Treatinghidradenitis suppurativa

Hidradenitis suppurativa is a lifelong, recurring condition that requires constant management and is often difficult to manage.

It's important to try to recognise anddiagnosethe condition in its early stages and prevent it getting worse.

Treatment forhidradenitis suppurativa will be tailored to the individual. In the early stages, it may be controlled with medication. Surgery may be required in severe or persistent cases.The treatments are outlined below.

Antibiotics

If you have lumps that are particularly painful, inflamedand oozing pus, you may be prescribed a one or two week course of antibiotic tablets, as you may have an infection. However, inhidradenitis suppurativa, a secondary bacterial infection isn't that common, so it's best if a swab of the affected area is taken.

If bacterial infection isn't present,low-dose antibiotics (usually tetracycline) may be used as a suppressive treatment (to prevent inflammation). This longer course of antibiotics will last at leastthree months,with the aim being to reduce the number of lumps that develop.

Topicalantibiotics, such asclindamycin 1% used daily on affected areas can also sometimes help. Oral antibiotics (tablets, capsules or a liquid that you drink) include erythromycin, tetracycline,lymecycline and doxycycline, alongside a number of other options.

In severe cases ofhidradenitis suppurativa, a combination of clindamycin and rifampicin can be effective, but these antibiotics are usually prescribed by dermatologists rather than GPs.

Antiseptics

Antiseptic washes, such as 4% chlorhexidine, applied daily to affected areas are oftenprescribed alongside other treatments.

Retinoids

Retinoids, such asisotretinoin and acitretin, are vitamin-A based medications. They're not as effective for treatinghidradenitis suppurativa as they are for treating acne, but they may help some people.

Retinoids are always prescribed by dermatologists. They mustbe used with caution and can't be taken during pregnancy.

Contraceptives

Women whosehidradenitis suppurativa flares up before their periodmay benefit from taking the combined contraceptive pill .

Immunosuppressive treatments(Infliximab and adalimumab)

In very severe cases ofhidradenitis suppurativa, treatments that suppress the immune system, such asadalimumab (a biological therapy)can be useful.

However, there are risks associated with suppressing the immune system, so they're usually only prescribed by a dermatologist if other treatments don't work.

Infliximab and adalimumab are immunosuppressive treatments that are given by injection at regular intervals either at home or in hospital.

Corticosteroids

Rarely, you may be prescribed a corticosteroid, such as prednisolone, to reduce severely inflamed skin. Corticosteroids can be taken as tablets, or you may have an injection directly into affected skin.

Possible side effects of corticosteroids include weight gain, poor sleep and mood swings.

Having to regularly change dressings and constantly live with the pain, discomfort and embarrassment of the symptoms can affect your quality of life and lead to depression .

Speak to your GPif you're having problems coping. Charities, such as The Hidradenitis Suppurativa Trust , can also provide help support.