How do I know if I have hidradenitis suppurativa or just regular boils?

HS is diagnosed based on recurring nodules in characteristic locations (armpits, groin, buttocks) that occur at least twice within six months, along with scarring or tunnel formation. Unlike isolated boils, HS follows a persistent pattern and worsens without treatment.

Can biologic medications really prevent ER visits?

Yes, biologic therapies have transformed HS care by controlling the underlying inflammation that drives severe flares. Many patients who previously required frequent ER visits for drainage and pain management find they no longer need emergency intervention once their biologics effectively control the disease.

Will my insurance cover biologic treatments for HS?

Most insurance plans cover FDA-approved biologics for hidradenitis suppurativa when prescribed by a dermatologist. The practice works with patients to navigate insurance authorization and can explore patient assistance programs when needed.

Is hidradenitis suppurativa contagious or caused by poor hygiene?

HS is not contagious and is not caused by poor hygiene. It results from genetic predisposition combined with immune system dysfunction. Patients with HS are not at fault for their condition.

How long does it take to see improvement with treatment?

With biologic medications, many patients notice reduced pain and fewer new lesions within 2-12 weeks. Topical and oral treatments may provide more immediate relief for acute flares. Patience is important, as finding the optimal treatment combination takes time.

Can hidradenitis suppurativa be cured?

While there is currently no cure for HS, the condition can be effectively controlled with proper medical management. Many patients achieve long-term remission with biologic therapies and appropriate lifestyle modifications, allowing them to live comfortably without constant flares.

Hidradenitis Suppurativa - Kayal Dermatology & Skin Cancer Specialists

Hidradenitis Suppurativa Treatment

Living with painful, recurring skin abscesses doesn’t have to define your daily life. Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that creates deep, painful lumps under the skin, typically in areas where skin rubs together. While this condition can feel isolating and frustrating, advanced medical treatments—including biologic therapies—offer hope for long-term control and improved quality of life. With proper dermatologic care, many patients avoid emergency room visits and find lasting relief from this challenging condition.

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Our Approach to HS Management in Marietta

Dr. Kayal and the team understand that hidradenitis suppurativa affects every patient differently. The physical discomfort, combined with the emotional impact of dealing with a chronic condition, requires comprehensive care that goes beyond temporary fixes. The practice focuses on controlling inflammation, preventing new lesions, and minimizing scarring through evidence-based treatments tailored to each patient’s specific disease severity and lifestyle needs.

“Hidradenitis suppurativa requires a proactive, multi-faceted treatment strategy,” says Dr. Kayal. “With biologic medications and modern medical approaches, we can significantly reduce flares and help patients reclaim their comfort and confidence.”

What Is Hidradenitis Suppurativa

Hidradenitis suppurativa is a chronic inflammatory skin disorder that causes painful nodules, abscesses, and tunnels to form beneath the skin’s surface. The condition typically appears in areas with apocrine sweat glands and where skin folds meet—including the armpits, groin, buttocks, and under the breasts. HS begins when hair follicles become blocked, leading to inflammation that extends deep into the surrounding tissue.

Unlike simple boils or acne, HS lesions can connect through tunnel-like tracts beneath the skin and may drain fluid or pus. Without proper treatment, the condition often worsens over time, creating more extensive scarring and recurring painful episodes. HS affects approximately 1-4% of the population, with onset typically occurring after puberty and before age 40.

Why Patients Seek Hidradenitis Suppurativa Care

Recurring Painful Nodules: Deep, painful lumps that develop under the skin can make simple movements uncomfortable and disrupt sleep, work, and daily activities.

Frequent Infections: The condition creates an ongoing cycle of inflammation and infection that standard antibiotics often fail to control effectively.

Drainage and Odor: Lesions may rupture and drain fluid, causing embarrassment and social anxiety that impacts relationships and self-esteem.

Limited Mobility: When lesions develop in areas like the groin or armpits, even basic movements like walking or raising your arms become painful.

Emergency Room Visits: Severe flares often send patients to the ER for drainage or pain management—expensive, stressful visits that biologic treatments can help prevent.

