Your Treatment Journey.
Practical guidance for treatment, procedures, healing, daily care, and family support.
Hidradenitis suppurativa care can involve many moving parts. This journey brings medications, surgery, wound care, deroofing education, nutrition, and family support into one guided experience so you can start with what matters most today and return as your needs change.
Choose the support that fits where you are today
You do not need to read everything at once. Select the starting point that feels most relevant, then move through the journey at your own pace.
I am exploring treatment
Learn about medication classes, treatment goals, monitoring, and questions for your dermatologist.
Explore treatmentI am considering surgery
Compare deroofing, excision, and incision and drainage while preparing for a surgical consultation.
Consider a procedureI am preparing for recovery
Plan supplies, dressing changes, mobility, pain support, and practical help before healing begins.
Prepare for healingI need help with wound care
Review general wound-care principles, supplies, dressing changes, and warning signs.
Go to wound careI am looking for nutrition support
Explore flexible, nonjudgmental nutrition and lifestyle resources without one-size-fits-all rules.
Support daily wellbeingI am supporting a child or teen
Find parent education, school support, pediatric resources, and teen connection.
View family resourcesMove through your treatment journey one step at a time
These stages are not always linear. You may return to earlier sections, skip ahead, or need several kinds of support at once.
Explore Treatment
Review medication categories, treatment goals, monitoring, and care conversations.
Consider a Procedure
Compare deroofing, excision, and temporary drainage approaches.
Prepare for Healing
Plan for recovery, wound care, supplies, mobility, and caregiver support.
Support Daily Wellbeing
Explore nutrition, symptom tracking, sustainable habits, and peer connection.
Care for a Child or Teen
Find practical family, school, emotional, and pediatric-care resources.
Choose the Next Step
Find the most useful action to take after reviewing the information.
There is no one-size-fits-all medication plan for HS.
Treatment depends on symptoms, severity, medical history, response, and personal goals. Many people use more than one therapy, and plans may change over time.
Use this section to become familiar with the major treatment categories and prepare questions for your dermatologist.
Ask what the treatment is targeting. Discuss expected changes in pain, drainage, flares, and lesion development.
Ask how success will be measured. Clarify how long a treatment trial may take and when the plan will be reassessed.
Ask about monitoring and precautions. Review lab work, infection risks, pregnancy considerations, interactions, and side effects.
Ask whether you may be a candidate for surgery. Discuss whether deroofing, excision, or another procedure could help address recurring tunnels, scarring, or areas that do not respond fully to medication.
Ask about topical and wound-care support alongside systemic treatment. Discuss cleansers, topical treatments, dressings, drainage management, and other practical care that may support your overall treatment plan.
Help your dermatologist get the complete picture.
Arriving with a list of your current flares, symptoms, drainage patterns, pain levels, treatments you have already tried, and photos of symptoms that may not be visible that day can help your provider better understand what you are experiencing and make more informed treatment decisions.
Take the Shared Decision-Making Tool to your next appointment
Use this guide to organize your symptoms, treatment history, questions, and priorities before meeting with your dermatologist. It is designed to help you have more productive conversations and make treatment decisions together.
- Track symptoms and flares
- Review treatment history
- Prepare questions
- Record treatment goals
Skin Cleansers
Benzoyl peroxide, chlorhexidine, zinc pyrithione, and resorcinol may be discussed as part of daily skin care.
Intralesional Treatment
Triamcinolone may be injected into a painful or inflamed lesion by a qualified provider.
Antibiotics
Topical and oral options may be used for anti-inflammatory effects or short-term rescue treatment.
Hormonal & Metabolic
Options may include combined contraceptives, spironolactone, finasteride, and metformin.
Retinoids
Acitretin, isotretinoin, and other retinoids may be considered in selected situations.
Immune Modulators
Short-term steroids and other systemic immune-modulating therapies may be considered.
Small Molecule Inhibitors
JAK, PDE-4, and other targeted inhibitors include medications in use or under study.
Biologics
Biologic therapies may be used for moderate-to-severe HS depending on medical history and treatment goals.
Planning your next step?
Whether you are considering medication, discussing surgery, or exploring a new treatment plan, having your questions and priorities prepared can make your appointment more productive.
Download the Shared Decision-Making ToolPreparing for surgical conversations, procedures, and recovery
Surgery planning should happen with a provider who understands HS. The right approach depends on tunnels, tissue involvement, location, wound size, closure, recovery needs, and the broader plan for controlling systemic inflammation.
Deroofing
The roof of an HS tunnel or tract is removed so the area can heal from the inside out. Deroofed areas are commonly left open rather than stitched closed.
- May fit recurrent draining areas or established tunnels
- Often performed with local anesthesia
- Healing may take weeks depending on size and location
- Can be used alone or within a larger surgical plan
Excision
Affected tissue is surgically removed. The wound may heal open, be closed primarily, or be repaired with a graft or flap depending on the situation.
