Liposuction For Hidradenitis Suppurativa

Hidradenitis suppurativa is a chronic skin condition that causes painful abscesses, boils, and cysts on the skin. It most often affects the armpits, groin, or buttocks.

Liposuction can be used to treat hidradenitis suppurativa by removing excess fat from the affected areas. Liposuction helps to relieve symptoms and improve self-esteem in patients with hidradenitis suppurativa. This is because it helps to reduce scarring and contour the body by removing excess fat that may have been contributing to the problem.

However, liposuction should only be considered as part of a comprehensive treatment plan for hidradenitis suppurativa. Liposuction alone will not cure hidradenitis suppurativa but it can help to relieve symptoms and make it easier for other treatments such as antibiotics or steroid injections to work more effectively.

Right here on Cosmeticsurgerytips, you are privy to a litany of relevant information on what treatments are available for hidradenitis suppurativa, most effective treatment for hidradenitis suppurativa, what is the surgery for hidradenitis suppurativa, and so much more. Take out time to visit our catalog for more information on similar topics.

Liposuction For Hidradenitis Suppurativa

Hidradenitis suppurativa is a chronic inflammatory skin disease involving the hair follicles and sweat glands. Also known as acne inversa, this condition usually begins with the appearance of pimple-like bumps on the skin. Without treatment, these bumps can worsen, grow deep into the skin and turn into painful hard lumps or pockets of pus (boils). The pockets often break open. After they heal, thick scars often form.

Where does hidradenitis suppurativa occur?

Hidradenitis suppurativa typically affects areas of the body where skin touches skin. These areas may include the underarms, buttocks, breasts, and groin (genitals and around the anus), and the inner thigh.

Who gets hidradenitis suppurativa?

Hidradenitis suppurativa affects between 1 to 4 percent of people in the U.S. It is more commonly seen in females than males. Hidradenitis suppurativa is typically seen in young people, starting at puberty (around 11 years of age) up to about age 40. It is also more commonly seen in African Americans, smokers, and overweight or obese people.

SYMPTOMS AND CAUSES

What causes hidradenitis suppurativa?

The skin bumps seen with hidradenitis suppurativa occur when hair follicles and/or sweat glands become clogged and inflamed due to abnormal overgrowth of cells. This overgrowth is thought to be secondary to hormones and/or nicotine. After becoming blocked, these structures then rupture causing increased local inflammation and scarring. Hidradenitis suppurativa is not contagious, sexually transmitted, or caused by poor hygiene.

Doctors do not know what causes some people to develop this disease. Researchers are investigating whether hidradenitis suppurativa is genetic (passed down among family members). Sex hormones are also thought to be a possible cause since many cases of hidradenitis suppurativa begin to be seen at puberty.

People with hidradenitis suppurativa often have other medical issues in common. These conditions include:

• Acne
• Diabetes
• Heart disease
• Dissecting cellulitis (severe patchy hair loss on the scalp)
• Inflammatory bowel diseases (some, like Crohn’s, have skin symptoms that mimic hidradenitis suppurativa)
• Polycystic ovarian syndrome (hormonal disorder in women)
• High body mass index (being overweight)

What are the symptoms of hidradenitis suppurativa?

When it first develops, hidradenitis suppurativa can have symptoms that range from mild itching and discomfort to the appearance of a red, tender, and swollen areas. Pimple- and/or boil-like bumps appear and can grow, fill with pus, and then break open. The pus that drains sometimes has a foul odor due to the presence of bacteria. Healing of the bumps can cause scarring. Symptoms vary from person to person.

In some patients, the breakouts can reoccur in the exact spot; in others, breakouts occur in the same area but not in the exact same spot. Some people have constant breakouts on their skin; in others, scars are the only sign present at that point in time.

DIAGNOSIS AND TESTS

How is hidradenitis suppurativa diagnosed?

To diagnose hidradenitis suppurativa, a dermatologist (a doctor specializing in skin disorders) will:

• Ask you about your family history of skin problems
• Do a physical exam
• Closely study the appearance of your skin
• Note where the bumps are located
• Ask how long the bumps have been present and if they disappear and reappear

Blood tests can help confirm a diagnosis of hidradenitis suppurativa. If pus is present, your doctor may also take a biopsy (a skin sample) of it to rule out other skin conditions.

MANAGEMENT AND TREATMENT

How is hidradenitis suppurativa treated?

Although there is no cure for hidradenitis suppurativa, early diagnosis and treatment help prevent the disease from getting worse and forming additional scars. Symptoms appear and disappear and vary from person to person. Many treatments are available and usually a combination of the following treatments is tried. Treatment choice depends on the severity of hidradenitis suppurativa.

