HS (Hidradenitis Suppurativa)

Your journey is important to us. It takes the average patient with HS 7-10 years before receiving their diagnosis. HS patients are often diagnosing themselves. Even after the referral, it can take months to get in to Dermatology. At River City Dermatology, we address this with:

Urgent new patient visits for HS:

• If you are a new patient with HS, we will expedite your new patient appointment. 
• Appointments available in as little as a few days after we receive your referral.
• We take pride in giving you the urgent care and attention your HS needs. 

Urgent work-in visits for established patients: If you are an established patient and are having an HS flare, we can work you into the schedule to address it. 

Screenings: We screen all our patients for HS because we believe it will lead to earlier identification, intervention, and improved outcomes for patients with HS. Sophisticated treatments tailored to meet your needs in combination with education and realistic expectations. 

If you are suffering with HS, or suspected HS, we are here to help. HS is a complex disease, and together we can work towards improving your quality of life.

HS, or hidradenitis suppurativa, is an immune disease that results in painful boils or nodules primarily in the folds of the skin like armpits, groin, under breasts, thighs and buttocks. Hormones also influence this disease. This typically onsets around puberty and can be either continuous or cyclical, having periods or worsening and remission. If HS remains uncontrolled, it can result in rope-like scars that can limit a patient’s mobility. Overall, the course of HS is chronic and requires long term management.

What HS is NOT:

• it is not contagious
• it is not caused by infection
• it is not caused by poor hygiene
• it is not rare

• Stress: One of the most common triggers is stress. Stress stimulates our immune system, which thus stimulates our immune disease causing worsening of HS. This worsening of HS can, in turn, cause us more stress. It is a vicious cycle. Stress is not always manageable, but being mindful of stress and using healthy coping mechanisms can help. 
• Physical Injury and Friction: Injuring the skin promotes inflammation, which draws the immune system to the site of injury to fight any potential infection and promote healing. This is normally a good thing. However, when we have an immune disease, this also draws the disease to the area of injury. This is quite often why surgical intervention for HS fails if the underlying disease is not well controlled at the time of surgery. Friction is another form of injury that promotes worsening of HS. This can make physical activities and certain exercises intolerable for these patients. 
• Infection/Illness: Anything our immune system needs to fight will kick it into high gear, bringing our immune disease along for the ride.
• Hormones: flaring around the menstrual cycle can be common for patients with HS. If you’re experiencing cyclical flaring, please mention it to your HS provider as it could help direct appropriate treatment. 

What treatment options are available?

• Topicals: such as topical antibiotics can help especially in combination with other treatments
• Oral Medications: oral antibiotics, and agents that target the hormonal component can be helpful for HS management
• Biologics: The most sophisticated treatments ever created for HS, these are injectable medications can be an important part of achieving and continuing HS control. 
• Surgery: To remove scarring after the disease is under control. This is best performed after successful medical management is achieved, not before. 

For most patients, the treatment of HS involves multiple medications to target the complex components of the disease.