Hidradenitis Suppurativa Surgery: 3 Important Things You Need to Know

If you’re reading this, you or someone you love likely have been living with Hidradenitis Suppurativa (HS), a condition that can test your strength in ways you never imagined. Hidradenitis Suppurativa is a formidable adversary from the relentless cycle of painful abscesses to the mental strain it brings. And now, you stand at the threshold of considering a new pathway to relief: Hidradenitis Suppurativa surgery. Here’s what you need to know.

1. Hidradenitis Suppurativa Surgery Options

Hidradenitis Suppurativa (HS) is a chronic and often debilitating skin condition presenting recurrent and inflamed nodules and abscesses. These abscesses can progress into painful, draining wounds and interconnected sinus tracts, leaving behind extensive scarring. In severe cases, surgical intervention may become necessary. Among several surgical options, outpatient surgeries offer less invasive treatments and faster recovery times.

Incision and Drainage

This procedure relieves the pressure and pain of an abscess caused by HS. Your doctor will make a small incision and drain the pus-filled nodule. While this procedure offers immediate relief, it is not a long-term solution as it does not remove the inflamed tissue or prevent the recurrence of nodules.


This is a more substantial procedure than incision and drainage, but it can be done in an outpatient setting. It involves removing the ‘roof’ of the abscess or sinus tract and exposing the underlying tissue to promote healing from the bottom up. Deroofing can reduce the recurrence of lesions in the treated area, but it may not prevent new lesions from forming in other areas.

Minor Excision

Sometimes, your doctor may recommend a minor excision to remove an individual nodule or small area of the affected tissue. This is generally done under local anesthesia and can help prevent the recurrence of lesions in the treated area.


This is a somewhat new surgical process in HS treatment. So most doctors may not be offering it. During the procedure, a specialist sprays liquid nitrogen (freezing cold) into the HS tunnels to destroy the lining. This procedure doesn’t require numbing or analgesia because it’s less comfortable. Note that multiple treatments are necessary.

in this scenario, a female doctor is discussing the possibility of hidradenitis suppurativa surgery with a female patient.
Hidradenitis suppurativa surgery: 3 important things you need to know

2. Before the Hidradenitis Suppurativa Surgery…

No matter how minor, any surgical procedure shouldn’t be taken lightly. It can be scary and stressful. So knowing what to expect from your surgery and how to prepare can be helpful. Here’s what you need to know.

Deciding to Have Hidradenitis Suppurativa Surgery

The decision to have surgery is not taken lightly, especially when it comes to a complex condition like Hidradenitis Suppurativa (HS). When exploring your treatment options, engage in an open and honest conversation with your healthcare provider. Your doctor can guide you through the different treatments available, their efficacy, potential side effects, and how they might fit into your lifestyle and health objectives.

Also, consider seeking a second opinion to confirm your diagnosis and treatment options. Remember, you are an active participant in your healthcare decisions, and your comfort and understanding are critical to the process.

Preparing for Hidradenitis Suppurativa Surgery

Preparation is paramount to the success of your Hidradenitis Suppurativa surgery. Your doctor will walk you through the details of the procedure, explaining its intricacies and the potential risks and complications. This is your chance to clarify any doubts or concerns. Some of the essential questions to ask may include:

  • What can I expect during the recovery period?
  • What kind of aftercare will I need?
  • How long before I can return to my normal daily activities?
  • What is the likelihood of HS recurrence after this surgery?

Prior to surgery, your doctor will provide specific instructions on eating, drinking, and medication use. Certain medications might need to be paused or adjusted. Also, dress comfortably on the day of your surgery to ease your transition post-procedure.

Managing your HS Treatment Expectations

Setting realistic expectations is crucial when preparing for Hidradenitis Suppurativa surgery. It’s essential to understand that surgery is not a cure for HS. HS is more than a skin condition—it’s an inflammatory disease that manifests in different ways, including swelling, itching, and discomfort, and it may affect various parts of the body.

Hidradenitis Suppurativa surgery can help manage and alleviate some of these symptoms, reducing the severity and frequency of flare-ups. However, it doesn’t eliminate the underlying condition. Therefore, comprehensive management, which may include ongoing medication, lifestyle changes, and possibly more surgeries, may still be necessary.

Understand that the journey to managing HS is often one of trial and error. What works well for one patient may not work for another. So be patient with your body, and stay open to adjustments in your treatment plan.

3. Talk with HS Specialists and Other Patients who understand

Remember, living with HS can be challenging, but support is available. Reach out to others living with HS, seek counseling if needed, and maintain a positive, proactive approach to your health. These are people who understand what you are up against. HS specialists can answer your questions and advise you.

Other people living with HS can share their stories which can be encouraging. Remember, courage and resilience are your most powerful tools in this journey.