A serious skin condition that can greatly affect a patient’s daily life is hidradenitis suppurativa. This long-term disease is rare and can be very painful for sufferers. The condition is characterized by small and painful lumps that are underneath the skin. In turn, the lumps can split open and emit an odor. The lumps can also cause tunnels to form beneath the skin. The lumps form on parts of the body where the skin comes into contact with itself, such as the armpits, under the breasts, the groin, and the buttocks. To alleviate painful symptoms and help a patient maintain his or her quality of life, Ashburn, VA cosmetic surgeon, Dr. Timothy Mountcastle, offers several surgical procedures. Since there’s no cure for hidradenitis, Dr. Mountcastle uses high-grade treatments to manage the disease.
Doctors will often use any number of medications to treat hidradenitis. These can include antibiotics, anti-inflammatory drugs, hormones, immunosuppressants, and pain medications like morphine and codeine. When drugs alone don’t work, surgical procedures might need to be performed.
With incision and drainage, a small incision will be made in the sore and the contents will be drained out. Unroofing, or uncovering the tunnels, occurs when the surgeon cuts away and removes the skin that covers the tunnels. This option is gaining popularity over other procedures like incision and drainage. Punch debridement is referred to as mini-unroofing and is usually used to treat only one lump.
Tissue-sparing excision with electrosurgery is reserved for more severe and difficult-to-treat cases. Excision is combined with electrosurgical peeling to remove damaged skin while preserving normal, surrounding skin as much as possible. Surgical removal involves removing all of the damaged skin. A skin graft is sometimes needed to close the wound after surgery.
With incision and drainage, unroofing, and punch debridement, local anesthesia is usually only needed. With tissue-sparing excision with electrosurgery and surgical removal, general anesthesia would be needed. The length of time of any procedure is dependent upon the patient’s condition and severity. More invasive procedures will require a longer recovery period. Since surgical removal may require skin grafting, additional procedures may be needed. It’s also important to note that even with surgical intervention, the symptoms of hidradenitis can return and will require additional treatment.
There are certain things that you can do at home, such as following a skincare regimen where you use gentle cleansers and your hands to wash your body and not washcloths or loofahs. Avoiding tight clothes can also help the skin and avoiding injuring the skin is another solution.
What are the risk factors?
Women are more affected than men and it’s more common in women in their 20s. There can also be a genetic component to hidradenitis since it seems to run in families. Having other chronic conditions like arthritis, diabetes, and Chron’s disease can increase the likelihood of developing the condition. Smoking has also been associated with hidradenitis.
Will insurance cover costs?
Since hidradenitis is a chronic, painful condition, insurance should cover the costs of treatments. Depending on your insurance, a portion or all related costs might be covered. It’s important to reach out to your insurance company to ensure coverage.
"This review only contains a rating"- S.A. / Google / Aug 24, 2016
"This is my second time getting my lip fillers done by Meredith, and I could not be any happier with the results. Meredith has always made me completely comfortable and at ease. She talked with me a lot beforehand about my decision on either Restylane Silk VS Juvederm XC. My first time I got the Restylane Silk done, which I loved. She made sure my lips were symmetrical and talked with me about the recovery. This time I decided to go with the Juvederm, and I am absolutely pleased. I have so much more volume now in my lips, and she did the shape exactly how I had hoped they would turn out. She made sure to take breaks in between injections; massaged my lips to even out areas. She sent me home with an ice pack. For anyone who feels as self conscious as I have always felt with my lips, or lack of lips I should say, I would highly consider going in for a consultation. Thank you again, Meredith, for making me feel comfortable and giving me the lips I've always dreamed of. Also, thank you to Maggie at the front desk for answering the questions I had beforehand, offering me a water bottle and giving me such a nice compliment before I left."- C.K. / Yelp / May 25, 2017
"My postpartum spider veins weren't so itsy bitsy! After much research and denial, I decided to give sclerotherapy and Mountcastle a try. The office has the ambiance of a "spa" with the professional staff of a medical/dermatological clinic (win-win). Ashley performed the 30min procedure while chatting with me and I was so at ease that I hadn't realized my legs looked like I'd slid into first base with shorts on!!! The post procedure instructions were provided both verbally and in writing. I diligently wore the compression stockings as instructed. I've noticed significant improvement to the worse veins and slight improvement to the least veins. I plan to follow-up for more treatments."- J.J. / Yelp / Apr 25, 2017
"Very professional, welcoming and well-run practice."- K.C. / Google / Mar 24, 2017
"This review only contains a rating"- C.S. / Google / Mar 23, 2017