Skin · Treatment

Hidradenitis Suppurativa Treatment

Hidradenitis Suppurativa (HS) is a chronic inflammatory condition that causes painful nodules, abscesses, and tunnels in the underarms, groin, and skin folds. It is frequently misdiagnosed as recurrent boils or acne — and treated as such for years. A structured HS plan stages the disease (Hurley I–III), addresses the underlying inflammation, and prevents the scarring that causes the most long-term distress.

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SessionPer visit, calibrated to your case

CourseLong-term management — review every 6–8 weeks initially

DowntimeNone for medical care; recovery varies for surgical intervention

Quick answer

Doctor-led HS treatment in Pune: Hurley staging, comprehensive medical plan (topical antiseptics, oral antibiotics, hormonal therapy where appropriate, retinoids), in-clinic intralesional steroid for active flares, and surgical / laser options for recurrent tunnels. Lifestyle support — weight, smoking, friction — is part of every plan.

Best suited for

Who this treatment helps

Recurrent painful nodules in underarms / groin / under breasts

Boils that keep coming back in the same areas

Sinus tracts and tunnels with discharge

Scarring from prior HS lesions

What to expect

A measured, four-stage process.

Step 01

Diagnosis and staging

A careful examination to confirm HS and stage the disease (Hurley I — isolated nodules; II — recurrent abscesses with sinus tracts; III — interconnected tracts and scarring). Staging guides everything that follows.

Step 02

Medical plan

Topical clindamycin or chlorhexidine washes, oral antibiotics in courses (tetracyclines or clindamycin + rifampicin), hormonal therapy in women where appropriate, and oral retinoids for nodulocystic patterns. Adalimumab is considered for moderate-to-severe HS not responding to standard therapy.

Step 03

In-clinic care for flares

Intralesional steroid for acutely painful nodules — provides rapid relief within 24–48 hours. Incision and drainage is avoided where possible because it does not address the underlying tunnel and often recurs.

Step 04

Surgical / laser for tunnels

For Hurley II and III with persistent tunnels, deroofing or wide excision provides definitive treatment. CO₂ laser excision is offered for selected cases. Laser hair removal addresses follicular obstruction in affected areas. Lifestyle support — weight management, smoking cessation, reducing friction — runs alongside every plan.

FAQ

Common questions about Hidradenitis Suppurativa Treatment.

Why do my "boils" keep coming back in the same spots?

Recurrent painful nodules in the underarms, groin, or under the breasts are far more often Hidradenitis Suppurativa than ordinary boils. HS is a chronic inflammatory condition — not an infection that can simply be drained. Correct diagnosis changes the entire treatment approach.

Will antibiotics alone solve this?

Antibiotics help during flares and are part of the plan, but HS is not a simple infection. Long-term management combines antibiotics, anti-inflammatory therapy, hormonal balance where relevant, and addressing triggers — friction, weight, smoking — that drive recurrence.

Is HS related to hygiene?

No — HS is not caused by poor hygiene, despite how often patients are wrongly told this. It is an inflammatory disease of the hair-follicle units in skin folds, with strong genetic and hormonal components.

Can HS be cured?

HS is best managed rather than cured — but with a structured long-term plan, most patients achieve significant reduction in flare frequency and pain. Early treatment prevents the scarring that causes the most long-term distress; late-stage HS is harder to control.

Clinical references

Selected sources informing our protocol. We follow IADVL standard treatment guidelines and peer-reviewed dermatology literature, with adaptations for Indian skin tones.

Hidradenitis Suppurativa — Indian context and management approach Indian Journal of Dermatology, Venereology and Leprology (IJDVL)
Hidradenitis Suppurativa — guidelines of care Journal of the American Academy of Dermatology (JAAD)
HS staging (Hurley) and treatment escalation — review Indian Journal of Dermatology
Adalimumab and biologic therapy for moderate-severe HS IADVL clinical recommendations
Hidradenitis Suppurativa — patient information DermNet NZ

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