Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that affects thousands of Americans. People with HS experience breakouts of pimple- or boil-like lesions on areas of their body where skin touches skin. This may include the armpits, buttocks, breasts, groin, and upper thighs. The painful lesions of HS may also fill with an unpleasant-smelling fluid that can leak without warning.
Although there is currently no cure for HS, there is a wide variety of medical and surgical options to help you manage your symptoms. If you’re living with HS, it’s helpful to be aware of all the treatment options available so you can find the best option for you.
Read on to learn about the different types of HS treatments and how they work.
Topical antibiotics are one of the most commonly prescribed treatments for mild HS. They can be applied directly to your skin to treat infections, reduce inflammation, and prevent new lesions from forming. Antibiotics also work to reduce the odors that can sometimes accompany infection.
A typical course of treatment with topical antibiotics might involve applying lotion to your HS lesions twice a day. The duration of such treatment varies from person to person.
Side effects of topical antibiotics can include bacterial infection and a mild burning sensation. Rare side effects can include diarrhea, colitis, and Clostridium difficile (C. diff).
Oral antibiotics are typically prescribed in moderate to severe cases of HS, or when topical treatment hasn’t been effective. Like topical antibiotics, these drugs help to treat infection and manage inflammation.
They are taken by mouth for seven to 10 days. Some cases may require longer periods of treatment.
Side effects of oral antibiotics can include diarrhea, C. diff, bacterial infection, and rust-yellow to brown discoloration of urine.
Corticosteroids can also be used for HS to decrease swelling, reduce inflammation, and manage pain. They’re usually administered through injection or orally.
Side effects of injected corticosteroids can include pain near the injection site, facial flushing, high blood sugar, and insomnia.
Since oral corticosteroids affect your whole body, their side effects can be more severe. They can include high blood pressure, weight gain, mood swings, delirium, and glaucoma. Long-term use may also lead to thinning skin, high blood sugar, and osteoporosis.
Since HS is thought to be triggered by hormones called androgens, your doctor may recommend hormone therapy as a treatment option. This could involve taking contraceptives that contain hormones like estrogen, norgestrel, and finasteride.
Hormone therapy can help to decrease pain and reduce the amount of fluid draining from HS lesions during a breakout.
Side effects of hormone therapy in women can include blood clots if taken during pregnancy. Men may experience decreased libido and problems ejaculating. In rare cases, men and women could develop breast tumors as a side effect.
For more severe cases of HS that don’t respond to antibiotics or hormone therapy, biologic drugs may be an option. Biologics are administered via injection or an IV infusion. They help your body fight HS by targeting the parts of your immune system that stimulate inflammation.
Biologics are usually taken on a weekly basis and can be done at home or by a medical professional at a hospital or clinic.
Side effects of biologics can include pain near the injection site, fever, difficulty breathing, low blood pressure, and increased risk of infections. If you experience infections, your doctor will likely discontinue use of biologics and explore other treatment options.
Rare but serious side effects can include autoimmune nerve symptoms and heart failure. Biologics can also cause an increased risk for lymphoma. Speak with your doctor about the benefits and risks of this treatment.
A variety of surgical options are available for the treatment of HS, ranging from minor incisions to electrosurgical peeling to the complete removal of the skin affected by lesions.
Whether you are eligible for HS surgery depends on the severity of your HS and how well you respond to other forms of treatment. If you think you might be a good candidate for surgery, talk to your doctor about which option might be right for you.