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Hidradenitis Suppurativa - Northern Virginia*

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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. 

Surgical Technique

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.

During/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. 

Hidradenitis FAQs

Home treatments?

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.

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* All information subject to change. All gallery images contain real patients and are the property of Mountcastle Plastic Surgery & Vein Institute. Individual results are not guaranteed and may vary.