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Hidradenitis Treatment

George Woodbury MD 1/23/2023

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Hidradenitis, also called Hidradenitis suppurativa, is a painful and nodular underarms and sometimes groin eruption. From my perspective as a Memphis Dermatologist for the last 30 years, let’s take a look at Hidradenitis treatment options, because research in Dermatology has uncovered new promising management options to help control what can become a frustrating, disabling condition.

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First, what is Hidradenitis? It’s a nodular eruption that develops from clogged pores in the axillae or underarms or in the groin. It can develop in childhood or adulthood. The body forms what are called cysts, abscesses, boils, or furuncles, in which the body tries to expel infected oil glands to the surface. The result is skin nodules that can lead to draining channels or tracts.

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From my perspective as a Memphis Dermatologic Surgeon, often a first move is to try to get the infected areas to heal by doing what’s called an incision and drainage, cutting into the area, to allow the pus to drain.

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It’s ideal later to get the cyst sack removed, with a cyst excision: the cyst is numbed up or anesthetized, with a local shot, then cut out, the site frequently being closed with stiches.

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This excision procedure leaves a scar, and sometimes even a raised scar or Keloid, which may need later Keloid treatment, so we Dermatologists advise the patient whether it’s best to completely remove the cyst with stitches. The advantage is that the lesion can be sent off to the Dermatopathology Laboratory to be checked for cancer.

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Sometimes for recurrent Hidradenitis or widespread cysts, Dermatologic treatment involves oral antibiotics, and/or topical (meaning “on top of the skin”) use of Clindamycin Gel and/or Retinoid creams or gels, such as Tretinoin Cream. Sometimes we use short courses of an oral steroid medication, and sometimes an oral medication called Dapsone, or even an injectable Tumor Necrosis Factor medication - Humira® or adalimumab.

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A best first move if you or a family member may have Hidradenitis is a consultation with a Board-certified Dermatologist for a skin check-up, an especially high priority for people with skin lesions that could be cancerous. Check out “Understanding the Melanoma Crisis: Scarlet’s Story,’ a 2018 movie sponsored by my Dermatology practice on Youtube.

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My own practice as a Cordova Dermatologist is with Rheumatology and Dermatology (www.Rheumderm.com), Memphis, TN, near Germantown, Bartlett, and Arlington (8143 Walnut Grove Road, Cordova TN 38018 1-901-753-0168).  Or you could find a Board-certified Dermatologist closer to you from the American Academy of Dermatology’s “Find a Dermatologist” site (AAD.org). Plug in your zip code, and you’ll get a list.

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And if you have oily or combination skin and complexion issues, a company of which I am President – Big River Silk Skincare – manufactures and distributes a helpful deep cleanser – AmberSoy Soap Gel – which can be used as a type of skin mask, for 3-5 minutes prior to washing off. (www.Bigriversilkskincare.com).

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Big River Silk Skincare also manufactures a gentle lubricating moisturizer: HypoShea Moisturizer Cream, free of dyes, oil, sulfates, and propylene glycol. 1 oz: $12.95; 2 oz: $18.95; 8 oz: $39.95. All of our products can be picked up at 8143 Walnut Grove Monday-Friday 7:30 AM to 4:30 PM. Otherwise, for orders under $40.00: $5.00 shipping and handling ($10 for Canadian orders), otherwise free shipping and handling: https://www.Bigriversilkskincare.com).

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