Recurrent painful lumps, drainage, odor, tunnels, and scarring from hidradenitis suppurativa can be physically and emotionally exhausting.
We take the condition seriously and look at severity, affected areas, scarring, flares, and prior treatment before discussing a plan.
Options can include topical or oral medicines, injections, biologic therapy, and procedures for selected lesions.
When recurring “boils” may be HS
HS is an inflammatory disorder involving hair follicles. It is not contagious and does not mean your skin is dirty. Repeated drainage, tunnels beneath the skin and scars distinguish established HS from an occasional boil or abscess. Early recognition can help limit progression.
Diagnosis and treatment planning
We assess the locations, frequency of flares, tunnels, scarring, pain and effect on daily life. Treatment may combine medication with wound care and, when appropriate, procedures for persistent tunnels.
Hidradenitis suppurativa treatments and medications
- Localized disease: Topical clindamycin, selected antiseptic washes or an injection into an inflamed lesion may help.
- More frequent flares: Oral doxycycline or other antibiotic regimens can reduce inflammation. Spironolactone may be considered for selected patients with hormonal flares. These uses may be off-label; pregnancy plans and medication interactions matter.
- Biologics: FDA-approved options for appropriate moderate-to-severe HS include Humira (adalimumab) and eligible biosimilars, Cosentyx (secukinumab), and Bimzelx (bimekizumab). Eligibility and age requirements vary by product.
- Procedures: Deroofing or excision may address persistent tunnels. Simple drainage can relieve pressure but does not control the underlying disease. We discuss appropriate procedural care or referral.
Before a biologic, we review infections, tuberculosis screening, vaccination history and other medical conditions. Risks vary: TNF inhibitors have serious infection warnings; IL-17 medicines require attention to inflammatory bowel disease. Bimzelx also requires review of liver health and mood history. The linked official medication pages contain fuller safety information.
HS across skin tones
Inflammation may look red, purple or darker than surrounding skin. Tenderness, drainage and scarring matter even when redness is subtle. Dark marks may remain after a flare settles.
Common questions
Can HS be cured?
There is no guaranteed cure. A sustained plan aims to reduce flares, pain and new scarring.
When should I seek prompt care?
Fever, rapidly spreading redness or rapidly worsening pain needs prompt medical assessment.
Learn more: AAD guidance on HS treatment.
Schedule an evaluation
Appointments are available in Garden City, Syosset, and Bellerose, NY. Book Appointment or call (516) 246-8800.