When is surgery recommended for HS?
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Quick Answer
Surgery is typically recommended for HS when medical management has not adequately controlled the disease, when there are persistent abscesses or sinus tracts, or when significant scarring is affecting function or quality of life. Wide local excision - removing the affected skin and underlying tissue - is the most definitive surgical option.
Why This Happens
Chronic HS can create extensive networks of sinus tracts and scarring beneath the skin that medical therapy cannot resolve. Surgical removal of affected tissue eliminates the diseased follicles and sinus tracts, reducing the source of recurrent inflammation. However, surgery does not cure HS, and recurrence in adjacent areas is possible.
What Research and Dermatology Guidance Say
Research supports wide local excision as the surgical approach with the lowest recurrence rates for HS. Less extensive procedures such as deroofing (unroofing of sinus tracts) are associated with faster recovery and are appropriate for selected lesions. Laser-assisted procedures are also used in some centers. Surgery is most effective when combined with ongoing medical management.
Practical Considerations
Surgical decisions for HS should involve a multidisciplinary discussion between the patient, dermatologist, and surgeon. Understanding the extent of the procedure, expected recovery, and the need for continued medical management after surgery is important. Our surgery guide covers all options in detail.
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Key Takeaways
- Surgery is recommended when medical management has not controlled HS adequately.
- Wide local excision has the lowest recurrence rates among surgical options.
- Deroofing is a less extensive procedure appropriate for selected lesions.
- Surgery does not cure HS - recurrence in adjacent areas is possible.
- Surgical decisions should involve a multidisciplinary discussion and informed consent.
Medical Disclaimer
This article is provided for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional regarding your specific condition, symptoms, and treatment options. War Against HS does not endorse any specific treatment, product, or healthcare provider.