Management of hidradenitis suppurativa depends on the severity of the lesions and the underlying cause. Various measures may be recommended to reduce symptoms such as pain and drainage, speed up healing, and prevent further infection or scarring. Lifestyle changes like smoking cessation and weight loss may reduce the risk of HS formation. Additionally, personalized skin care plans may be recommended and may include regular washing of the affected areas with water and soap, avoiding irritants like deodorants; and scheduling laser treatments for removing hair or older scarring can also be beneficial.
Individuals with persistent HS that does not resolve with the conservative measures might require medications, like
corticosteroid injections;
anti-androgens (e.g.,
spironolactone); oral antibiotics (e.g.,
clindamycin); or tumor necrosis factor (TNF) inhibitor medications (i.e.,
adalimumab) to
reduce inflammation. Resorcinol, an organic chemical compound known as benzenediol, may also be prescribed to open the clogged hair follicles and minimize the inflammation. Pain management is also critical, and depending on the disease severity and type of pain, topical
lidocaine, topical or systemic nonsteroidal
anti-inflammatories,
gabapentin, or serotonin-
norepinephrine reuptake inhibitors may be beneficial. Due to the pain, sensitive location of lesions, scarring, drainage, and odor, the negative psychosocial impact of the disease should also be considered in treatment. Other treatment options include incision, drainage of the lesions, and surgical removal of any existing sinus tracts.
