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
"Very professional and skilled. No wait for us. Office staff knowledgeable and welcoming. Definitely worth the drive for us."- D.J. / Google / Mar 10, 2017
"Highly recommend this place, Dr Mountcastle and his team members are very knowledgeables."- H.H. / Google / Mar 08, 2017
"This review is for the IPL-BBL treatment for age spots. In past years, I have wasted many thousands of dollars on IPL (non-BBL), microdermabrasions, chemical peels, facials, and products to treat dark spots that started showing up in my mid-fifties. IPL-BBL from Mountcastle is the only one that has made a huge improvement for me. After treatment, many of the spots turned almost black before they healed, and I was warned that this would happen. After my first treatment, it took about a week to completely heal and see the full results, and they were amazing. I had one blotch that was so deep it felt leathery. Although the blotch still exists, it is lighter and smaller and no longer feels or looks like leather. I purchased four treatments and I had my second treatment yesterday. I can see many spots turning dark now, so I know they will heal and look better next week. Many of the spots on my face have completely disappeared. I don't expect to be spot-free after this second treatment, but I am getting there. If all continues to go as remarkably as I expect, I plan on doing my hands next. Ragan was my aesthetist. She is excellent. She answered all my questions and she suggested some products to use at home. She used an IPL machine that has a cooling feature, a real plus. I felt a hot snap and an instant cooling at each spot. It wasn't painful enough to make me jump and it's well worth the results. I have one minor complaint: They don't always answer the phone or return calls promptly."- M.M. / Yelp / Mar 08, 2017
"Wonderful Experience. Very easy to schedule appointment. Staff very nice. Ragan was great - very knowledgeable. Beautiful and clean facility. Would highly recommend."- S.Z. / Yelp / Mar 08, 2017