Treatments and drugs
By Mayo Clinic staffThere is no cure for hidradenitis suppurativa. But early treatment can help manage the symptoms and may prevent new lesions from developing.
Medications
Your doctor might suggest trying one or more of the following types of medications:
- Antibiotics. Long-term use of antibiotics can help prevent the disease from worsening and might reduce the risk of future outbreaks. These drugs can come in pill form to take by mouth or in a cream or ointment to spread on the affected skin.
- Corticosteroids. Injecting steroid medications directly into the tender nodule can reduce inflammation. Oral steroids, such as prednisone, can also help. But long-term use of prednisone has many side effects, including osteoporosis.
- Tumor necrosis factor (TNF)-alpha inhibitors. Medications such as infliximab (Remicade) and adalimumab (Humira) show promise in the treatment of hidradenitis suppurativa. However, these drugs can increase the risk of infection, heart failure and certain types of cancers.
Surgical and other procedures
For severe or persistent cases or for deep lesions, surgery may be necessary.
- Incision and drainage. Surgical drainage may be an option when the disease involves a single small area. However, this treatment is generally used for short-term relief.
- Uncovering the tunnels. Known as de-roofing, this procedure cuts away the skin and flesh that cover any interconnected tunnels linking separate lesions. However, the disease may still return in the treated area or another area of the body.
- Surgical removal. Surgical treatment of recurrent or severe symptoms involves removal of all involved skin. A skin graft may be necessary to close the wound. 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.
- Goldsmith LA, et al., eds. Fitzpatrick's Dermatology in General Medicine. 8th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=740. Accessed Feb. 11, 2013.
- Margesson LJ, et al. Pathogenesis, clinical features and diagnosis of hidradenitis suppurativa. http://www.uptodate.com/home. Accessed Feb. 11, 2013.
- Danby WF, et al. Hidradenitis suppurativa. Dermatologic Clinics. 2010;28:779.
- AskMayoExpert. Hidradenitis suppurativa. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2013.
- Margesson LJ, et al. Treatment of hidradenitis suppurativa. http://www.uptodate.com/home. Accessed Feb. 11, 2013.
- Ferri FF. Ferri's Clinical Advisor 2013:5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2012. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-0-323-08373-7..00002-9&isbn=978-0-323-08373-7&about=true&uniqId=343863096-23. Accessed Feb. 11, 2013.
- Gibson LE (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 14, 2013.


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