with HS are encouraged to work closely with healthcare providers to develop a personalized treatment plan that includes lifestyle modifications, medications, and surgical interventions, if necessary.
What Is the Success Rate of Hidradenitis Surgery?
The success rate of HS surgery can vary depending on the type of procedure and the individual’s response to treatment. Surgical interventions can be highly effective in draining abscesses, removing infected tissue, and providing relief from pain and discomfort.
However, it is essential to remember that HS is a chronic condition, and recurrence of symptoms is possible even after successful surgery. Regular follow-up appointments and ongoing management are crucial for long-term success.
Does Hidradenitis Suppurativa Affect Fertility?
HS is primarily a skin condition, and it typically does not directly affect fertility in both men and women. However, it’s essential to understand that the psychological impact of living with HS can lead to stress and anxiety, which might indirectly affect fertility in some cases. Stress is known to affect hormonal balances, which, in turn, can influence reproductive health. Therefore, seeking emotional support and coping mechanisms for managing the challenges posed by HS can be crucial for individuals concerned about their fertility.
Can You Live a Long Life with HS?
Yes, you can live a long life with HS. While HS is a chronic condition that persists over time, it is not life-threatening in itself. With proper management, including medical treatments, lifestyle adjustments, and emotional support, individuals with HS can lead fulfilling lives. It’s essential to work closely with healthcare professionals to develop a personalized treatment plan to effectively manage the symptoms and prevent complications.
Can HS Be Cancerous?
No, HS itself is not cancerous. It is a chronic inflammatory skin condition that affects the hair follicles and sweat glands. However, some studies have suggested that individuals with HS may have a slightly increased risk of developing squamous cell carcinoma, a type of skin cancer, in the affected areas. Regular monitoring and early detection of any suspicious changes are crucial in managing HS and reducing the risk of potential complications.
Can HS Lead to Other Diseases?
HS is primarily a skin condition, but its impact can extend beyond the skin. Research has indicated potential associations between HS and other diseases, including metabolic syndrome, inflammatory bowel disease (IBD), and other autoimmune conditions. These connections are not fully understood, but they highlight the importance of a holistic approach to managing HS and its potential impact on overall health.
What Happens if HS Is Left Untreated?
Leaving HS untreated can lead to various complications. The affected areas may become increasingly painful and inflamed, leading to the formation of abscesses, fistulas, and scarring. Additionally, untreated HS can have a severe impact on an individual’s emotional well-being, causing anxiety, depression, and reduced quality of life. It is crucial to seek medical attention and follow a treatment plan to effectively manage HS and prevent its progression.
What Happens if You Don’t Treat HS?
Not treating HS can have serious consequences. The condition may worsen over time, leading to increased pain, inflammation, and the formation of tunnels (sinus tracts) under the skin. These tunnels can become infected, causing recurrent abscesses and increasing the risk of complications. Moreover, untreated HS can significantly affect a person’s self-esteem and mental health, resulting in social isolation and reduced productivity.
Are People Born with HS?
HS is not a congenital condition, meaning individuals are not born with it. It typically develops after puberty when hair follicles and sweat glands in certain areas of the body become blocked and inflamed. The exact cause of HS is not fully understood, but factors like genetics, hormonal changes, and lifestyle may play a role in its development.
What Makes Hidradenitis Suppurativa Worse?
Several factors can worsen HS symptoms and flare-ups. Obesity and excess weight can put additional strain on the affected areas, leading to increased inflammation. Smoking is also associated with worsened HS, as it can contribute to inflammation and hinder the body’s ability to heal. Moreover, wearing tight clothing or friction from clothing in the affected areas may exacerbate HS symptoms.
Can You Stop HS from Progressing?
While HS is a chronic condition, its progression can be managed and slowed down with proper treatment and lifestyle adjustments. A comprehensive treatment plan may include medications to reduce inflammation and pain, wound care, and lifestyle changes such as weight management and smoking cessation. Working closely with healthcare professionals can help individuals develop effective strategies to halt the progression of HS and improve their quality of life.
Can Someone with HS Have Kids?
Yes, individuals with HS can have children. HS itself does not directly affect fertility or the ability to conceive. However, as mentioned earlier, the psychological impact of living with HS can lead to stress, which might indirectly affect fertility in some cases. It’s essential for individuals with HS who wish to have children to seek emotional support and manage stress effectively.
Can People with HS Have Kids?
Yes, people with HS can have kids. HS does not affect reproductive capabilities. However, individuals with HS should consider managing their condition effectively and seeking proper medical care to minimize the impact of stress and other emotional factors on their fertility and overall health.
Who Is Most at Risk of HS?
HS can affect individuals of any age and gender, but certain factors may increase the risk of developing the condition. People who have a family history of HS are more likely to develop the condition themselves. Additionally, obesity, metabolic syndrome, and conditions like Crohn’s disease and other inflammatory disorders may also increase the risk of HS.
Can People with HS Eat Eggs?
The impact of diet on HS is not yet fully understood. Some individuals with HS may find that certain foods, including eggs, trigger flare-ups or worsen symptoms. However, this can vary from person to person. It is recommended for individuals with HS to keep a food diary and monitor how specific foods affect their symptoms. Consulting with a registered dietitian or healthcare professional can also provide valuable guidance.
Can I Breastfeed with Hidradenitis Suppurativa?
Yes, individuals with HS can breastfeed their babies. HS does not generally affect a person’s ability to breastfeed. However, if HS causes significant discomfort or pain in the breasts, it may be helpful to seek support from a lactation consultant or healthcare professional to ensure a positive breastfeeding experience.
sential to develop a comprehensive treatment plan tailored to individual needs and circumstances.