Hidradenitis Suppurativa Surgery

For many Hidradenitis Suppurativa (HS) patients, surgery can feel like a dreaded procedure that is the last line of treatment. At Texas Hidradenitis Center, we help manage your symptoms, both clinically and surgically. This includes treatment with prescription medications that relieve flare-ups, and surgical treatments to remove the boils and features of HS that complicate your quality of life.

Our goal? Help patients achieve remission from their HS symptoms and prevent future flare-ups. At Texas Hidradenitis, our mission is to help patients devise a plan to tackle HS to the root of the cause both clinically and surgically.

When Surgery Is the Right Option

Many patients do not see a dermatologist about their Hidradenitis Suppurativa (HS) symptoms until they have unbearable symptoms. By that time, they usually fall under Hurley Stages II or III, otherwise known as moderate-to-severe HS. This is where there is formation or expansive sinus tracts beneath the surface of the skin beneath the nodules. These sinus tracts and tunnels cause more nodule and abscess formation that generally require surgical intervention. These usually include deroofing or wide excision with second-intent healing.

Deroofing

Deroofing procedures are usually requested by patients before they consider a wide excision. Many patients see deroofing as being less invasive than a wide excision procedure. While true to a certain extent, patients may notice sinus tracts reforming or causing the formation of new abscesses and nodules. Deroofing is basically the excision of the sinus tracts to drain the built-up fluid beneath the skin. This procedure can help relieve the pain and formation of new nodules and abscesses in the areas where the deroofing was done. This procedure, along with management by systemic therapies, can help patients reduce the flare-ups and lead to possibly dormant nodules.

Wide Excision

Wide excisions for Hidradenitis Suppurativa (HS) may sound like a very big hill that many patients with HS avoid. However, many of our HS patients have found relief, remission, and return of lifestyle post HS excision procedures.

To break it down, HS wide excision is the surgical removal of the affected areas of the skin and the affected areas beneath the skin. The sinus tracts that form abscesses that drain and ooze are surgically removed. With that, the pain, symptoms, and skin involvement of these areas are removed with it.

Laser Treatment

Laser hair removal (LHR) is another procedure that patients with Hidradenitis Suppurativa (HS) are often recommended. The basis of HS is the inclusion of hair follicles, leading to the formation of nodules that may later develop into abscesses. With LHR, the areas of the skin that may become involved are prevented by removing the hair altogether, preventing the involvement of further areas of the skin.

Recovery and Wound Care

HS wide excision procedures include a process of second intent healing. Second-intent healing is when the skin is allowed time to heal itself from the inside out. Imagine a cut that is bandaged until the body is able to fully restore itself back, recreating the skin barrier.

Second-intent healing means that patients are not to submerge the wound in water for an extended period of time. Itching or irritation during the healing process can usually be addressed with over-the-counter pain medications. Patients are recommended to wash with a Hibiclens (chlorhexidine) solution, along with regular dressing changes.

Who Performs Your Surgery

At Texas Hidradenitis Center, we specialize in providing patients with preventative, management, and surgical interventions for their symptoms of Hidradenitis Suppurativa (HS). Dr. Harrison Nguyen alongside our entire clinical team will be with you every step of the way whether that be preparing you and walking you through the process of surgery, performing the surgical procedure, wound care and post-operative instructions, and assisting with any necessary paperwork for your leave from employment or insurance purposes.

Dr. Harrison Nguyen has performed more than a thousand procedures for our many HS patients. Many of these patients are currently in, or advancing towards remission in their HS journey. Dr. Harrison Nguyen will frequently evaluate how patients are healing after the procedure for months after the procedure is completed. You will never be alone in any step of the process here with us at Texas Hidradenitis.

Frequently Asked Questions

Is hidradenitis suppurativa curable?

Hidradenitis suppurativa (HS) is a chronic disease with no known cure, but there are many therapies approved to help manage the symptoms of HS.

What is the best treatment for HS?

Treatment plans vary from patient to patient. We offer patient-focused care and longterm management of HS symptoms.

Are biologics safe?

Biologics are generally considered safe and approved methods of treating autoinflammatory diseases such as HS.

Can HS come back after surgery?

HS can come back after surgery; however, with long-term management, we can closely monitor the signs and symptoms after surgical procedure.

Is HS contagious?

HS is not a contagious disease, rather an auto-inflammatory disease.

Does weight loss help HS?

Speak with a provider today about how weight loss can help your symptoms of HS.

What foods trigger HS?

Obesity, smoking, and environmental factors can be triggers for HS, as well as patients being genetically predisposed.

How long does treatment take?

Treatment duration varies from patient to patient. HS is a chronic condition, meaning we will work with you to manage your HS long-term.

When should I see a dermatologist?

See a dermatologist as soon as signs and symptoms start appearing.

Can smoking affect HS?

Yes, studies have shown that smoking is a potential trigger for HS.

Surgical Treatments for Hidradenitis Suppurativa | Texas Hidradenitis