Scarring and Skin Changes: Repeated inflammation leads to permanent scarring, skin thickening, and tunnel formation that worsens without proper intervention.

What to Expect During Your HS Consultation

Initial Assessment

Dr. Kayal conducts a thorough examination of affected areas to evaluate the severity of your hidradenitis suppurativa. This assessment includes identifying the stage of disease, mapping current lesions and scarring patterns, and discussing how HS impacts your quality of life. Understanding your complete medical history, including any previous treatments and their effectiveness, helps create the most appropriate care plan.

Personalized Treatment Planning

Based on the severity of your condition, Dr. Kayal develops a comprehensive treatment approach that may include:

Biologic Medications: FDA-approved biologic therapies specifically target the inflammatory processes driving HS. These injectable medications, such as adalimumab, can significantly reduce flares and prevent new lesion formation. Many patients experience dramatic improvement within weeks of starting biologic treatment, avoiding the pain and expense of repeated ER visits.
Topical and Oral Medications: Prescription antibiotics, anti-inflammatory medications, and topical treatments help control infection and reduce inflammation during acute flares.
Procedural Interventions: For active lesions, drainage, intralesional steroid injections, or surgical excision of problematic areas may provide relief.
Lifestyle Modifications: Guidance on skin care, weight management, smoking cessation, and clothing choices that minimize friction helps reduce triggers.

Ongoing Management

Hidradenitis suppurativa requires consistent follow-up to monitor treatment response and adjust therapies as needed. Regular appointments allow for early intervention when new lesions appear and ensure biologic medications continue working effectively. The goal is keeping you comfortable and preventing the severe flares that would otherwise require emergency care.

Frequently Asked Questions About Hidradenitis Suppurativa

: HS is diagnosed based on recurring nodules in characteristic locations (armpits, groin, buttocks) that occur at least twice within six months, along with scarring or tunnel formation. Unlike isolated boils, HS follows a persistent pattern and worsens without treatment.
: Yes, biologic therapies have transformed HS care by controlling the underlying inflammation that drives severe flares. Many patients who previously required frequent ER visits for drainage and pain management find they no longer need emergency intervention once their biologics effectively control the disease.
: Most insurance plans cover FDA-approved biologics for hidradenitis suppurativa when prescribed by a dermatologist. The practice works with patients to navigate insurance authorization and can explore patient assistance programs when needed.
: HS is not contagious and is not caused by poor hygiene. It results from genetic predisposition combined with immune system dysfunction. Patients with HS are not at fault for their condition.
: With biologic medications, many patients notice reduced pain and fewer new lesions within 2-12 weeks. Topical and oral treatments may provide more immediate relief for acute flares. Patience is important, as finding the optimal treatment combination takes time.
: While there is currently no cure for HS, the condition can be effectively controlled with proper medical management. Many patients achieve long-term remission with biologic therapies and appropriate lifestyle modifications, allowing them to live comfortably without constant flares.

Why Choose Kayal Dermatology & Skin Cancer Specialists

Dr. Kayal’s extensive training, including his Yale internship and Emory residency, provides the expertise needed to manage complex inflammatory conditions like hidradenitis suppurativa. As a board-certified dermatologist and fellow of the American Academy of Dermatology, he stays current with the latest biologic therapies and evidence-based treatments that offer real relief. The practice combines state-of-the-art medical care with genuine compassion for patients dealing with chronic skin conditions that impact every aspect of life.

Take Control of Your Hidradenitis Suppurativa in Marietta

Living with chronic pain, recurring infections, and the uncertainty of when the next flare will strike takes an enormous toll. Biologic medications and comprehensive dermatologic care can break this cycle, helping you avoid costly emergency visits and reclaim your quality of life. If you’re experiencing painful lumps, drainage, or recurring abscesses in areas like your armpits, groin, or under your breasts, specialized HS treatment can make a profound difference. Contact Kayal Dermatology & Skin Cancer Specialists in Marietta to schedule your consultation and discover how modern therapies can help you live more comfortably.