Hidradenitis Suppurativa: Deroofing, Surgery and More
A painful lump in your armpit is bad enough. Now imagine it keeps coming back, forming tunnels under the skin, draining on your schedule instead of yours, and forcing you to plan your day around bandages and friction. That’s the reality for many people living with hidradenitis suppurativa (HS), and it’s why we wanted a clear, practical conversation about procedures that can actually help.
We’re joined by Dr. Nader Aboul-Fettouh, a board-certified dermatologist and Mohs surgeon, to break down what HS is at the follicle level and why chronic inflammation leads to nodules, abscesses, scarring, and sinus tracts. Then we get specific about HS procedures and where they fit alongside modern medical therapy like biologics. We talk through intralesional Kenalog injections for fast flare relief, why standard incision and drainage tends to recur, and why deroofing can be such a high-satisfaction option when the same spot keeps flaring.
From there, we zoom out to the bigger toolbox: excision for long-standing scar “balls” that no medication can penetrate, plus niche and emerging options like cryoinsufflation, laser hair removal, CO2 laser ablation, photodynamic therapy, IPL, and even Botox for sweat and friction. We also cover real-world constraints that patients and clinicians face, including healing expectations, skin type considerations, and insurance coverage.
If you’re trying to build a smarter HS treatment plan or you care for patients with HS and want procedural options you can confidently discuss, listen now. Subscribe, share this with someone who needs it, and leave a review with your biggest HS question.
DISCLAIMER: The views and opinions expressed in the Derm-it Trotter! podcast are those of the host and guests and do not necessarily reflect the views or positions of the guests’ or host’s institution or employers. The Derm-it Trotter! Podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user’s own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professionals for any such conditions.
