Hidradenitis Suppurativa

Hidradenitis Suppurativa

Hidradenitis Suppurativa (HS) is a chronic, often painful skin condition characterized by multiple pimples, nodules, and abscesses, all of which lead to scarring. Typical affected areas include the armpits, groin, buttocks and under the breasts in females. HS can flare for a variety of reasons and often requires a combination of topical and systemic medications for treatment.


HS can present as tender and recurrent pimples, nodules, and abscesses under the arms, in the groin, and on the buttocks. Patients may notice several “blackheads” in these locations as well. For women, symptoms can flare during periods of hormonal fluctuation such pregnancy and/or menstruation. Over time, recurrent flares lead to painful scar tissue formation. Tunneling can occur between scars that leads to chronic drainage.


HS is still not fully understood. Current research suggests that the lesions of HS are caused
by an irregular response of the immune system that leads to a collection of infection-fighting cells in hair bearing areas. While bacteria do aggravate these lesions, HS is not thought to be an infectious process.


There are many treatments for acne, however they can take 2-3 months to start working. Because of the many options for treatment and causes of acne, please discuss the best treatment for you with your physician.

It is important to use gentle oil-free cleansers and moisturizers daily along with a sunscreen to prevent scars from worsening.

Topical treatments

  • Over the counter topical treatments include cleansers and spot treaters with benzoyl peroxide or salicylic acid.
  • Retinoids – Medications such as topical tretinoin, adapalene, tazarotene, and similar medications can help to treat whiteheads and blackheads. It is also a great preventative medication.
  • Antibiotics – topical clindamycin and minocycline can help red, inflamed acne lesions.
  • Other topical agents include topical dapsone (Aczone®) and azelaic acid.

Oral medications

  • Oral antibiotics such as doxycycline, minocycline or Seysara® can help moderate inflammatory acne.
  • For women, oral contraceptives or spironolactone may be recommended to treat the hormonal cause of acne.
  • For treatment resistant acne, your doctor may recommend isotretinoin.


Other treatments:

  • Chemical Peel – Salicylic acid peels can help with whiteheads, blackheads and some inflammatory lesions. These are most helpful if administered once a month for 3-4 months.
  • Our GTZ (glycolic acid, trichloroacetic acid and zinc) peel can help with redness, scarring and inflammation due to acne. This peel is performed every 2 weeks. Approximately 6 peels are recommended for best results.
  • Intralesional steroid injection works well to treat isolated, painful nodules and cysts. It is injected directly into the lesion to provide rapid pain relief.

If you have any questions about your condition, please call our office at 704-784-5901