Initial treatments for mild disease may involve home remedies including:

• Sit in a warm bath and/or apply warm compresses to the affected area for 10 minutes at a time.
• Apply topical cleansing agents, including antibacterial soaps, antiseptics, and acne washes to reduce/kill bacteria.
• Take anti-inflammatory medications, such as ibuprofen (Advil®, Motrin®), naproxen (Aleve®), and celecoxib (Celebrex®).
• Wear loose-fitting clothing to prevent rubbing against the skin.
• Maintain a proper weight. Being overweight causes more friction on the skin in the areas affected by this condition.

When painful skin lesions are present (moderate disease), treatments may include:

• Corticosteroids, such as prednisone, to reduce pain and swelling.
• Anti-inflammatories, such as ibuprofen (Advil®, Motrin®), naproxen (Aleve®), and celecoxib (Celebrex®).
• Antibiotics, such as tetracycline, erythromycin, minocycline and amoxicillin/clavulanate potassium. An erythromycin-based skin cream is also sometimes prescribed. These are used to treat infected lesions.
• Adalimumab (Humira®), a tumor necrosis factor alpha inhibitor, is the first biologic agent approved by the Food and Drug Administration to treat moderate to severe hidradenitis suppurativa.
• Other medications that can be tried include retinoids (acne-fighting drugs) and birth control pills (to address the hormonal cause of hidradenitis suppurativa).

Severe cases of hidradenitis suppurativa are treated using the following surgical procedures:

• Laser. A laser is used to clear new and deep seated breakouts.
• Deroofing. Breakouts are turned into scar tissue (a procedure called deroofing).
• Draining abscesses. Abscesses can be drained to provide some relief.
• Excision (cutting out) of the lesions and skin grafting. In this type of surgery, larger areas of the skin and scar tissue are removed. A skin graft from a healthy area of the body may be needed to replace the lost skin.

What are the complications of hidradenitis suppurativa?

Hidradenitis suppurativa occurs in cycles throughout a patient’s lifetime, with periods of breakouts and healings. In some cases, the disease progresses and causes abscesses (pus-containing areas of infection) to form deep within skin tissue. Continued healing and scarring can cause that area of the skin to become thick and in extreme cases, the scarring makes the affected area firm and difficult to move. Continued healing and scarring can also cause fistulas to form inside the body. Fistulas are hollow passages that are painful and require surgery to repair.

What are the outcomes after treatment for people with hidradenitis suppurativa?

Some people with the disease have recurrent outbreaks for the rest of their lives. Some people who treat the disease early with surgery have no further symptoms. In rare cases, hidradenitis suppurativa clears up without any treatment.

PREVENTION

Can hidradenitis suppurativa be prevented?

Because doctors do not know what causes hidradenitis suppurativa, there is no known way to prevent it. However, there are some simple steps that can be taken at home to lessen the symptoms of hidradenitis suppurativa. These include:

• Achieve a healthy weight
• Wear loose-fitting clothes
• Take warm baths
• Do not shave affected areas
• Clean affected areas daily with antibacterial soap
• Avoid smoking

OUTLOOK / PROGNOSIS

What is the outlook for people with hidradenitis suppurativa?

No known cure exists for hidradenitis suppurativa. The outlook (prognosis) depends on the severity of the disease.

What Treatments Are Available For Hidradenitis Suppurativa

The condition can be mistaken for an infection, an ingrown hair or other conditions. Many people live with undiagnosed hidradenitis suppurativa for years before receiving a correct diagnosis.

Your doctor will base a diagnosis on your signs and symptoms, skin appearance and medical history. You might be referred to a doctor who specializes in skin conditions (dermatologist), as hidradenitis suppurativa can be difficult to diagnose and requires specialized care.

No laboratory test is available to diagnose hidradenitis suppurativa. But if pus or drainage is present, your doctor might take a sample for testing in a lab.

Treatment

Treatment with medications, surgery or both can help control symptoms and prevent complications of hidradenitis suppurativa. Talk with your doctor about the risks and benefits of the treatment options and how to develop an approach tailored to you.

Expect to have regular follow-up visits with your dermatologist. Some people might need the comprehensive care provided by a multidisciplinary health care team.

Medications

Your doctor might prescribe one or more of the following types of medications:

• Antibiotics applied to the skin. Mild symptoms might be managed with a topical antibiotic in liquid or gel form. For more-widespread disease, your doctor might prescribe antibiotic pills, such as doxycycline (Monodox), clindamycin (Cleocin), rifampin (Rimactane) or both. People with severe disease might need to take antibiotics for months.
• Steroid injections. Triamcinolone (Aristospan, Kenalog-10) injected into the sores might help reduce swelling and inflammation.
• Hormonal therapy. Hormone pills, such as estrogen-containing combined oral contraceptives (Estrace, Prefest), might be effective for people with mild hidradenitis suppurativa.
• Biologics. These drugs, usually administered by injection, alter the immune system in a way that disrupts the disease cycle and improves symptoms and signs of disease within weeks. Several of these drugs are approved for the treatment of moderate to severe hidradenitis suppurativa. Two of them are the tumor necrosis factor (TNF) inhibitors adalimumab (Humira) and infliximab (Remicade). Many other biologics are in clinical trials for hidradenitis suppurativa.
• Retinoids. Oral retinoids might be an option for some people with acnelike (acneiform) disease. These drugs are not recommended when you’re pregnant or breastfeeding or if you intend to become pregnant.
• Pain medication. If over-the-counter pain relievers don’t help, your doctor might prescribe a stronger pain medication or refer you to a pain clinic.