- May fit broader disease, scarring, or interconnected tunnels
- Can require office-based or operating-room care
- Healing may take weeks to months
- Closure decisions affect recovery and wound-care needs
A note about incision and drainage
Incision and drainage may temporarily reduce pressure or pain, but it is not generally considered a definitive long-term surgical treatment for HS. Ask whether deroofing or excision may better address recurring tunnels or diseased tissue.
Build a recovery and wound-care plan you can realistically follow
Your surgeon or wound-care team’s instructions come first. General wound-care education can help you prepare supplies, understand healing, and recognize when a change deserves medical attention.
Clean hands and gloves
Start every dressing change with clean hands and fresh gloves.
Remove gently
Moisten stuck gauze with saline rather than pulling it away from healing tissue.
Irrigate as directed
Use saline or the cleansing method recommended by your surgical team.
Protect the wound bed
Use the contact layer or moisture approach recommended for your wound.
Fill only when instructed
Deep wounds may require light filling, but should not be packed tightly.
Manage drainage
Choose an absorbent outer dressing based on drainage and wound location.
Secure comfortably
Consider tape, silicone borders, mesh, netting, or clothing-based support.
Document healing
Photos and notes can help you and your care team track change over time.
Contact a medical professional for concerning changes
Seek guidance for spreading redness, fever, worsening pain outside your usual pattern, foul-smelling drainage, red streaking, wound separation, or feeling systemically unwell.
Watch and understand deroofing before the conversation
These videos are designed to help you understand deroofing, how it differs from incision and drainage, and what healing and wound care may involve before you discuss the procedure with your healthcare provider.
Understanding Deroofing
Learn what deroofing is, why it may be used, and what to know before discussing the procedure with your healthcare provider.
Watch Video →
Deroofing vs. Incision & Drainage
Understand how deroofing differs from temporary incision and drainage and why the goals of the two procedures are different.
Watch Comparison →HS Wound Care Workshop
Watch our wound care workshop for practical education about dressings, healing expectations, pain management, and recovery after HS surgery.
The embedded video begins at the wound care workshop (1:48:38).
Open Wound Care Workshop at 1:48:38 →Looking for instructional deroofing procedure videos?
The videos above are intended to help you understand the procedure and prepare for a conversation with your healthcare provider. For educational footage of actual deroofing procedures, visit our dedicated Deroofing Videos library.
Please note: The procedure library contains real medical and surgical footage and may not be appropriate for all viewers.
Support your body without shame, extremes, or one-size-fits-all rules
Diet is not a trigger for everyone, and nutrition is not a cure for HS. Some people find that food and lifestyle choices support overall wellness or help them better understand personal symptom patterns.
Build sustainable habits
Focus on approachable changes, balanced meals, and habits that work for your life.
Notice your own patterns
Track symptoms carefully instead of assuming that a popular trigger applies to everyone.
Learn with support
Join Inflammation Nation or review patient-centered guides, research, and practical recipes.
Helping parents and teens navigate HS with more confidence
Raising a child with HS can involve medical appointments, school planning, emotional support, privacy concerns, and advocacy. Families deserve practical tools and connection—not another place where they have to figure everything out alone.
HS Parent Network
Connect with other caregivers and find support for appointments, advocacy, and daily life.
Explore parent resources →Teen Support
Help teens find a safe, supported place to meet others who understand living with HS.
View support groups →School & Care Advocacy
Find school communication tools, pediatric dermatology resources, and guidance for accommodations.
View family tools →Educational resources are not a substitute for personalized medical care.
Treatment, surgery, wound care, nutrition, and pediatric decisions should be discussed with qualified healthcare professionals who understand the person’s symptoms, medical history, and needs.
Bring questions to appointments. Use these resources to support informed, shared decision-making.
Follow your care team’s instructions. Specific medical and wound-care directions take priority over general education.
Seek urgent help for serious symptoms. Spreading redness, fever, severe worsening pain, or feeling very unwell deserve prompt attention.
Turn information into the next helpful action
Choose the option that best matches what you need after reviewing your care journey.
Find an HS-informed dermatologist
Search for a provider who may have experience diagnosing and treating hidradenitis suppurativa.
Find a dermatologist →Prepare for an appointment
Write down your goals, questions, current treatments, prior procedures, symptoms, and concerns.
Review treatment questions →Watch deroofing education
Learn how deroofing differs from incision and drainage and what healing may involve.
Watch the videos →Review wound-care resources
Explore practical guidance and supplies that may help with daily wound management or surgical recovery.
Explore wound care →Connect with support
Find peer spaces for patients, parents, teens, and others affected by HS.
Join a support group →Explore family resources
Find school support, pediatric-care guidance, and tools for helping a child or teen navigate HS.
View parent resources →Do not go to your next appointment unprepared
The HS Connect Shared Decision-Making Tool helps you document your experience, compare options, prepare questions, and communicate your treatment priorities with your healthcare team.
- Symptoms and flare history
- Medication and procedure discussions
- Questions for your provider
- Space for goals and notes
Your journey does not have to look like anyone else’s.
Use these resources to ask better questions, understand options, and build a care plan that reflects your needs, priorities, and lived experience.