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Treatments and drugs

By Mayo Clinic staff

There is no cure for hidradenitis suppurativa. But early treatment can help manage the symptoms and prevent new lesions from developing.

Treatments depend on the extent of the affected areas and whether the sores are painful or infected. Mild cases can be treated with self-care measures, including warm compresses and regular washings with antibacterial soap. Moderate cases may require medications, such as those you rub on the affected areas (topical medications) or those you take by mouth (oral medications). Possible medications include:

  • Antibiotics. Antibiotics taken for a long time early in the disease help fight infection and may prevent future outbreaks or prevent the disease from worsening.
  • Oral retinoid medications. Taken to stop oil gland functions, these medications can help prevent the plugging of the hair follicles.
  • Nonsteroidal anti-inflammatory drugs. These can help alleviate pain and swelling.
  • Corticosteroids or immunosuppressant drugs. These may help reduce inflammation, especially in the early stages of hidradenitis suppurativa.
  • Tumor necrosis factor (TNF)-alpha inhibitors. These medications show promise in the treatment of hidradenitis suppurativa. They can be used only in the short term, however, due to the risks involved with longer use.

For severe or persistent cases or for deep lesions, surgery may be necessary.

  • Incision and drainage. Surgical drainage or removal of the lesions may be an option when the disease involves a single small area. However, this treatment won't prevent the disease from returning and is generally used for short-term relief.
  • Uncovering the tunnels or tracts. Cutting away skin and flesh that cover any tunnels or tracts can increase healing of the lesions and minimize scarring. This doesn't prevent the disease from returning in the treated area or another area of the body, however.
  • Surgical removal. Surgical treatment of recurrent or severe symptoms involves removal of all involved skin followed by direct closure with skin flaps or with skin grafting (removing skin from one area of your body and attaching it to another). Full surgical removal of the affected areas can treat the disease that is present but doesn't prevent the disease from occurring in other areas.

Obesity, incomplete removal and ongoing skin infections can increase the chances that hidradenitis suppurativa returns, even after surgical treatment.

References
  1. Hidradenitis suppurativa. American Osteopathic College of Dermatology. http://www.aocd.org/skin/dermatologic_diseases/hidradenitis_suppu.html. Accessed June 22, 2010.
  2. Alikhan A, et al. Hidradenitis suppurativa: A comprehensive review. Journal of the American Academy of Dermatology. 2009;60:539.
  3. Smith HS, et al. Painful hidradenitis suppurativa. Clinical Journal of Pain. 2010;26:435.
  4. Beshara MA. Hidradenitis suppurativa: A clinician's tool for early diagnosis and treatment. Advances in Skin and Wound Care. 2010;23:328.
  5. The morbidity of hidradenitis suppurativa. The Hidradenitis Suppurativa Foundation. http://www.hs-foundation.org/abouths/morbidity.htm. Accessed June 22, 2010.
  6. Stewart EG, et al. Treatment of hidradenitis suppurativa. http://www.uptodate.com/home/index.html. Accessed June 28, 2010.
DS00818 Sept. 21, 2010

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