The sooner you get treatment for blocked hair follicles behind your hidradenitis suppurativa (HS), the faster you can clear your skin of the painful, pimple-like bumps it causes. There’s no cure for the condition, but if you spot the symptoms of it and see a doctor ASAP, you can stop it from getting worse.
You'll need to see a doctor to find out if you have this rare condition or if it’s something else. They’ll ask about your symptoms and look at the bumps on your skin.
If there’s any fluid leaking from them, they might take a sample of it and get it tested to see if you have an infection.
The treatment your doctor recommends depends on:
- How severe your HS is
- How many bumps you have
- Where they are on your body
You might need to try a few options before you find one that works for you.
A few types of meds can treat blocked sweat glands.
If you have an infection, antibiotics can treat it and prevent new breakouts. You take them by mouth or rub them on your skin. You may need to keep taking them for a few months until your skin clears.
An antiseptic wash flushes bacteria off your skin to prevent an infection.
Hormone medicines -- such as birth control pills and other types of drugs that lower androgen (male hormone) levels -- may help women who get symptoms before their periods. But further study is needed, and pregnant women shouldn’t get hormone therapy, due to the chance of side effects.
Retinoids are a form of vitamin A that some people use to treat acne. If you take them for HS, it may take 6 to 12 months for your skin to clear up. The drugs can cause side effects like dry skin, and they aren't safe to use if you’re pregnant.
Steroids relieve swelling and pain. They can clear up the bumps you have and stop new ones from forming. Your doctor might give you steroids in a shot, or you can take them as a pill. These medicines can cause side effects such as weight gain, constipation, and mood changes.
Metformin, a medicine for diabetes, has helped some women who have blocked sweat glands, but studies haven't proved that it's safe or works well for everyone with the condition.
If one or more of these medicines don't work and your HS is severe, your doctor might prescribe a biologic drug that turns down your immune system. Adalimumab (Humira) is the first and only one that the FDA has approved to treat HS.
Another biologic that research shows has promise is infliximab (Remicade). There is research to suggest that when paired with Humira or Remicade, methotrexate (Otrexup (PF), Rasuvo, Trexall, Xatmep), a drug that powers down your immune system, can help your symptoms and make the antibiotics you take work better. But more research is needed.
Three more drugs -- anakinra (Kineret), canakinumab (Ilaris), and ustekinumab (Stelara) -- may also help in severe cases of HS.
Depending on the drug you take, you can give yourself a shot or get an IV at a hospital. These medicines can sometimes cause some serious side effects, such as a higher chance of infection or, rarely, cancer. You should talk with your doctor about these risks if you are considering taking one of these drugs.
Research has shown that radiation treatment can also be effective for HS. But it’s only used in rare cases because of the chance of long-term side effects to your skin. Talk with your doctor about it.
If the bumps have grown deep into your skin, medicine may not be enough to clear them up. In that case, you might need surgery at your doctor's office or a hospital.
The doctor can cut open and drain a few of the bumps at a time. This procedure helps for a while, but the nodules (bumps) can form again. In that case, you might need the surgery again.
Another type of surgery removes the lumps and some of the skin around them. It can leave a deeper wound, so your doctor will also take a piece of skin from somewhere else on your body to cover it. This is called a skin graft. The bumps will not come back in the same spot, but you can still get new breakouts in other places.
Laser therapy and cryosurgery are promising treatments for HS. They use beams of light or cold gases to destroy the hair follicles that get infected and remove HS bumps. Some people’s breakouts clear up after a few treatments.
Deroofing surgery is a treatment for people with painful HS that comes back over and over. A surgeon turns painful nodules into scars. You might also get this procedure if tunnels have formed under the skin between nodules.
Ask your doctor which of these treatments you need. Talk about the pros and cons before you try one.