What are the treatment options for hidradenitis suppurativa?

Hidradenitis suppurativa causes recurring inflamed lumps, drainage, and tunnels in areas where skin rubs together. A dermatologist considers the number and location of active areas, scarring, drainage, pain, and how often new lesions appear. The aim may be to calm inflammation, control infection when present, reduce new flares, protect movement, and manage established tunnels or scars.

Oral antibiotics may be used for their anti-inflammatory effect or when bacterial infection needs treatment. A steroid injection into a painful inflamed lesion can settle a targeted flare. Laser hair removal may help selected areas by reducing hair-bearing follicles. Biologic therapy can be considered when disease remains active or widespread. Hidradenitis surgery may be appropriate for persistent tunnels, scarred tissue, or areas that do not respond adequately to medical care. Do not squeeze lesions; gentle cleansing, loose clothing, and a plan for wound drainage can reduce friction and irritation.

Arrange a dermatology assessment for recurring lumps, draining openings, or painful underarm, groin, breast, or buttock lesions. Seek prompt care if redness is rapidly spreading, pain is escalating, fever develops, or drainage has a strong new odour. Urgent review is also sensible when swelling makes walking, sitting, or moving an arm difficult.

Which areas need treatment now, and are tunnels or scars present? Would a local injection, oral medicine, biologic therapy, or surgery address the main problem? How should an open or draining area be dressed at home? What changes should prompt an earlier review?