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Treatment

Hidradenitis suppurativa is very difficult to treat. For mild to moderate cases, dermatologists first attempt therapy topically, such as with benzoyl peroxide and a topical retinoid. Simple cases can be treated with moist heat or incision and drainage of the abscesses.

In more serious cases, oral antibiotics are prescribed. Accutane® (see Acne) can be effective in more difficult cases of hidradenitis suppurativa. However, it must be taken in much higher doses than when taken to treat acne.

Cortisone injections in the abscesses may promote healing.

In severe cases, surgical removal of scarred (fibrotic) skin and underlying diseased tissues may be the only alternative. These areas are often left to heal without skin grafting. It takes about 2 months for these areas to heal, and noticeable scars may result. Another surgical procedure for hidradenitis suppurativa is subcutaneous fistulectomy. In this treatment, the doctor cuts away the bridging fibers between scars. This seems to be an effective approach with less drastic side effects than more invasive surgery.

Prevention

Keeping the affected areas clean with an antibacterial cleanser is helpful. Long-term antibiotics are sometimes necessary to control the disease.

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