Surgery

Combined medical and surgical approaches help manage hidradenitis suppurativa. Surgery is an important part of disease management when a tunnel and bump (abscess) are present. Which surgical approach is right for you depends on the extent and severity of your condition. Talk with your doctor about the risks and benefits of the options, which include:

• Uncovering the tunnels. This procedure involves removing tissue (unroofing) to expose the tunnels under the skin. It’s used for people with moderate or severe hidradenitis suppurativa. This solution usually doesn’t have to be repeated.
• Punch debridement. This procedure, also called limited unroofing, involves removing a single inflamed bump.
• Laser therapy. A carbon dioxide laser can be used to make hidradenitis suppurativa sores go away. After this type of treatment, the sores are not likely to return. Laser hair removal can help hidradenitis suppurativa in early stages.
• Surgical removal. This approach might be an option for people with persistent or severe symptoms. It involves removing all of the affected skin. A skin graft might be needed to close the wound. Even after surgery, sores might still occur in other areas.
• Incision and drainage. Surgical drainage is no longer considered an effective option for treating hidradenitis suppurativa. The method might be considered to provide short-term pain relief, but afterward, sores usually flare again.

Lifestyle and home remedies

Mild hidradenitis suppurativa can sometimes be effectively controlled with self-care measures. Self-care is also an important complement to any medical treatment you’re getting. The following suggestions might help relieve discomfort, speed healing or prevent flareups:

• Follow a daily skin care routine. Gently wash your body with a nonsoap cleanser. It can sometimes be helpful to use an antiseptic wash such as chlorhexidine 4% or benzoyl peroxide wash when showering. First try it once a week, then increase usage up to once a day if your skin tolerates it well. Pat dry.When washing, avoid using washcloths, loofahs or other such items on affected areas, as they can irritate skin. Don’t squeeze pimples and sores. And avoid shaving or using depilatory creams.
• Manage your pain. Gently applying a wet, warm compress can help reduce swelling and ease pain. Ask your doctor about an appropriate pain reliever and how to care for your wounds at home.
• Try to keep or achieve a healthy weight and stay active. Not being at a healthy weight can worsen the symptoms of hidradenitis suppurativa. Talk with your doctor or a dietitian to develop a plan. Try to find activities that don’t irritate your skin.
• Consider altering your diet. Hidradenitis symptoms might be worsened by diets that include dairy, red meat and foods with a high glycemic index. If your diet includes these foods, talk with a dietitian about the benefits of eliminating them.
• Quit smoking. If you smoke, try to quit. Smoking cessation has the potential to ease the symptoms of hidradenitis suppurativa.

Coping and support

Hidradenitis suppurativa can be a challenge to your emotional health and well-being. Painful sores might affect your sleep, ability to move or sex life. Or the sores might drain pus with an odor, which might make you feel anxious, embarrassed, angry, self-conscious or depressed. The ongoing, persistent nature of the disease and its treatment challenges only add to the burden.

Try to find support among your family and friends. The concern and understanding of other people with hidradenitis suppurativa also might be comforting. Don’t hesitate to ask for help with your mental health and coping strategies. Your doctor can refer you to a mental health professional or provide the contact information of a support group.

Preparing for your appointment

You’ll likely first see your primary care doctor. You might then be referred to a doctor who specializes in diagnosing and treating skin diseases (dermatologist). Depending on the severity of your condition, your care might also involve specialists in colorectal surgery, plastic surgery or digestive diseases (gastroenterology).

Here’s some information to help you get ready for your appointment.

What you can do

Make a list of the following:

• Symptoms you’re experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment
• All medications, vitamins and supplements you take, including doses
• Questions to ask your doctor

For hidradenitis suppurativa, some basic questions to ask your doctor include:

• What’s the most likely cause of my symptoms?
• Are there other possible causes?
• Do I need any tests?
• How long will my condition last?
• What treatments are available, and which do you recommend for me?
• What side effects can I expect from treatment?
• Is this condition related to another medical disorder?
• Do you have any brochures or other printed materials that I can take with me? What websites do you recommend?

What to expect from your doctor

Your doctor is likely to ask you several questions, such as:

• When did your symptoms begin?
• What did the skin lumps look like when they started?
• Do they come back in the same spots?
• Are your symptoms painful?
• Have your parents or siblings ever had this problem?
• What, if anything, seems to improve your symptoms?
• What, if anything, seems to worsen your symptoms?
• Do you smoke or use tobacco products?