Treatment for patients with hidradenitis suppurativa depends on the disease's progression and the patient's preference. The severity of HS and whether the patient has developed complex and deep sinus tracts determine treatment. In general, patients can either use antiseptic soaps and antibiotics, or they can choose to surgically remove an entire area of skin. Options should be discussed with a patient's doctor and surgeon after both have mapped the progression of the disease for that person.
But first, we need to look at the stages of the disease, which are generally separated into three categories.
Stage 1 represents mild forms of HS characterized by the beginnings of lesions, lumps and blackheads. Typically, patients pursue less aggressive treatment options at this stage. Using topical treatments such as antiseptic soaps and tea tree oil may minimize early symptoms. Anti-inflammatory drugs and antibiotics can provide relief in cases in which inflammation poses a problem or if the patient develops a bacterial infection. At this time, the patient should maintain good hygiene and consider wearing loose, breathable clothing that reduce friction with the skin [source: Slade et al.].
Stage 2 signifies a more severe form of HS, as lesions and infections form deeper in the skin. In addition to treatments for less developed forms of HS, more aggressive treatment options may include the partial surgical removal of affected areas, especially before the skin begins to drain pus. Removal methods include exteriorization, local incisions and laser evaporation.
Stage 3 of the disease reflects inflammation, suppuration and scarring of large areas. This stage often coincides with the development of complex sinus tracts beneath the skin. Treatment for patients experiencing severe HS is limited, and wide excision of skin remains one of the few short-term options left.
Surgeons and doctors have experimented with multiple methods to treat HS, including hormonal therapy, radiotherapy, immunosuppression, radical excision techniques and laser treatment. Some may be viable options in the future, but for now the long-term safety and overall effectiveness of these options are still debatable.
In addition to managing physical symptoms, patients with HS should consider seeking professional help if the disease is causing feelings of depression or isolation [source: Slade et al.]. Joining a support group or talking openly about HS can increase a patient's quality of life and self confidence. Since patients spend years of their lives battling HS, maintaining good mental heath is vital to minimizing negative effects of HS.
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